title: Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation.
abstract: Reflective practice is used increasingly to enhance team functioning and service effectiveness; however, there is little evidence of its use in interdisciplinary teams. This paper presents the qualitative evaluation of the Interdisciplinary Management Tool (IMT), an evidence-based change tool designed to enhance interdisciplinary teamwork through structured team reflection. The IMT incorporates three components: an evidence-based resource guide; a reflective implementation framework based on Structured, Facilitated Action Research for Implementation methodology; and formative and summative evaluation components. The IMT was implemented with intermediate care teams supported by independent facilitators in England. Each intervention lasted 6 months and was evaluated over a 12-month period. Data sources include interviews, a focus group with facilitators, questionnaires completed by team members and documentary feedback from structured team reports. Data were analysed qualitatively using the Framework approach. The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resource use; need for role clarity and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues identified. Participants valued dedicated time to focus on the processes of team functioning; however, some were uncomfortable with a focus on teamwork at the expense of delivering direct patient care. The IMT is a relatively low-cost, structured, reflective way to enhance team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective teamwork, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take for reflection, and executive support to be able to broker changes that are beyond the scope of the team.
authors.affiliation: Health and Human Sciences, Southern Cross University, East Lismore, New South Wales, Australia.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Nancarrow
authors.affiliation: Centre for Leadership in Health and Social Care, Sheffield Hallam University, Sheffield, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Smith
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Ariss
authors.affiliation: School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Enderby
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D004739:England; D017144:Focus Groups; D006284:Health Plan Implementation / Q000379:methods*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D015279:Organizational Culture; D010348:Patient Care Team; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: action research; interdisciplinary; intermediate care; interprofessional; reflective teamwork; transition care