Figure 1
The Integrated-Component Assessment Framework (I-CAF).
Table 1
Key values, benefits, and challenges of multi-professional working as identified by the scoping review.
| VALUES | BENEFITS | CHALLENGES |
|---|---|---|
| Early intervention | Cost-effectiveness | Budgetary restrictions |
| Trust | Improved outcomes | Staff turnover |
| Communication | Patient satisfaction | Lack of understanding |
| Collaboration | Knowledge sharing | Poor communication |
| Equity | Faster assessments | Mistrust |
| Empowerment | Improved patient reach | Access to records |
| Quality improvement | Increased engagement | Differing priorities |
| Innovation | Fewer admissions | Poorly defined responsibility |
| Accessibility | Shorter hospital stays | Time restraints |
| Sustainability | Fewer crisis referrals | ‘Territorial’ behaviour |
Table 2
Top five ranked statements by participants in each domain.
| IMPORTANCE | IMPACT | EASE OF COLLECTION | COMBINED | |
|---|---|---|---|---|
| 1 | Delivery of safe, high quality, effective care | Delivery of safe, high quality, effective care | Staff retention | Staff retention |
| 2 | Person receiving timely, coordinated, collaborative care | Person receiving timely, coordinated, collaborative care | Regular multi-professional meetings | Staff satisfaction |
| 3 | Respect for others | Staff wellbeing | Staff satisfaction | Using shared IT systems |
| 4 | Valuing the peoples’ voice | Maximising people’s independence | Using shared IT systems | Staff wellbeing |
| 5 | Enabling people to have involvement in their care | Positive leadership | Co-location of services | Measuring service user perspective |
Table 3
An overview of the eight domains and 45 indicators included in the DMI.
| DOMAIN | INDICATORS |
|---|---|
| 1. Buy-in | 1.1 | Connections with people, patients and the wider public |
| 1.2 | Strategic and senior leader engagement | |
| 1.3 | Influence within key organisations (health board and/or local authority and/or third sector) processes | |
| 1.4 | Buy-in of other professionals | |
| 2. Internal relationships, collaboration, and cohesion | 2.1 | Internal leadership and culture |
| 2.2 | Shared vision, common direction, culture and purpose | |
| 2.3 | Opportunities for meeting and discussion | |
| 2.4 | Networking with others | |
| 2.5 | Communication between professionals | |
| 3. External relationships | 3.1 | Engagement with social services |
| 3.2 | Engagement with the third sector | |
| 3.3 | Engagement with secondary care/community hospitals | |
| 3.4 | Engagement with primary care | |
| 3.5 | Engagement with other key stakeholders [only if additional and relevant to 3.1, 3.2, 3.3, 3.4] | |
| 4. Information sharing and governance | 4.1 | Appropriate IT systems access |
| 4.2 | Communication between IT systems | |
| 4.3 | Record keeping | |
| 4.4 | Confidentiality and consent | |
| 4.5 | Clear policies and procedures | |
| 4.6 | Robust systems for information governance | |
| 5. Equity and equality | 5.1 | Geographical equity |
| 5.2 | Managing capacity | |
| 5.3 | Parity of esteem | |
| 5.4 | Voice of those closest to the person | |
| 6. Person-centred practice | 6.1 | Focus and responsivity of the service |
| 6.2 | Flexibility and responsivity of the practitioner | |
| 6.3 | Clear definition of professional roles | |
| 6.4 | Feedback from people supported by the service | |
| 6.5 | Clarifying what matters to the person the service is supporting | |
| 6.6 | Involvement and communication with a person’s support network (where appropriate to the needs of the person) | |
| 6.7 | Communication and language preferences | |
| 6.8 | Flows through the whole system | |
| 7. Resources – human and financial | 7.1 | Staff retention |
| 7.2 | Staff recruitment | |
| 7.3 | Budget | |
| 7.4 | Development of individual team | |
| 7.5 | Individual staff development | |
| 7.6 | Space for physical co-location | |
| 7.7 | Virtual co-location | |
| 8. Embedding data in practice | 8.1 | Culture of quality improvement and learning |
| 8.2 | Appropriate range of skills and systems | |
| 8.3 | Quality of data and evidence | |
| 8.4 | Embedding data in processes of improvement | |
| 8.5 | Shared learning between teams | |
| 8.6 | Co-production of service and quality improvement |