Implementing the Multi-Disciplinary Expertise Team method to reduce involuntary care in intellectual disability care:...

Area of Science:

• Intellectual Disability Care
• Mental Health Services
• Healthcare Management

Background:

• Involuntary care in intellectual disability settings presents ethical and practical challenges.
• The Multi-Disciplinary Expertise Team (MDET) method previously demonstrated efficacy in reducing involuntary care.
• Understanding implementation variations is crucial for the successful scaling of interventions.

Purpose of the Study:

• To investigate how four organizations adapted the MDET method during its implementation.
• To assess the effectiveness of these adapted MDET versions in reducing involuntary care.
• To compare the impact of MDET implementation against care-as-usual (CAU).

Main Methods:

• Qualitative analysis of semi-structured interviews with MDET coordinators using the Framework Reporting Adaptions and Modifications-Expanded.
• Quasi-experimental interrupted time-series design to analyze weekly involuntary care recordings.
• Comparison between 24 care homes implementing MDET and care homes receiving CAU.

Main Results:

• Significant adaptations to the MDET method were observed across organizations.
• Common adaptations included omitting independent MDET teams and modifying involuntary care recording protocols.
• No significant difference in involuntary care recordings was found between MDET implementation and CAU groups.

Conclusions:

• Adaptations made during the scaling-out of the MDET method may have diminished its positive effects on reducing involuntary care.
• Implementation fidelity is critical for maintaining the effectiveness of interventions in intellectual disability care.
• Further research is needed to optimize MDET implementation strategies for diverse organizational contexts.