Dans le cadre du programme PATIenTS, le RUISSS Université de Sherbrooke lance son projet d’amélioration de la trajectoire de services auprès des personnes avec des troubles mentaux courants en soins primaires sur son territoire. Le projet SoutienTMC sera dirigé par Ariane Girard, Jeune leader SSA FRQS et professeure à l’École de sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, et Joëlle Bernard-Hamel, patiente partenaire. Catherine Hudon, Catherine Wilhelmy et Yessica-Haydee Gomez, respectivement codirectrice scientifique, codirectrice patiente partenaire et coordonnatrice de l’équipe SSA-RUISSS Université de Sherbrooke de l’Unité de soutien SSA Québec, veilleront à ce que le projet soit aligné sur les priorités du ministère de la Santé et des Services sociaux (MSSS) et de l’Unité et qu’il favorise le travail en partenariat et la promotion de la perspective patient.
Service trajectory for people with common mental disorders in primary care
The SSA-RUISSS Université de Sherbrooke team is launching a project to improve practices and the trajectory of services for people living with anxiety or depression while they are receiving primary care outreach services.
Primary care services are provided by family medicine groups, general social services and primary mental health teams of the CLSCs of the CISSS/CIUSSS, community organizations and private clinics.
Issue
In the scope of this project, the SSA-RUISSS Université de Sherbrooke team is considering the following problematic:
- Primary care teams do not always have access to the clinical and organizational support required to ensure that patients receive the best interventions for their health and recovery needs;
- The service trajectory is not always clearly defined and there are redundancies in the steps, a lack of access to best practice knowledge that reflects the complexity of the practices, and difficulty accessing experts.
Hypothesis and objectives
To address these issues, the team offers three hypotheses for improvement:
1) Improve identification and assessment practices;
2) Enhance clinical monitoring activities as part of care management to support trajectory alignment with patient needs;
3) Improve continuity when a stage in the trajectory involves moving from one stakeholder to another within different organizational teams.
Participatory research approach of the living laboratory type
Within the framework of the SupportTMC project of the PATIenTS program, the team in charge adopts an innovation development approach centered on the needs of the users in their real environment to plan the improvement of the trajectory (consultations, co-design) and to aim at the empowerment of local actors in parallel with the research work.
This work is carried out in partnership with the five CISSS/CIUSSS of the RUISSS Université de Sherbrooke, a group of patient-clinician experts (advisory), the RUISSS steering committee, as well as local teams or change agents.
Impact Measurement
As part of the SupportTMC project of the PATIenTS program, the project team identified items that could be measured to assess the impact of the project on each of the quintuple aim items.
PATIenTS Program
The Unité de soutien SSA Québec is launching the Life Trajectory Improvement and Innovation Partnerships in Transition to Sustainable Health (PATIenTS program) in collaboration with the four integrated university health and social services networks (RUISSSs). Through the PATIenTS program, the activation of the Québec learning health system is being carried out in the RUISSS territories of Québec through four tangible projects over a one-year period.