Quest project summaries

Quest project summaries

Quest cohort 4

Quest cohort 4 consisted of seven teams beginning their Quest journey in June 2024. Teams finished the cohort activities in June 2025. Projects focused on themes related to clinical practice, improving access, client engagement, and organizational systems. Read their project summaries below.

What was the opportunity?

CDI aimed to demonstrate positive client outcomes, meet service benchmarks and reduce wait times. To achieve this, they focused on strengthening clinical supervision for their staff, largely early career clinicians. The team identified that clinical supervision practices were not standardized or consistently applied across their clinical management team, which may have had implications on the services clients received at CDI. The goal was to build staff confidence and improve retention, while also easing the burden on current supervisors. CDI also prioritized the importance of intentionally embedding inclusion, diversity, equity and accessibility (IDEA) best practices and principles into clinical supervision.

What was the goal?

The team recognized the need for clinical supervision to be consistent across programs and aligned with IDEA practices and principles. They set out to develop a standardized framework for clinical supervision at CDI with an accompanying practice guide or toolkit.

What were the improvements?

  • Developed a clinical supervision framework outlining three key domains of supervision: administrative, formative and supportive/restorative.

  • Mapped out the essential elements of a toolkit to support implementation of the framework. This includes a new clinical supervision note template, onboarding guide, reflective practice tools and tools for direct observation and delivering corrective feedback.

  • Integrated a community of practice (CoP) into monthly clinical managers’ meetings to facilitate discussion and peer learning around shared challenges and priorities.

  • Initiated plans to revise the agency’s performance appraisal template to better align with the new supervision framework.

What was the impact?

While still in the early stages of implementing most of this work, CDI has already observed some early benefits. The establishment of a clinical supervision framework, including the three identified domains, has provided a clear structure to guide future efforts. Operationally, the implementation of the CoP into clinical managers’ meetings has helped accelerate discussions and identify improvement opportunities more efficiently. Additionally, collaboration with the Knowledge Institute offered valuable insights from the literature review on IDEA in clinical supervision, which will inform how these principles are embedded into the future toolkit.

What was the opportunity?

Keystone observed a critical gap in their service delivery; the absence of a structured, integrated and evidence-informed system for delivering psychoeducational workshops and targeted psychosocial group interventions across developmental stages. This led to inefficiencies throughout the client journey from intake to discharge. Practices were inconsistent and not always guided by clinical appropriateness which created confusion for both staff and clients. Therefore, Keystone staff wanted to ensure they were providing the best evidence-informed services in the most efficient and effective way.

What was the goal?

The team sought out to improve service accessibility while delivering evidence-informed solutions that support timely and appropriate care across developmental stages. By aligning service delivery with clinical assessments and client needs, they aimed to ensure participants are matched to the right group at the right time.

Specifically, Keystone aimed to deliver evidence-informed workshops and group sessions on a timely schedule, utilizing a manualized and standardized approach that includes pre- and post-assessment measures to evaluate service effectiveness and satisfaction, to best address community and client needs along the continuum of care.

What were the improvements?

During the project the team identified and began to implement a number of improvement ideas including:

  • Creating a clear, consistent communication strategy to promote group offerings internally and externally, ensuring clients, staff and community partners are aware of available services and schedules.

  • Designating or hiring a coordinator to support the planning, promotion and evaluation of groups and workshops, ensuring consistency, accountability and alignment with organizational priorities.

  • Standardizing the use of outcome and satisfaction measures across all group offerings to evaluate service effectiveness, track client progress and support continuous quality improvement.

  • Utilizing community needs assessment to inform prevention services (0–6 years).

  • Identifying opportunities to improve workflows at intake by integrating group planning earlier in the client journey and minimizing duplication of work.

  • Using the Microsoft Teams platform for webinar-based groups to automate reminders, simplify registration and support timely communication with families.

  • Implementing a staff training plan aligned with accreditation standards.

What was the impact?

