ENDING WAIT TIMES PROJECT UPDATE – MAY 2018

The goal of the Ending Wait Times project is to eliminate wait times for core child/youth mental health services in Dufferin and Wellington. The project is laid out in five phases, described below.

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MAP SERVICES AND PATHWAYS - Complete!

Mapping our services and pathways allows us to see the whole picture of our system. Creating and validating the maps with clients, staff and partners helps us understand the current landscape and how clients flow in, through, and out of services.

  • 6 mapping sessions with 50 staff at CMHA Waterloo Wellington and Dufferin Child and Family Services (DCAFS) focused on how clients move ‘In’, ‘Through’, and ‘Out’ of the system (December 2017 – February 2018).
  • 15 validation sessions held with staff, partners and clients in Wellington and Dufferin to understand how people move in to and out of services from their perspectives (March-April 2018).
  • Draft maps posted in staff areas for CMHA WW staff to comment on (see photos, below).

EXPLORE DATA INSIGHTS - Complete!

To build on what we learned through mapping, we gathered information from Caseworks and other sources.

  • Reviewed service delivery statistics (e.g. numbers served in different programs, wait times, etc.) and client demographics from Caseworks and other sources.
  • Reviewed demographic and socio-economic information for Dufferin and Wellington.
  • Explored processes that have been successful in reducing wait times in other communities.
  • Findings from the Brief Services Evaluation are informing the Ending Wait Times project.
  • Staff in Children’s Services at CMHA tracked their workloads manually for two weeks in late February-early March, and an automated process to gather workload data through Caseworks is being developed.

FRAME THE OPPORTUNITY - In progress

Summarize the “ideal future state” for our system. Pull together what the data and the feedback from stakeholders tells us is working well, where there are pain points in the system, what processes do not add value for clients or staff, and ideas to improve services and reduce wait times.

  • Present to and prioritize with Moving on Mental Health Operations Committee - June 26.

IDENTIFY ACTIONS – Summer 2018

For each priority, get clear on what “better” looks like and develop projects to get us there. Identify actions such as developing or revising tools and processes that will improve the flow of service. Involve clients and staff in the co-design of proposed solutions.

TEST AND ITERATE – starting Fall 2018

Test out solutions “on the ground” and collect ongoing, rapid feedback to understand how the proposed solutions are responding to the needs of the system. Involve staff and clients in testing prototypes, solutions and tools.

"In" map with comments from staff at CMHA WW's Silvercreek office. April 2018.

"In" map with comments from staff at CMHA WW's Silvercreek office. April 2018.

The Validation Roadshow!

It’s been a busy past few weeks visiting staff, partners, and clients to validate the Ending Wait Times Project maps. Hearing first-hand from people about their experiences with the child/youth mental health services and referral pathways for CMHA and DCAFS has brought to light many interesting insights. We are excited to be pulling together this feedback and wrapping up this phase of the project.

 Highlights from March 2018:

●     A big thanks to staff at the Silvercreek office and DCAFS office who interacted with the large drafts system maps which were on display during the week of March 12. Your feedback was much appreciated!

Validation session, March 2018

Validation session, March 2018

●     There was great energy from the staff of CMHA WW and DCAFS when they came together on Monday, March 19 for a networking session. During this gathering, the two teams worked together to provide feedback on the maps and the system as a whole. They also set a shared vision for what we want to achieve in the coming years for the CYMH system in Dufferin-Wellington. (Check out some photos below from the session!)

 

●     Validation sessions with clients and partners across Dufferin-Wellington have continued to provide detailed feedback. We hosted two partner validation sessions in March (one in each region), both of which had great attendance! One-on-one conversations with clients have also offered a way for families to share feedback at a time that works for them.

What do the maps look like?

●     Draft maps "in" for Wellington and Dufferin are shown below, to give you a sense of the information that staff, partners and parents were invited to validate. 

Wellington In map_draft.png
Dufferin In map_draft.png

What’s coming up next?

●     We will keep working through all the rich and detailed feedback received from staff, partners, and clients. Revisions to the maps are ongoing, and a final report summarizing what we have learned during this phase of the project is in progress.

●     The Moving on Mental Health Operations Committee met on March 27 to hear an update on this phase of the work and discuss the main themes from mapping and validation.  Together, we also began ideating on what the future state of the system might look like without wait times.

●     Mapping and validation are just the beginning! The next phase of the project will focus on identifying processes that can be improved to reduce wait times.

