This story originally appeared in PHC News on August 3, 2017.

In 2016, the PHC Mental Health program began a partnership with CHÉOS Scientist Dr. Joseph Puyat, and a team of researchers and health professionals, to assess the care delivered to patients with early psychosis.
The team set out to compare current practices in the program against international evidence on best practices to identify potential gaps and how care could be tailored to match those practices.

“We are confident in the quality of care that we provide,” said Dr. Puyat. “But we wanted to identify areas that we can improve to optimize mental health care here at St. Paul’s. Early psychosis is of particular importance because the research shows that this is a group that can really benefit from early identification and intervention.”

The team analyzed the clinical charts of people 25 years or younger who were admitted to St. Paul’s mental health units between 2013 and 2015 with psychotic symptoms. To capture those experiencing early psychosis, only those people who had psychotic symptoms for five years or less were included in the study. The team collected information on the frequency of mental status exams, administered doses of anti-psychotic medication, and patients’ histories of substance use, violence, diagnosis, and symptoms.

“What we found is that approaches to this patient group can be inconsistent,” said Dr. Kofi Bonnie, Clinical Nurse Specialist. “The information we collected has been instrumental in our process of better standardizing care and developing evidence-based, patient-centred initiatives.”

“We want to provide the best care possible,” added Clinical Nurse Educator Brenda Vaughan, who is a co-author on the study. “Reporting our findings help us to be transparent and accountable.”

With an overall goal of improving care, the Mental Health program has addressed gaps identified in the study by incorporating changes in the clinical setting.

“We’ve now brought on a dedicated pharmacist to those teams who didn’t have one; it’s been a great resource for improving clinical care and patient education” said Vaughan.

Other practice improvement initiatives are underway including improving documentation and charting consistency and the collection of health and outcome indicators.

Brenda joins the other team members in celebrating the success of this first stage of practice development, stating “It’s been a great resource for improving clinical care and patient education. We are now looking at how to reduce unnecessary days in hospital and identifying barriers that prevent people from moving through the continuum of care.”

The study, published in the journal Early Intervention in Psychiatry, is only a small subset of the information that the study team collected and several more publications are expected.