Internal Medicine Virtual Specialist Assessment Program Reduces Emergency Department Transfers from Long-Term Care.

BACKGROUND: Transfers to emergency departments (EDs) from long-term care (LTC) can expose residents to care discontinuities and risks. Virtual platforms can increase the breadth of care available for residents within their facility, thus replacing transfers to EDs when safe and appropriate. The authors aimed to assess whether leveraging a virtual care platform at an LTC facility would reduce the number of transfers to EDs. METHODS: Data on the number of transfers to EDs were collected from January 2019 to October 2021 at an LTC facility. In June 2020 the home began using a virtual care platform that allowed residents to speak with specialist physicians through video and receive management plans remotely. The authors evaluated the Internal Medicine Virtual Specialist Program (IMVSP) using a pre-post study design by comparing the number of transfers to EDs and the proportion of transfers resulting in hospital admission before and after program implementation. Unstructured phone interviews were conducted with employees at the home to understand their experiences. RESULTS: The median number of transfers to EDs per month after program implementation showed a 13.0% reduction. The median proportion of these transfers resulting in hospital admission per month increased by 26.1%. Employees at the LTC home were satisfied with the program. CONCLUSION: The IMVSP reduced transfers to EDs and allowed for a higher proportion of transfers that resulted in hospital admission. Early access to specialist care via virtual platforms has important implications for improving accessibility to high-quality care for LTC residents and reducing risks associated with transfers.

Psychiatry and the Opioid Crisis in Canada.

A position statement developed by the Canadian Psychiatric Association's Professional Standards and Practice Committee and approved by the CPA's Board of Directors on April 18, 2019.

The Mentally Ill Physician: Issues in Assessment, Treatment and Advocacy.

This position paper has been substantially revised in collaboration with the Canadian Psychiatric Association's Professional Standards and Practice Committee and approved for republication by the CPA's Board of Directors on April 8, 2019. The original position paper, 1 now an historical document, was first approved by the Board of Directors on October 4, 1996.

Community Treatment Orders and Other Forms of Mandatory Outpatient Treatment.

This position paper has been substantially revised by the Canadian Psychiatric Association's Professional Standards and Practice Committee and approved for republication by the CPA's Board of Directors on July 26, 2018. The original position paper1 was first approved by the Board of Directors on January 25, 2003. It was subsequently reviewed and approved for republication with minor revisions on June 2, 2009.

Education programs for medical psychiatry collaborative care: A scoping review.

OBJECTIVE: To understand the current state of collaborative care education programs reported in the literature. METHODS: Following Arksey and O'Malley methodology for scoping reviews, data was abstracted in following domains: article details, program details, program outcomes, and implementation factors. Numerical summaries were calculated where necessary. Implementation factors underwent a qualitative thematic analysis. RESULTS: This review identified 40 unique collaborative care education programs. Most programs (n = 25; 62.5%) were delivered to a multi-disciplinary group of learners through didactic (n = 34; 85.0%) and/or in vivo (n = 32; 80.0%) training methods. The majority of programs focused on clinical knowledge/skill acquisition (n = 38; 95.0%) as opposed to attitudes towards mental health and collaboration (n = 27; 67.5%). Implementation factors fell within four themes: program development, supportive environment, necessary resources, and clinical change agents/leaders. CONCLUSION: Despite the growing evidence for collaborative care, few collaborative care education programs are reported in the literature. Key elements of collaborative care education programs include: routine multi-disciplinary interaction, curriculum focus on attitudes; clinical change agents and leaders to accelerate implementation; and a user-centred design development process. Future implementations can learn from these experiences to avoid potential barriers and focus on enabling successful programs to enhance care.

Scoping review protocol: education initiatives for medical psychiatry collaborative care.

INTRODUCTION: The collaborative care model is an approach providing care to those with mental health and addictions disorders in the primary care setting. There is a robust evidence base demonstrating its clinical and cost-effectiveness in comparison with usual care; however, the transitioning to this new paradigm of care has been difficult. While there are efforts to train and prepare healthcare professionals, not much is known about the current state of collaborative care training programmes. The objective of this scoping review is to understand how widespread these collaborative care education initiatives are, how they are implemented and their impacts. METHODS AND ANALYSIS: The scoping review methodology uses the established review methodology by Arksey and O'Malley. The search strategy was developed by a medical librarian and will be applied in eight different databases spanning multiple disciplines. A two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing collaborative care education initiative for healthcare providers. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardised form. The extracted data will undergo a 'narrative review' or a descriptive analysis of the contextual or process-oriented data and simple quantitative analysis using descriptive statistics. ETHICS AND DISSEMINATION: Research ethics approval is not required for this scoping review. The results of this scoping review will inform the development of a collaborative care training initiative emerging from the Medical Psychiatry Alliance, a four-institution philanthropic partnership in Ontario, Canada. The results will also be presented at relevant national and international conferences and published in a peer-reviewed journal.