Implementing Integrated Care for Youth: Rejecting traditional Project Management for Adaptive Learning

Health Standards Organization

Project implementation in integrated service delivery often assumes that complex issues can be solved with an available set of processes, expertise, or procedures. However, as we have seen time and time again in the field, technical solutions alone rarely work. In 2019, Health Standards Organization (HSO) supported by Health Canada and Frayme kicked off a national project titled the “Improving Integrated Care for Youth Initiative '' (IICY). Through this work, they discovered the need to both teach adaptive change and live it through thor implementation; adapting and pivoting the project based on real-time feedback. HSO’s work has highlighted the need to build in adaptive approaches to integrated youth services implementation across all levels of the health system.

Presenters

Jennifer Wilkie
Jennifer Wilkie is a leader in health system transformation. She has more than a decade of experience and is passionate about building relationships to support integration and improvement within and across organizations. Jennifer is an empathetic and energetic leader. She loves working with people to challenge and investigate new and innovative ways to approach complex problems. She is a connector of ideas and people, constantly thinking about how to collaborate and improve the systems around her. Prior to co-founding BoardWalk Group, Jennifer was the Director of Continuous Improvement at Centre for Addiction and Mental Health (CAMH). In that role, she was responsible for the implementation of Integrated Care Pathways, Measurement-Based Care, and leading strategies to support CAMH in becoming a Learning Health System. Jennifer has spent a considerable part of her career leading ground up transformation within the community health sector. She worked as a freelance consultant leading the implementation of a Rapid Access Addiction Medicine Clinics and evaluating the need for First Response Mental Health Crisis services in Peel. She has also held the roles such as Director of Technology and Shared Services at Reconnect Community Health Services and Community Care Implementation Lead as part of the Ministry of Health, along with many others. In 2019, she completed her masters in Health Administration from the University of Toronto Institute for Health Policy and Management and her Certified Health Executive (CHE) from the Canadian College of Health Leaders (CCHL).

Hannah Wadman-Scanlan
In her current role as Project Officer at Choices for Youth (CFY), Hannah has been leading work with the Health Standards Organization’s (HSO) for the Improving Integrated Care for Youth (IICY) Initiative, which aims to sustainably improve the integration of community-based mental health and addiction services for youth. At the same time, Hannah and the CFY team have been leading and collaborating with community partners across NL to develop a provincial Integrated Youth Services (IYS) network, which involves the development of four new IYS sites across the province. Hannah has supported this provincial expansion work by finding meaningful ways to engage provincial partners in the IICY Initiative and promote knowledge translation. Hannah’s passion for working with community-based organizations led her to become the volunteer Choir Director for the Stella’s Circle Inclusion Choir, a non-audition community choir for adults who face barriers to fully participating in their community. Through this work, Hannah spearheaded research at Memorial University on the importance of community programming in building social connections. As a former Research Assistant at the Children and Youth in Alternate Care (CAYAC) Clinic – a medical home for children and youth in alternate care arrangements – Hannah also brings with her experience in pediatric research.

Jen Crowe
As Manager of Strategic Initiatives at Choices for Youth, Jen works with communities in Newfoundland and Labrador (NL) in the areas of community development, impact measurement, public policy, and systems change. 

For the past two years, Jen has been leading work to develop an Integrated Youth Services (IYS) network across NL, building from the existing IYS site in St. John’s, NL, and working with 65+ community partners to build a model that meets the provincial and regional needs of youth in our province. Jen leads a team that is responsible for impact measurement, research, and public policy for Choices for Youth and the IYS network.

Jen’s background is in the areas of youth engagement, public policy, and community development. Prior to coming to Choices for Youth, Jen led student leadership development efforts at Memorial University, including conferences, fellowship programs, and courses. Jen is on the Board of Directors of the YWCA NL and is Past Chair of Happy City St. John’s. Jen holds a Masters in Public Administration from Western University.

Key takeaways

  • Improving Integrated Care for Youth (IICY) is a strategic initiative used to create sustainable improvements for community based mental health services for youth
  • Findings based on receptions from Choice for Youth who focus on tackling issues of youth homelessness and youth poverty in Newfoundland and Labrador
    • Focusing on 4 core areas: health and mental health, faminial supports, employment and education, and housing
  • Takes a wrap-around model to care through addressing systemic root causes of poverty and homelessness
    • A “one-stop-shop” where youth can receive supports for a wide range of issues they may be facing
  • Prioritized co-design in the initial creation of standards 

Key Learning Objectives (defined by presenters)

Leading by example and knowing the risk to deliverables and timelines, HSO took an intentional pause early into the implementation to ensure feedback could be actioned meaningfully. From there, HSO developed an adaptive approach to incorporate real-time feedback from the networks into the implementation and the products. This included:

  1. Creating more opportunities for collaboration and knowledge exchange through online platforms and shared meetings
  2. Developing a framework to evaluate and adjust implementation approaches and materials moving forward
  3. Building “What We’ve Heard” into town halls and information sessions

The outcome of the pause and feedback approach included:

  • Increased engagement and participation by networks
  • Increased trust and meaningful participation from all stakeholders including youth, community providers, etc
  • Higher quality feedback on HSO standards and tools

Key Themes

  1. Implementing user feedback
  2. Systemic approaches to change

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