Early results demonstrate progress toward a more structured, accountable and evidence-informed model. Keystone leadership has observed improvements through increased staff engagement, clearer group scheduling and coordination and reduced administrative burden. They note they are in the process of implementing pre- and post-measures in the Greenspace Measurement-Based Platform, which staff have begun utilizing in 1:1 sessions with young people and families. Further, they indicate community needs are better reflected in programming, and teams are demonstrating a stronger awareness of accreditation standards.

What was the opportunity?

Lynwood Charlton Centre had recently assumed responsibility for the single point of access for child and youth mental health services in the Hamilton region. As the Access and System Navigation (ASN) program took shape during its launch, the team wanted to ensure it evolved in a way that was meeting the needs of children, young people, families and service providers.

The team identified inefficiencies in the ASN referral process, as unclear and inconsistent steps created confusion and frustration for ASN staff, referral partners and the children, young people and families they support. This often led to duplicated work and lengthy wait times.

What was the goal?

The team’s goal was to streamline and standardize the ASN practices to reduce wait times within the program to the point of receiving service.

What were the improvements?

Improvements fell within four key themes:

  • Communication: development of a communication plan for the program; staff engaged with the clients, families and caregivers who go through ASN; modified voicemail messaging; increased education about ASN; they are working towards improving the website content and guidance.

  • Staffing: improvements to the work distribution of the ASN navigators and addition of an administrative assistant and navigator to the team.

  • Process and documentation: process for documenting priority criteria established, referral and intake forms modified, creating FAQs for all referents; they are currently exploring future EMHware improvements to simplify workflows.

  • QI culture: quality improvement discussions have been intentionally embedded into team and leadership meetings to enhance conversation and program development within the agency.

What was the impact?

While implementation is ongoing, the team has already observed shorter process times because of a number of the improvements to date. The flow of the work has changed due to new processes and the streamlining of how a client moves through the ASN journey. With the data being collected and monitored in real time, they can trust in the electronic medical record (EMR) and use it to its full capacity. 

What was the opportunity?

The team at Maryvale emphasized the need for a structured and consistent way of working across the organization. Employees had different approaches to completing tasks and managing data; therefore, they didn’t reap the benefit of the work they did as they were unable to demonstrate outcomes and impact. Further, they noted the organizational need to have clear benchmarks, key performance indicators and to foster a culture of continuous improvement. These factors impacted staff engagement, morale, performance as well as the quality of services they delivered.

What was the goal?

The team aimed to develop a comprehensive quality framework enabling Maryvale to standardize processes linked to benchmarks and key performance indicators to achieve more efficient, effective and data-driven approaches to treatment, leading to improved client care and agency performance.

What were the improvements?

During the project the team identified and began to implement a number of improvement ideas to define the quality framework but also to ensure practicality across the organization including:

  • Developing a consistent/standardized process and documentation.

  • Identifying capacity within the quality team and teams supporting quality initiatives to be able to scale the support that they offer to all the programs.

  • Identifying inefficiencies/wastes in terms of tasks that could free up some capacity so that focus can be redirected to priority initiatives.

  • Determining strategies to have a single source of data (data in one place).

  • Enabling teams to be empowered and have access to data (avoiding reliance and dependencies on other staff).

  • Initiating an organization-wide initiative to educate programs on quality improvement, evaluation, the developed indicators and start to shift culture.

What was the impact?

The team refined the indicators and linked them to the service descriptions which facilitates being able to tell a story about the services they offer and how they are doing. Further, the team has implemented dashboards aligned with these indicators which enables users to understand the data visually and access it in a user-friendly way.

What was the opportunity?

Merrymount was looking to enhance their client engagement strategy to ensure that client, family and caregiver voice was at the core of everything they do. In exploring this opportunity, their team identified the lack of consistent and trackable feedback from the families across their programs and processes. Without a systematic approach to gather meaningful and measurable input from intake through to their mental wellness programs and case closures, they had no channels to capture what families are really looking for nor to engage them in more meaningful ways.