For questions or to learn more please contact Heather Callum, Systems Coordinator for Child/Youth Mental Health at hcallum@cmhaww.ca or 226-979-6060.

ON TO THE NEXT PHASE...FROM MAPPING TO VALIDATION!

Summary:

From the information gathered during CMHA's Children's Services' "Ending Wait Times" project mapping sessions, we are now working to move from sticky notes, to a rough design of the maps, to what you will see during the upcoming validation sessions! Check out the photos to see the progress so far.

What’s a validation session?

We will bring together staff/managers from partner agencies, youth, and family members to review the maps we created with staff at CMHA and DCAFS, and ask them to add their perspectives and experiences, tell us what is currently working well in terms of child/youth mental health services and referral pathways, and identify where they experience challenges in accessing, moving through or exiting services at CMHA or DCAFS.

Highlights from February 2018:

  • A big thanks to the 50 people across CMHA WW and DCAFS who participated in the mapping sessions! We can’t wait to engage even more people during validation sessions.

  • If you attended any one of the mapping sessions and haven’t provided feedback yet, you can find the online survey here.

What’s coming up in March 2018:

  • We’ve started putting together all of the information gathered and first drafts of the maps will be posted soon at CMHA and DCAFS so staff who were not able to attend the mapping sessions (and those who did, too!) can add additional information.

  • Validation sessions on the maps will begin at DCAFS with partner agencies on March 7! Wellington partners will follow (March 19).

  • Drop-in validation session with children, youth, and families will be held at CMHA Silvercreek office on March 12 from 2-4pm and 6:30-8pm. Children, youth, and families who receive services from DCAFS and CMHA Fergus and Mt Forest will be booked for one-on-one conversations over the next month at a time that works for them!

Image A: Sticky note map from the CMHA “Out” mapping session on February 7, 2018 facilitated by the Centre of Excellence.

Image A: Sticky note map from the CMHA “Out” mapping session on February 7, 2018 facilitated by the Centre of Excellence.

 

 

 

 

 

 

Image B: Draft designed map of the CMHA “Out” phase developed by the Centre of Excellence—representing the very same data as seen in Image A!

Image B: Draft designed map of the CMHA “Out” phase developed by the Centre of Excellence—representing the very same data as seen in Image A!

For questions or to learn more, please contact Heather Callum, Systems Coordinator for Child/Youth Mental Health at hcallum@cmhaww.ca.

ENDING WAIT TIMES PROJECT: MAPPING THE SYSTEM

The Ending Wait Times (EWT) Project was launched by CMHA Children’s Services and Dufferin Child and Family Services in fall 2017, and has been in full gear ever since. (If you are learning about the EWT Project for the first time, we are working to eliminate wait times for core child and youth mental health services across Dufferin Wellington.) Our goal is a big one, and so we’ve divided our work into key pieces—the first of which is mapping the system.

Photo of “In” mapping session at CMHA in December 2017.

Photo of “In” mapping session at CMHA in December 2017.

Mapping our services (the programs we offer) and pathways (how children, youth, and families move between services) is an important step in learning how clients move in, through, and out of services. We want to understand where challenges or bottlenecks exist, and what we can change to improve client flow and decrease (and eliminate) wait times.

 

 

 

So far, we’ve hosted 6 mapping sessions with staff at CMHA WW and DCAFS to map how children, youth and families move in to, through, between and out of services in Dufferin and Wellington (take a look at the handy diagram above, which shows the sessions completed in dark grey and the sessions yet to come in light grey).

 

Staff at the mapping session worked together with the help of facilitators from Taylor Newberry Consulting and the Ontario Centre of Excellence for Child/Youth Mental Health to create a “map” that shows our services, referral pathways and processes, and communication processes and tools, along with their feedback on what is working well and what needs to change.  Staff participation at the mapping sessions was fantastic and we heard from people representing a range of roles and sites.

 

As we look ahead to what’s next, we are excited to complete validation sessions for the ‘In’, ‘Through’, and ‘Out’ maps. Validation sessions will bring together external partners, and additional staff, to explore areas of the maps that would benefit from more perspectives or additional information, and to help pinpoint changes that will decrease wait times for service. We will also co-design with clients and families a few validation sessions—specifically for them—to support their involvement in the EWT Project.

 

Children’s Mental Health staff from CMHA and DCAFS have been invited to a session on March 19 where they will be able to see the maps they/their colleagues have created and add their own feedback as well.


