The utility of a fidelity measure to monitor early psychosis services across Australia

ABSTRACT

Aims: This project aims to describe the development, implementation, and adaptation of a fidelity tool to measure service quality in a national network of early psychosis services across Australia-the headspace Early Psychosis program. Method(s) An 80-item Early Psychosis Prevention and Intervention Centre Model Integrity Tool (EMIT) was developed. The tool assesses adherence in six sites across Australia. Ratings were informed by interviews, routine data and site policies. The EMIT has been adapted for use virtually during Covid-19 restrictions on in-person site visits. A review is underway to enhance the tool to capture quality of services. The Revised EPPIC Model Integrity Tool (REMIT) will be utilized to assess fidelity and service quality in 2023. Result(s) All six sites participated in five fidelity assessments since 2017. In the initial visits, average scores were in the 'low' fidelity range. By the fifth fidelity visit, the network average improved to 'superior' fidelity. The EMIT was successfully adapted for use virtually during Covid-19 and sites were able to maintain scores of high to superior fidelity. The results from the use of the redeveloped tool, the REMIT will be presented. Conclusion(s) The Australian Early Psychosis model has been successfully implemented across the headspace Early Psychosis program. Ongoing fidelity assessments are an effective method to improve and maintain fidelity. The review and development of the REMIT reflects the sites state of implementation and ensures services are of high quality. The findings of the initial use of the REMIT tool in fidelity assessments in early 2023.