Evaluating the impact of team formulation on staff perceptions of patients and impact on care in an acute inpatient setting

Abstract

Team formulation is a widely used method of conceptualising mental health needs and aims to develop staff understanding of the complex challenges and behaviours that can occur when providing care; however, research understanding application to acute wards is limited. This study assessed whether team formulation using the Comprehend Cope Connect model in an acute inpatient setting impacted staff perceptions of patients, and whether it influenced subsequent care. A mixed- methods study with a primary repeated-measures, quantitative questionnaire design was used with staff self-rating their knowledge, understanding, confidence and motivation pre- and post-team formulation meetings and providing feedback about the helpfulness of the formulation. Patient notes were examined for evidence of formulation plan action points. Staff ratings increased significantly on all areas of knowledge (t = 10.89;p <0.001), understanding (t = 7.96;p <0.001), confidence (t = 7.74;p <0.001) and motivation (t = 11.12;p <0.001) following team formulation, with a significantly greater increase in confidence reported by less experienced staff. Feedback was positive, with the opportunity to learn and share information particularly valued. An inspection of clinical notes two weeks later found evidence of completion for almost 40% of actions identified in the plan from the formulation meeting (a 65% completion rate if actions which were unlikely to have been recorded in clinical notes within two weeks were excluded from the calculation). The results provide evidence of a positive impact on staff perceptions and patient care, and suggests that team formulation may particularly help less experienced staff to feel more confident.