143. Transforming Mental Health Care in Nova Scotia: Implementing Health System Change in Child and Adolescent Mental Health Services
Contributed abstract in session MC-3: Evaluation and Implementation, stream Regular talks.
Monday, 11:00-12:30Room: Room S2
Authors (first author is the speaker)
| 1. | Leslie Anne Campbell
|
| Community Health & Epidemiology, Dalhousie University | |
| 2. | Debbie Emberly
|
| IWK Health Centre |
Abstract
The creation of client-centred, accountable care is a priority for many child and adolescent mental health services. Major philosophical and organizational shifts are required to replace traditional systems where “clinicians are experts, clients are help seekers”, and that have little ability to actively engage clients and families in a tailored care process or measure client-centred outcomes. The complex adaptive nature of health care systems and different implementation contexts may contribute to unanticipated variation in outcomes.
The Choice and Partnership Approach (CAPA) is a comprehensive transformational service model that incorporates collaborative, participatory practice with lean thinking for demand and capacity management. We aimed to develop a theory-informed understanding of the conditions that hinder or support the implementation of CAPA in Nova Scotia, Canada. Specifically, we asked “to what degree does CAPA work, for whom, and under what circumstances?”.
Using a realist approach, we generated, tested, and refined mid-range theories based on a scoping review, document review, and key informant interviews.
Our findings highlight that implementation of CAPA is influenced by multiple highly interrelated levels of context. For CAPA to “work” as intended, the implementation process requires empowered leadership, transparency, intentional planning and resourcing of implementation, and an understanding of the influence of the service ecosystem.
Keywords
- Implementation Science
- Health Services Research
Status: accepted
Back to the list of papers