Crisis resolution and home treatment in the UK: A survey of model fidelity using a novel review methodology

Lamb, Danielle; Lloyd‐Evans, Brynmor; Fullarton, Kate; Kelly, Kathleen; Goater, Nicky; Mason, Oliver; Gray, Richard; Osborn, David; Nolan, Fiona; Pilling, Steve; Sullivan, Sarah; Henderson, Claire; Milton, Alyssa; Burgess, Emma; Churchard, Alasdair; Davidson, Mike; Frerichs, Johanna; Hindle, David; Paterson, Beth; Brown, Ellie; Piotrowski, Jonathan; Wheeler, Claire

doi:10.1111/inm.12658

Cited by 23 publications

(26 citation statements)

References 25 publications

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“…One earlier and two recent randomized controlled trials on CRTs showed that CRTs can reduce inpatient admissions, reduce bed use, and increase service users' satisfaction with acute care [2][3][4]. However, there has been considerable variation in organisation and practice of CRTs, and there is limited knowledge of the implementation of the various components of the CRT model [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

et al. 2021

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Background Crisis resolution teams (CRTs) are specialized multidisciplinary teams intended to provide assessment and short-term outpatient or home treatment as an alternative to hospital admission for people experiencing a mental health crisis. In Norway, CRTs have been established within mental health services throughout the country, but their fidelity to an evidence-based model for CRTs has been unknown. Methods We assessed fidelity to the evidence-based CRT model for 28 CRTs, using the CORE Crisis Resolution Team Fidelity Scale Version 2, a tool developed and first applied in the UK to measure adherence to a model of optimal CRT practice. The assessments were completed by evaluation teams based on written information, interviews, and review of patient records during a one-day visit with each CRT. Results The fidelity scale was applicable for assessing fidelity of Norwegian CRTs to the CRT model. On a scale 1 to 5, the mean fidelity score was low (2.75) and with a moderate variation of fidelity across the teams. The CRTs had highest scores on the content and delivery of care subscale, and lowest on the location and timing of care subscale. Scores were high on items measuring comprehensive assessment, psychological interventions, visit length, service users’ choice of location, and of type of support. However, scores were low on opening hours, gatekeeping acute psychiatric beds, facilitating early hospital discharge, intensity of contact, providing medication, and providing practical support. Conclusions The CORE CRT Fidelity Scale was applicable and relevant to assessment of Norwegian CRTs and may be used to guide further development in clinical practice and research. Lower fidelity and differences in fidelity patterns compared to the UK teams may indicate that Norwegian teams are more focused on early interventions to a broader patient group and less on avoiding acute inpatient admissions for patients with severe mental illness.

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Section: Introductionmentioning

confidence: 99%

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

et al. 2021

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“…The standards could provide national-level benchmarking data about practice and variation in TMCD services, information which is useful to policy makers and service planners. The CORE adult crisis team fidelity scale provides an example of this as it was used in a national survey [21], and is recommended in policy [22].…”

Section: Discussionmentioning

confidence: 99%

Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach

et al. 2020

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Background Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia. Methods The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing). Results One hundred sixty-five candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48 to 92/100. The median score for the crisis teams was 74.5 (range 67–92), and the median score for non-crisis teams was 60 (range 48–72). Conclusions With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.

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“…The standards could provide national-level benchmarking data about practice and variation in TMCD services, information which is useful to policy makers and service planners. The CORE adult crisis team delity scale provides an example of this as it was used in a national survey (21), and is recommended in policy (22).…”

Section: Discussionmentioning

confidence: 99%

Developing a model of best practice for teams managing crisis in people with dementia: A consensus approach

Yates

Stanyon

Challis

et al. 2020

Preprint

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Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia. Methods: The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing). Results: 165 candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48-92/100. The median score for the crisis teams was 74.5 (range 67-92), and the median score for non-crisis teams was 60 (range 48-72).Conclusions: With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.

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Crisis resolution and home treatment in the UK: A survey of model fidelity using a novel review methodology

Cited by 23 publications

References 25 publications

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach

Developing a model of best practice for teams managing crisis in people with dementia: A consensus approach

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