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Development of a measure of model fidelity for mental health Crisis Resolution Teams

Lloyd-Evans, Brynmor, Bond, Gary R., Ruud, Torleif, Ivanecka, Ada, Gray, Richard, Osborn, David, Nolan, Fiona, Henderson, Claire, Mason, Oliver, Goater, Nicky, Kelly, Kathleen, Ambler, Gareth, Morant, Nicola, Onyett, Steve, Lamb, Danielle, Fahmy, Sarah, Brown, Ellie, Paterson, Beth, Sweeney, Angela, Hindle, David, Fullarton, Kate, Frerichs, Johanna and Johnson, Sonia 2016, Development of a measure of model fidelity for mental health Crisis Resolution Teams, BMC psychiatry, vol. 16, no. 1, pp. 1-12, doi: 10.1186/s12888-016-1139-4.

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Title Development of a measure of model fidelity for mental health Crisis Resolution Teams
Author(s) Lloyd-Evans, Brynmor
Bond, Gary R.
Ruud, Torleif
Ivanecka, Ada
Gray, Richard
Osborn, David
Nolan, Fiona
Henderson, Claire
Mason, Oliver
Goater, Nicky
Kelly, Kathleen
Ambler, Gareth
Morant, Nicola
Onyett, Steve
Lamb, Danielle
Fahmy, Sarah
Brown, Ellie
Paterson, Beth
Sweeney, Angela
Hindle, David
Fullarton, Kate
Frerichs, Johanna
Johnson, Sonia
Journal name BMC psychiatry
Volume number 16
Issue number 1
Article ID 427
Start page 1
End page 12
Total pages 12
Publisher Nature Publishing
Place of publication London, Eng.
Publication date 2016-12-01
ISSN 1471-244X
Keyword(s) Acute care
Crisis Resolution Team
Fidelity
Implementation
Mental health services
Crisis Intervention
Humans
Mental Disorders
Mental Health
Psychometrics
Quality Indicators, Health Care
Reproducibility of Results
Surveys and Questionnaires
Science & Technology
Life Sciences & Biomedicine
Psychiatry
OUTCOMES
ENGLAND
SCALE
VALIDATION
ADMISSIONS
SERVICES
CARE
Summary Background
Crisis Resolution Teams (CRTs) provide short-term intensive home treatment to people experiencing mental health crisis. Trial evidence suggests CRTs can be effective at reducing hospital admissions and increasing satisfaction with acute care. When scaled up to national level however, CRT implementation and outcomes have been variable. We aimed to develop and test a fidelity scale to assess adherence to a model of best practice for CRTs, based on best available evidence.

Methods

A concept mapping process was used to develop a CRT fidelity scale. Participants (n = 68) from a range of stakeholder groups prioritised and grouped statements (n = 72) about important components of the CRT model, generated from a literature review, national survey and qualitative interviews. These data were analysed using Ariadne software and the resultant cluster solution informed item selection for a CRT fidelity scale. Operational criteria and scoring anchor points were developed for each item. The CORE CRT fidelity scale was then piloted in 75 CRTs in the UK to assess the range of scores achieved and feasibility for use in a 1-day fidelity review process. Trained reviewers (n = 16) rated CRT service fidelity in a vignette exercise to test the scale’s inter-rater reliability.

Results
There were high levels of agreement within and between stakeholder groups regarding the most important components of the CRT model. A 39-item measure of CRT model fidelity was developed. Piloting indicated that the scale was feasible for use to assess CRT model fidelity and had good face validity. The wide range of item scores and total scores across CRT services in the pilot demonstrate the measure can distinguish lower and higher fidelity services. Moderately good inter-rater reliability was found, with an estimated correlation between individual ratings of 0.65 (95% CI: 0.54 to 0.76).

Conclusions
The CORE CRT Fidelity Scale has been developed through a rigorous and systematic process. Promising initial testing indicates its value in assessing adherence to a model of CRT best practice and to support service improvement monitoring and planning. Further research is required to establish its psychometric properties and international applicability.
Language eng
DOI 10.1186/s12888-016-1139-4
Field of Research 1103 Clinical Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30110808

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.