 

Mapping (and validation) is just one piece of our work—yet, an incredibly important one. We’re building a solid understanding of the current child and youth mental health service system journey, and using that as a foundation for making change. We’ll be sure to keep you updated as we move forward!

 

To learn more and/or access regular updates, please contact Heather Callum, Systems Coordinator (Child/Youth Mental Health, Dufferin Wellington) at hcallum@cmhaww.ca.

 

Youth Engagement

The Ontario Centre of Excellence for Child and Youth Mental Health supports agencies around youth engagement through an integrated suite of services, including youth engagement training, coaching, and practice assessments.  CMHA Waterloo Wellington and Dufferin Child and Family Services are connecting with the Centre to develop a plan for meaningful youth engagement related to mental health and special needs services across Dufferin Wellington.

Click the "learn more" button below for an overview of the youth engagement services provided to community-based child and youth mental health agencies by the Centre of Excellence.

January 2017 Newsletter

Our second Moving on Mental Health newsletter provides updates on activities over the past few months, an overview of priorities the MOMH team will focus on between 2017 and 2019, and links to more information about this initiative.

A big thank you goes out to the 81 individuals who attended a feedback session in December 2016 or January 2017, and to all those who supported someone to share their input!  Your feedback will be used to improve the child/youth mental health system in Dufferin Wellington. We will continue to connect with youth, families/caregivers and service providers as we move forward.

If you have any questions, please get in touch with Heather Callum, Systems Coordinator for Child/Youth Mental Health, at 226-979-6060 or hcallum@cmhaww.ca.

Please click HERE to view the January 2017 Moving on Mental Health newsletter.

Going from 10 improvement ideas to 5

Over the past few months we have been busy working hard on Moving on Mental Health in Dufferin Wellington. Stakeholders (providers, leaders, parents and related social services) have been coming together to turn our insights into actions. We have been using a human-centred design process to guide this work.

In June and July we spent time together thinking about how we might improve services and experiences for children, youth and families. We all know there are a ton of things we can do better, which makes it hard to find a place to start. Thankfully the design process helped us focus on what matters to stakeholders and lead us to coming up with 10 high level ideas how we might improve:

We then used a process that forced us to really think about each idea in more detail. We identified:

  • The problem each idea was trying to solve
  • How the idea might improve things
  • How we’ll measure improvements
  • Added more details around what the idea might actually look like
  • Figured out possible ways we might actually test it

This process reminded me a lot of my grade 6 science experiment, minus the static electricity. We came up with a hypothesis, a way to measure our hypothesis, and a method to test it. It was actually far more rigid than I expected, and certainly made me think critically about each idea.

We had some great debates and conversations among the prototyping team which led us to combine and extend several of the initial ideas. We documented everything as we went so that anyone can understand our thinking at the time. We drew sketches of the ideas to help communicate them to others. We also came up with proto-personas (short for prototype personas), a representation of a stakeholder we might want to test the idea with.

We then took a step back and looked at what we had. We landed on 5 ideas that we thought we could move forward with testing in the time that we have. We put 3 in the parking lot for later to be sure we don’t forget about them even if we can’t do them right now. Here’s how all of that looks:

This is a snapshot of where we're at right now. We’re in the process of refining these ideas and packaging it all up in a way that supports the Moving on Mental Health Steering Committee in making decisions about where we should go from here. The Steering Committee will consider what impact these different ideas could have on our children’s/youth mental health system in Dufferin Wellington, and which one or two ideas have the greatest potential to improve the experiences of children, youth and the people who care for them when they need to approach an organization for a service or support. 

Once we've chosen one or two ideas, we’ll work with stakeholders to build them quickly and cheaply, and then take them out for feedback. This lets us know if we’re on the right track without spending a lot of time or money making sure the idea is ‘perfect’. It also allows us to quickly change the ideas and adapt them based on real feedback from our stakeholders. It should be a fun and eye-opening experience! We’ll keep you updated on the blog as we go. 

I Don't Know What That Means: Design Jargon

We're using a design-based approach for this project. Design philosophy, tools and methods are powerful resources for taking on complex problems, and are becoming more common around the world in places you may not expect like government, healthcare, and international development.

We know that this way of working may be completely new to you, and while some people are really familiar with it, most people have no idea what design, design thinking, prototyping, or ideation actually are. That's totally fine! Clear communication is a huge priority for us, and we want everyone to get a taste of what design can do. So we've created a design jargon dictionary below. 

