title: Can a facilitated programme promote effective multidisciplinary audit in secondary care teams? An exploratory trial.
abstract: This 24-month exploratory study evaluated whether a 6-month programme supported by a trained external facilitator was feasible, acceptable and led to the adoption of a multidisciplinary approach to audit by secondary care staff. Undertaken in five acute hospital sites in the East Midlands UK, 22 multidisciplinary teams were randomised to either an intervention or control arm. Employing mixed methods, a range of outcomes, including collaborative behaviour, was measured. The intervention was feasible and acceptable to staff. Involvement in the facilitated programme had a positive impact on self-reported knowledge (P=0.000 post-intervention and at 4-months follow-up), skills (P=0.000 post-intervention and P=0.02 at 4-months follow-up) and attitudes (P<0.01 post-intervention), appeared to have some influence on improving self-reported (P<0.05 post-intervention) and observed collaborative behaviour (P=0.01) and led to better quality audit resulting in measurable improvements to care. Improved collaborative behaviour may have resulted from an increase in assertive behaviour by nurses. Research to test approaches to support teams to work effectively together is currently hampered by a lack of suitable research instruments and needs addressing before main (phase 111) trials are undertaken.
authors.affiliation: School of Healthcare Studies, Baines Wing, University of Leeds, Leeds LS2 9UT, UK. f.m.cheater@leeds.ac.uk
authors.forename: Francine M
authors.initials: FM
authors.lastname: Cheater
authors.forename: Hilary
authors.initials: H
authors.lastname: Hearnshaw
authors.forename: Richard
authors.initials: R
authors.lastname: Baker
authors.forename: Michael
authors.initials: M
authors.lastname: Keane
mesh_terms: D001242:Assertiveness; D003299:Cooperative Behavior; D005240:Feasibility Studies; D007722:Health Knowledge, Attitudes, Practice; D006779:Hospitals, Public / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007318:Inservice Training; D008485:Medical Audit / Q000458:organization & administration*; D010348:Patient Care Team; D012107:Research Design; D006113:United Kingdom