Thanks mainly to the efforts of Ruth Mireau, the Provincial PCOMS Coordinator, Saskatchewan Is enjoying a province-wide successful implementation. This, of course, is not happening by happenstance but rather by a concerted effort to apply what is known about both implementation science and past successful PCOMS implementations. Training of trainers (TOT) has been a key feature, ensuring that each Health Region of the province has folks steeped in PCOMS available to train others and consult about all things PCOMS and Better Outcomes Now (BON). Seventeen more will attend a training in November from Northern Saskatchewan and 30 people will attend the TOT in December from the south part of the province. This will bring the total number of trainers in the province to an amazing 120!
Success is about many things (see PCOMS Readiness Checklist ) but a critical component is upper management support. The Saskatchewan Provincial Ministry of Health has mandated the implementation of PCOMS and Better Outcomes Now (BON) for Mental Health and Addictions staff and has set time lines to ensure that all staff are trained in using PCOMS and have started using BON. Success also requires follow-up at all levels and the use of PCOMS data to do what it is intended to do: to promote quality improvement and identify at risk clients so that new options can be considered at the client/therapist level and new programs can be considered at the agency level. Ongoing training is essential. All clinicians in the province are required to attend 12 hours of training before they are given access to BON, and all clinicians who are using BON are required to attend an annual 3 hour refresher to ensure data integrity.
Having trainers who feel confident in their ability to address obstacles and use PCOMS data significantly bolsters the chances for success. Consequently, every two months, Ruth meets with the trainers via weblink to talk about the successes and obstacles as well as to help them integrate new PCOMS training materials (e.g., the new Ten Skills of PCOMS/Therapist Adherence Scale ). This group also talks to each other about how to facilitate the peer supervision groups that are now functioning in most regions. Trainers report that they are finding the training process much simpler since integrating the new 20 minute webinars about the nuances of the ORS and SRS, supervision, working with families, and how PCOMS informs therapy after the first meeting.
In addition, each region of the province has a PCOMS Implementation Team that includes managers, trainers, and IT folks to address the practical issues related to the BON implementation process. Representatives from these teams also meet by weblink every few months, again to brainstorm about successes and obstacles to implementation. This group has recently started comparing notes from the BON stats pages and are talking about using the data in “plan-do-study-act” cycles.
It’s exciting to observe Ruth and Saskatchewan’s success where client feedback is having an impact not only in the service provided to each individual client, but also in the improvements made to client programming, system wide.