This is just a start and we'll keep adding to it, so please let us know in the comments section if there's a term you think we should add, or something we've described below that isn't clear. We'll also be adding a jargon dictionary for mental health terms too, so keep an eye out for that! Thanks for your feedback!!


design (n.) – a sketch, model, or plan of something made or to be made.

design (v.) – do or plan (something) with a specific purpose or intention in mind.

design thinking – a process of working through problems and/or situations beyond traditional design fields (e.g. graphic design, industrial design) with a similar mindset to professionals in those fields. This means considering the real needs of people, the possibilities of technology and the requirements for business success when we develop new solutions.

human-centred design – an approach to problem solving that aims to understand the people using a product or service. This understanding helps designers create new, or change existing, products and services that make more sense to the people using them.  

service design – a process involving activities of planning and organizing people, infrastructure, communication and material components of a service in order to improve its quality and the interaction between the service provider and the people being served.

prototype (n.) – a model of something, traditionally used as a tool for explaining how something works and for eliciting feedback.

prototype (v.) – the act of creating a model(s) of a proposed solution(s).

test – an activity in which people are asked to interact with prototypes and tell the researcher(s) what they think, which parts seemed easy to understand, which parts felt confusing, their ideas for how to make the next prototype even better, etc.

user – a person who actually interacts with the final product or service in some way. There may be multiple users in the mix. For products, these are the people who actually use the product to complete a task. For services, people trying to access services are considered users, and so are the service providers.

stakeholder – any person, group of people, or organization that could be affected by the expected change (e.g. end-users, staff, funders, government, etc.).

ideation – a process of generating lots of ideas for addressing a certain question or problem statement.

iteration – the act of repeating a process. Designers make multiple iterations when they’re designing new things with the goal of learning as much as possible each time, and adjusting the design to make it better.

engagement – an activity or series of activities involving interaction, listening and note-taking, with the goal learning from this sample of people to uncover insights about the larger community.

Transparency is key--this blog is where we share our learnings, failures, and successes

We've already learned so much through this initiative and we have a lot more to come! It's so important to us that we're not the only ones learning from this process--just because you're not in the room at our meetings doesn't mean we can't all benefit! This is why we've created this blog--to share openly about this process with everyone involved in our work; with other communities working on similar initiatives; and for anyone working to apply design philosophy, tools and methods to complex problems.

It's a messy and incredible space to be working in, and we're always learning. This blog is where we'll post about what we're doing, what we're learning, where we've failed, and where we've succeeded. Our goal is to always learn and evolve our ideas, and when we fail, to fail forward. That's why we've created a dedicated space for transparency, openness, feedback, and growth--it helps all of us learn from the process, and stay accountable to why we're here! 

Join us as we work to improve the child and youth mental health system in Dufferin Wellington!

Read Our Report on Phase One

The Insights Report has been finalized and submitted to the Ministry of Children and Youth Services along with the completed Community Mental Health Plan for Children and Youth, and the Core Services Delivery Plan.

The Insights Report outlines what we did for this phase of the project, and what we learned. It paints a common vision for the child and youth mental health system in Wellington Dufferin over the next three years and beyond, and describes the three priorities for CMHA WWD to focus on over the next year as the Lead Agency. 

Acting on these priorities and what was learned will continue to be a collaborative effort involving CMHA WWD, many community partners, and most importantly, children, youth and families with mental health needs. Please check back for more information on next steps.

If you have questions or comments about this report, please get in touch with Heather or Kate.

We are Deeply Grateful to Everyone Who Contributed

The success of this project relied on the participation and openness of people who’ve had experience with the child and youth mental health service system. We would like to express our sincere gratitude to the youth and families who so generously gave their time and shared parts of their stories so openly, in a courageous effort to improve this system, largely for the benefit of others. The strength and love that was observed throughout this engagement process was incredibly moving, and we wish continued hope, strength, and support to the youth and families that participated. 

We would also like to thank the many community partners who contributed to this project. Although CMHA WWD will continue to act as a facilitator within the child and youth mental health system in Wellington Dufferin, its success relies on ongoing collaboration with its community partners. We are extremely grateful for their continued enthusiasm and involvement.

Phase One Engagement is Complete

All engagement with children, youth, families, and service providers has been completed for Phase One. A draft Insights Report is in the final stages of revisions, and will be submitted to the Ministry of Children and Youth Services by March 31, 2016. This report describes what was learned during this initiative and the three priorities that CMHA WWD will focus on over the next year as Lead Agency. Please check back for further updates as this report is finalized.