lessons from early intervention in psychosis
TRANSCRIPT
Lessons from working in and managing an EI service
Early Intervention in Psychosis
11th September 2014
Sarah AmaniEarly Intervention Network Manager
1 Background
2 Proactive Intervention to Enhance Recovery (PIER)
3 My Journey Mobile Health App
4 Reach Out Project
Overview
5 Q & A
“Preventive endeavors in psychotic disorders have been hampered by many obstacles over the past century.
One important barrier has been the corrosive pessimism which has attached to the treatment prospects for schizophrenia in particular since the time of Kraepelin, and the
isolation of this disorder from progressive models of preventative intervention which operate in general health care.”
Patrick McGorry, 2004
2008 2012 20132009 2010 2011
Started work at EIP +University of Surrey
Vision Unclear
Noted frequentStaff turnover
Poor pt satisfactionPoor staff moralePoor clinical outcomes
Manager leftStaff posts cutStaff sickness rocketed
PIER Projectawarded £10,000 (National Leadership Council)
Took up management of teamBegan developing a vision
Completed Transformational Leadership Programme
Reach Out Projectawarded £12,500 Mary Seacole Award(DoH)
YMHN ProjectAwarded £20, 000 (SHA)
Started Proactive Intervention to Enhance Recovery (PIER) project
YMHN *Awarded £35, 000 for YMH economic evaluation by LSE(NHS Confed)
After numerous rejected proposalsMy Journey App awarded £40,000 for evaluation (Burdett Trust)
2014
EnergisersKeeping clinicians enthused
EnablersEnabling clinicians to shine
EssentialsDelivering what is expected “Must Dos”
“Differentiators”
“Distinguishers”“Aspirations”
“Wants”
“Needs”
Developing a way to sustain improvements
Slide 7 © Fjord 2012 | Confidential
Proactive Intervention to Enhance Recovery(PIER) Project
2
1. Create a youth orientated & accessible online resource for first episode psychosis & mental health.
2. Raise awareness & reduce Duration of Untreated Psychosis & enhance Recovery.
3. Embed leadership, innovation & service user involvement in EIP.
Triple Aim
1. Online questionnaires - Surveymonkey2. Website Analytics - Google Analytics3. Video Views - YouTube Analytics4. EIP Benchmarking - measure any changes in:
- Number of referrals- Source of referrals- Demographics - Hospital admission rates & bed stay- Use of sectioning & private provider beds- Post 3 year employment/education status etc- Discharge ‘Destinations’
Evaluation of PIER Project
Number of Young People Admitted to Hospital
Number of Young People Admitted Under Section
Slide 17 © Fjord 2012 | Confidential
My Journey Mobile App3
Released: 1998CPU: 233 MHz
RAM: 32 MB (512 MB max)Storage: 4 GB (+ optical drive)
Display: 38.1 cm Millions of coloursDimensions: 40.1 x 38.6 x 44.7 cm
Weight: 17.3 kgs
Released: 2007CPU: 412 MHzRAM: 128 MBStorage: 4 GB (8 GB max)Display: 8.9 cm Millions of coloursDimensions: 11.4 x 6.1 x 1.2 cmWeight: 135 g
This was ‘portable’...
<10 years...
Slide 20 © Fjord 2012 | Confidential
Engaging young people with familiar tools
92% of 14-25 year olds own a
smartphone
Sensors, devices, networks, software and
data
worklearning
navigation
discoveryWith a button or two!
creativityvideo
a big screen...
web browser+
applicationlayer
+ APIs
communicationplay camera
sharing
Enabling users to determinemusic their own experience
chat
Health
P
Phase one – 3 months
Final phase – 6 weeks
Slide 34 © Fjord 2012 | Confidential
Reach Out Project4
Community Health Ambassadors should be members of the communities where they live, work, study, play… should be selected by their communities, should be answerable to the communities for their activities, should be supported by the health system but not necessarily a part of its organization,
and have shorter training than professional workers.
World Health Organization (2007)
“
”
Community Health Ambassadors
Slide 38 © Fjord 2012 | Confidential
Key Lessons5
ComplacencyApathy
Fear
Exhaustion
The Four Horsemen
“The patient is the most underused resource in
medicine”e-Patient David deBronkart
Without people its just a whole pile of s….
Stuff.
Slide 43 © Fjord 2012 | Confidential
Thank You