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Measurement-Based Care (MBC) in the National Network of Operational Stress Injury (OSI) Clinics

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Key Details

Organisation Name

Veterans Affairs Canada /Government of Canada

Location

Veterans Affairs Canada, PO Box 7700, Charlottetown, PE, C1A 8M9
Canada

Website

Social

eMHIC Member Status

Community Member

At a Glance

Description

Veterans Affairs Canada (VAC) supports MBC across its national network of OSI clinics through the Client Reported Outcome Monitoring System (CROMIS), utilized by clients and clinicians and hosted by OQ-Measures.

Implementation Status

Routine service delivery

Initial CROMIS implementation began in 2012-2013. A re-implementation was launched in 2021-2022. CROMIS utilization is regularly reviewed, national meetings are held twice per year, and national client outcomes are reported annually.

Target Population

Veterans, military, police

Veterans, Canadian Armed Forces members, Royal Canadian Mounted Police members with service-related mental health issues

Impact & Outcomes

2022-2023; 2023-2024; 2024-2025; 2025-2026
The percentage of clients receiving treatment in OSI clinics who reported a clinically significant improvement on a valid and sensitive psychometric test of general mental health is reported for each fiscal year.

The Adult Outcome Questionnaire has been recognized as one of the leading outcome monitoring tools for quantifying and evaluating client progress. The OQ-45.2 uses a Reliable Change Index (RCI) to define standards for clinically significant change achieved during the course of a mental health treatment.

These outcomes exceed the 35% improvement reported in scientific literature (Hansen, Lambert, & Forman, 2002).
50%
Clients reporting improved mental health
51%
Clients reporting improved mental health
54%
Clients reporting improved mental health
54%
Clients reporting improved mental health
50%
Clients reporting improved mental health
51%
Clients reporting improved mental health
54%
Clients reporting improved mental health
54%
Clients reporting improved mental health

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Initiative Overview

The Current Gap

Treatments that integrate MBC have been found to generate superior client outcomes, including reduced treatment failure and discontinuation rates. Despite these findings, the implementation of MBC in mental health services remains a complex undertaking, especially when done on a large scale throughout a national network of mental health services.

Our Solution

VAC has supported MBC across its network of OSI clinics since 2012-2013 by providing online access to outcome questionnaires through CROMIS. A re-implementation initiative began in 2021-2022 and included clear expectations, targeted advanced trainings, engagement of local champions, and ongoing support strategies to increase and maintain client and clinician uptake.

Key Features

1

Online access to a national outcomes monitoring system

VAC provides online access to outcome questionnaires through CROMIS, ensuring accessible and timely outcomes monitoring information for clients and clinicians.

2

National training

National meetings for CROMIS champions are held regularly. All OSI clinic staff and champions received standardized training and monthly consultation sessions, with case discussions.

3

Local support for clients and clinicians

Local CROMIS champions provide ongoing training and support to OSI clinic staff, create annual action plans, and suggest improvements to local processes.

4

National funding and coordination

VAC covers all costs related to outcomes monitoring and CROMIS.

Collaboration in Action

Main Collaborators

BC OSI Clinic, Vancouver, British Columbia (operated by Vancouver Costal Health)
Carewest OSI Clinic, Calgary, Alberta (operated by Carewest)
Deer Lodge OSI Clinic, Winnipeg, Manitoba (operated by Winnipeg Regional Health Authority)
Edmonton OSI Clinic, Edmonton, Alberta (operated by Recovery Alberta)
Fredericton OSI Clinic, Fredericton, New Brunswick (operated by Horizon Health Network)
Nova Scotia OSI Clinic, Dartmouth, Nova Scotia (operated by Nova Scotia Health)
Québec OSI Clinic, Québec City, Québec (operated by Santé Québec)
Royal Ottawa OSI Clinic, Ottawa, Ontario (operated by The Royal)
St. Joseph’s OSI Clinic, London, Ontario (operated by St. Joseph’s Health Care)
Ste. Anne’s OSI Clinic, Ste-Anne-de-Bellevue, Québec (operated by Santé Québec)

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Key Learnings

• Implementing MBC across a national network of mental health clinics operated by different provincial health authorities

• Providing training material, outcomes monitoring tools, and ongoing support in two official languages

• Ensuring consistency of MBC knowledge and practices across multiple sites

• Sustaining utilization over time
Key learnings included the importance of:

• National leadership and project coordination when working with multiple sites and partners

• Providing continuous support after implementation/re-implementation

• Obtaining ongoing feedback from partners

• Using partner feedback to inform future strategies and supports

Looking Ahead

Ongoing feedback from OSI clinics will inform next steps in supporting MBC across the network of OSI clinics.

VAC will also review new trends in digital tools and research in MBC in order to update training and supports as needed and remain aligned with current best practices.
VAC will collaborate with other organizations who are interested in MBC, including Canada’s Department of National Defense.
VAC’s vision is to support the expansion of MBC beyond the network of OSI clinics so all VAC clients can benefit from this best practice.
eMHIC Directory_Key Contacts (4)

Key Contact

Dr Jean-Bernard Dupuy, Ph.D.
OSI - National Network Manager and National Clinical Coordinator
Veterans Affairs Canada /Government of Canada

Email

[email protected]

Website

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