In the midst of COVID-19, the team at Canadian Mental Health Association (CMHA) Windsor-Essex branch recognized they needed a better way to identify the level of service that clients need while adhering to provincial and federal guidelines for social distancing.  Review of the agency’s electronic medical record (EMR) system revealed challenges in quickly identify the most vulnerable clients within the agency’s database who would benefit from a higher (or lower) level of care. In addition there had not been a way to evaluate staff caseloads based on complexity of client needs and whether clients were receiving the level of mental health and addiction services best suited to these identified needs. Caseloads sizes varied and a waitlist for services steadily grew, with no way to evaluate the level of needs of clients both receiving and waiting for care. Issues of both health equity and efficiency of service delivery were wondered about with no measure to evaluate these. It was very quickly pinpointed that a tool to provide a standard, objective process or measure could be the key to providing data to guide the appropriate level of care for each client. The Level of Care Utilization System (LOCUS) evaluation tool was identified as a potential solution.  In a short time (just 2 weeks!) 80 mental Health Service staff were trained via the Zoom conferencing on the LOCUS tool and the necessary data was integrated into the agency’s electronic medical record.  Within one week of uploading LOCUS data, senior staff were able to run reports to better understand the composition of care required by each of their clients as well as match client needs to staff skill sets and better manage staff caseloads overall.  In addition, staff could identify clients who would benefit from a referral to alternate community services, resulting in potential increased capacity for taking on new clients and possibly reducing wait times.

While evaluating the effectiveness of this change, early results have been extremely positive and the team expects this change will persist post-COVID pandemic.  Congratulations CMHA Windsor Essex on your responsiveness and ability to adapt in this environment to support your clients in the best way possible!

If your agency is currently engaging in rapid quality improvement work the E-QIP Team is here to help you document your experience!  Download our “Quick QI template” and email us at to speak with a coach about your QI initiatives during COVID-19!