News & Updates

EPION Spotlight on…Transitions of Care: Report from EPION’s June 15 Consultation

On June 15, some 24 EPION members gathered from across the province.  We met at CAMH in Toronto in a ‘Transitions of Care’ Consultation specifically to address the issue of what comes after Early Intervention and how to support our clients in the transition from EPI programs. The group included a number of clinicians from several disciplines, an individual with lived experience and a family member, who also works as an EPI program Family Educator. We came from urban, & rural programs, were solo practitioners and from large teams, from North, East,  South and West  of the province.


#EPIONSpotlight: Transitions of Care, June 2018


Arising from the Strategic Plan

During EPION’s strategic planning process which took place last Fall and Winter, concern was raised about this issue.   It was observed that challenges in the ability to arrange appropriate and helpful discharge plans can affect the whole flow of clients through programs and the ability of programs to accommodate new clients and their families.


Now part of the Work Plan

This concern has come across as so important that addressing this issue has become part of EPION’s work-plan for this current fiscal year (April 1, 2018 – March 30, 2019)


The Process to date

  • The MOHLTC EPI Standards includes Standard 6: Graduation from the Program. This Standard is very brief and lacking in detailed guidance.
  • EPION’s Strategic Plan is available for everyone to see on our website. It includes four ‘Pillars of Activity’.  The second Pillar is: ‘Strengthen EPI Practice in line with the Ontario EPI program standards, current evidence and best practice’ and one of the supporting strategies was articulated as; ‘Facilitate a stakeholder dialogue around transitions of care, identifying implications for the EPI model, service delivery, care pathways, and systems level coordination to facilitate client flow to and from EPI services and easier access to EPI service.’
  • May 11,2018 EPION Network Meeting. During the last EPION Network meeting on May 11 we spent an hour brainstorming ideas.  These ideas formed the basis of the second step the ‘Transitions of Care’ Consultation on June 15.  The ideas fell into four domains:-
  • Discharge Planning
  • Disengagement
  • Readmission
  • Transfer & access to other services


The June 15 Consultation

The goal of this consultation day was to look at the four domains and start the process of developing together some ‘Principles of Care’ which would lead to articulating broad aspirations for EPI Programs in these areas.

We worked on our task both in small groups and within the large group.  Everyone came well-prepared having completed a bunch of readings, which included several recent papers which are part of an emerging body of research on the subject.  Particularly valuable was an ‘Issue Brief’ written by Dr Nev Jones (you may remember Nev was one of our plenary speakers at the 2017 EPION Conference).  For your interest, you can find her paper here.

In addition, several participants provided us with information about their own program’s Care-Paths and discharge planning processes, and everyone pooled their own knowledge, expertise and experience.

Our thanks to Milinda Alexander, Chair of EPION’s Event Planning Working Group & Brian Cooper, Chair of EPION’s PEAK Working Group who served as co-facilitators for the consultation day.  Also thanks to Avra Selick, EPION’s Research Coordinator, who filled a very helpful supportive role by spending the day listening to and recording our discussions.  Avra is currently working on making sense of all our deliberations by producing a written account of the day.


So, what happens next? 

  • ‘Transitions of Care’ will be an ongoing focus for EPION during our current fiscal year.
  • EPION will continue to work towards our goal of providing some guidance and potential practical options for EPI Program use by developing relevant Principles of Care.
  • The result has the potential to inform and refresh EPI Standard #6: Graduation


Your ideas are welcome

If you would like to contribute to the discussion please contact EPION at  Send in your program’s Care-Pathways or other templates of care, if you have them.

Heather & Sarah

 For more information or to add to the discussion, please contact:

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