Table 1 Distribution and median of fidelity scores on items for 28 Norwegian crisis resolution teams
Subscales and items | Fidelity | |||||
|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | Median | |
1.Referrals and accessibility | ||||||
1.The CRTs responds quickly to new referrals | 9 | 4 | 7 | 5 | 3 | 3 |
2.The CRT is easily accessible to all eligible referrers | 1 | 0 | 2 | 8 | 17 | 5 |
3.The CRT accepts referrals from all sources | 2 | 2 | 5 | 2 | 17 | 5 |
4.The CRT will consider working with anyone who would otherwise be admitted to adult acute psychiatric hospital | 0 | 0 | 0 | 7 | 21 | 5 |
5.The CRT provides a 24-h, seven days a week service | 28 | 0 | 0 | 0 | 0 | 1 |
6.The CRT has a fully impended “gatekeeping” role, assessing all patients before admission to acute psychiatric wards and deciding whether they are suitable for home treatment | 26 | 2 | 0 | 0 | 0 | 1 |
7.The CRT facilitates early discharge from hospital | 28 | 0 | 0 | 0 | 0 | 1 |
8.The CRT provides explanation and direction to other services for service users, carers and referrers regarding referrals which are not accepted | 0 | 1 | 5 | 17 | 5 | 4 |
9.The CRT responds to requests for help from service users and carers whom the CRT is currently supporting | 2 | 2 | 1 | 18 | 5 | 4 |
10.The CRT is a distinct service which only provides crisis assessment and brief home treatment | 10 | 7 | 7 | 4 | 0 | 2 |
2.Content and delivery of Care | ||||||
11.The CRT conducts a comprehensive assessment for all service users accepted for CRT support | 2 | 4 | 7 | 1 | 14 | 4 |
12.The CRT provides clear information to service users and families about treatment and visits | 0 | 1 | 21 | 5 | 1 | 3 |
13.The CRT closely involves and works with families and wider social networks in supporting service users | 11 | 7 | 5 | 3 | 2 | 2 |
14.The CRT assesses carers’ needs and offers carers emotional and practical support | 0 | 23 | 4 | 1 | 0 | 2 |
15.The CRT reviews, prescribes and delivers medication for all service users when needed | 17 | 7 | 4 | 0 | 0 | 1 |
16.The CRT promotes service user’ and carers’ understanding of illness and medication and addresses concerns or problems with medication | 8 | 16 | 3 | 0 | 1 | 2 |
17.The CRT provides psychological interventions | 0 | 1 | 2 | 17 | 8 | 4 |
18.The CRT considers and addresses service users’ physical health needs | 5 | 5 | 5 | 11 | 2 | 3 |
19.The CRT helps service users with social and practical problems | 0 | 1 | 14 | 5 | 8 | 3 |
20.The CRT provides individualized care | 1 | 2 | 3 | 8 | 14 | 4 |
21.CRT staff visits are long enough to discuss service users’ and families’ concerns | 0 | 1 | 8 | 12 | 7 | 4 |
22.The CRT prioritises good therapeutic relationships between staff and service users and carers | 0 | 3 | 25 | 0 | 0 | 3 |
23.The CRT offers service users choice regarding location, timing and types of support | 1 | 1 | 6 | 17 | 3 | 4 |
24.The CRT helps plan service users’ and service responses to future crises | 27 | 0 | 0 | 0 | 1 | 1 |
25.The CRT plans aftercare with all service users | 3 | 22 | 3 | 0 | 0 | 2 |
26.The CRT prioritises acceptability to service users in how CRT care is ended | 2 | 7 | 3 | 9 | 7 | 4 |
3.Staffing and team organisation | ||||||
27.The CRT has adequate staffing levels | 15 | 2 | 3 | 3 | 5 | 1 |
28.The CRT has a psychiatrist or psychiatrists in the CRT team, with adequate staffing levels | 3 | 9 | 1 | 0 | 15 | 5 |
29.The CRT is a full multi-disciplinary staff team | 7 | 5 | 9 | 6 | 1 | 3 |
30.The CRT provides a thorough introduction program for new staff and ongoing training and supervision in core competencies for CRT staff | 21 | 4 | 2 | 1 | 0 | 1 |
31.The CRT has comprehensive risk assessment and risk management procedures, including procedures for safeguarding children and vulnerable adults living with CRT service users | 14 | 8 | 5 | 1 | 0 | 1 |
32.The CRT has systems to ensure the safety of CRT staff members | 2 | 13 | 4 | 5 | 4 | 2 |
33.The CRT has effective record keeping and communication procedures to promote teamwork and information sharing between CRT staff | 2 | 11 | 6 | 7 | 2 | 3 |
34.The CRT works effectively with other community services | 5 | 13 | 8 | 1 | 1 | 2 |
35The CRT takes account of equality and diversity in all aspects of service provision | 0 | 5 | 21 | 2 | 0 | 3 |
36.The CRT has systems to provide consistency of staff and support to a service user during a period of CRT care | 0 | 4 | 6 | 5 | 13 | 4 |
4.Location and timing of care | ||||||
37.The CRT can access a range of crisis services to help provide an alternative to hospital admission for service users experiencing mental health crisis | 8 | 9 | 10 | 1 | 0 | 2 |
38.The CRT provides frequent visits to service users | 27 | 1 | 0 | 0 | 0 | 1 |
39.The CRT mostly assesses and supports service users in their home | 17 | 7 | 1 | 0 | 3 | 1 |