What was the goal?

The team sought to enhance the client engagement strategy across the organization to ensure that going forward they could create meaningful improvements to their programs and services. This would allow the organization to ensure that more effective and efficient practices and tools are in place to enrich the child and family experience. 

What were the improvements?

  • A comprehensive analysis of existing survey software was undertaken to explore potential improvements to software to gather important feedback. This facilitated both buy-in and better understanding of the value of their existing software, Survey Monkey for collection, analysis and reporting of client feedback. Enhancements were made to the processes for using the software including formalizing clear roles, responsibilities and timelines to further enhance the collection and use of client and family voice.

  • Improvements were made to refine and refresh existing surveys including updating each with more inclusive language (from an equity, diversity, inclusion and anti-racism lens) and potential solutions such as standardizing the collection method and data reporting schedule. They put in place processes to ensure the regular use of findings to ensure feedback is incorporated in program improvements.

What was the impact?

Merrymount is in the early stages of implementing their identified solutions, but they have already observed an increase in survey completion. Further, the staff team are knowledgeable about the new process and are demonstrating consistency in its application.
The team notes that monitoring and analysis of initial results demonstrates their change ideas are effective. This includes both the monitoring of response rates to the surveys as well as the feedback that is received.

What was the opportunity?

York Hills noted a key opportunity related to their frontline clinical staff with the Goal Focused Counselling and Therapy (GFCT) and Day Treatment (DT) programs. These teams highlighted an opportunity to enhance the delivery of their services by increasing the average number of clinical sessions they provided per week. This could have positive impacts on client outcomes and experiences, staff functioning and wellness and improved efficiency and effectiveness of services.

What was the goal?

The goal was to enhance agency efficiency and effectiveness by establishing clear, quantifiable definitions and expectations for direct and indirect service hours and other agency functions (workload) for the GFCT and DT teams.

What were the improvements?

  • Mapped out the service flow for GFCT and DT, establishing a clear and standardized understanding of key operational elements. These included definitions for clinical sessions, the structure of the work week, direct and indirect service hours and hours contributing to broader agency functions.

  • Conducted a value analysis to categorize activities into three groups: value-added activities to be optimized and standardized, non-value-added but essential activities to be minimized, and non-value-added and non-essential activities to be eliminated.

  • Took key steps including revising the clinical session booking system, refining the daily structure of the work week and clearly communicating expectations to clinical staff.

What was the impact?

The implementation of change initiatives is ongoing. The team plans to determine whether the changes lead to improvements by implementing a structured monitoring and response plan. This will involve collecting and analyzing data post implementation and comparing it to baseline metrics established prior to the change. This will help them assess the effectiveness of the change and guide any necessary adjustments.

What was the opportunity?

The Crisis Support Team (CST) services at Youthdale was set to re-launch in fall of 2025. The team recognized it was important to establish a robust and structured framework for data collection and analysis for the new CST launch in order to evaluate the effectiveness of the programs and align with Youthdale’s commitment to clinical services excellence. A comprehensive data measurement strategy would support all phases of quality improvement and enhance both the quality and efficiency of service delivery. 

What was the goal?

The team set out to develop quality improvement metrics for CST including specific criteria, identifying tools/processes to collect these metrics and overseeing the launch of these processes to identify any gaps/challenges in data collection. This would enable continuous evaluation and enhancement of CST services, ensuring they remain effective, efficient and responsive to client needs.

What were the improvements?

  • Developed clear quality improvement metrics aligned with CST service objectives.

  • Identified effective tools and processes for collecting and analyzing relevant data.

  • Developed a monitoring plan with all foundational elements in place to support continuous evaluation and improvement.

What was the impact?

The team has noted that the change has led to improvement. With the new data monitoring plan in place, there is capacity to understand the relevant information for how the CST supports are being utilized. With the client survey, there is a more accessible way for individuals who access the service to provide immediate feedback.