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What matters when implementing Flexible Assertive Community Treatment in a Swedish healthcare context : A two-year implementation study

Svensson, Bengt LU ; Hansson, Lars LU ; Markström, Urban and Lexén, Annika LU (2017) In International Journal of Mental Health Nursing p.1-15
Abstract

Despite the lack of scientific evidence for the effectiveness of Flexible Assertive Community Treatment (Flexible ACT), the model disseminates rapidly in the mental health services in a number of countries. This is in contrast to many evidence-based practices that often face comprehensive implementation barriers. Knowledge is needed on the dissemination of Flexible ACT to understand the relative success. The aim of this study was to explore program fidelity and factors influencing the implementation of Flexible ACT in a Swedish healthcare context over a 2-year period. Seven mental healthcare teams who decided to implement Flexible ACT were included in the study. Interviews were conducted regularly with project leaders and team leaders,... (More)

Despite the lack of scientific evidence for the effectiveness of Flexible Assertive Community Treatment (Flexible ACT), the model disseminates rapidly in the mental health services in a number of countries. This is in contrast to many evidence-based practices that often face comprehensive implementation barriers. Knowledge is needed on the dissemination of Flexible ACT to understand the relative success. The aim of this study was to explore program fidelity and factors influencing the implementation of Flexible ACT in a Swedish healthcare context over a 2-year period. Seven mental healthcare teams who decided to implement Flexible ACT were included in the study. Interviews were conducted regularly with project leaders and team leaders, and steering group meeting notes and implementation progress reports were collected during a 2-year period. Flexible ACT fidelity assessments were conducted 6 and 18 months after implementation started. Data was analysed using conventional and directed content analysis and the Sustainable Implementation Scale. All teams reached at least good fidelity 6 months after implementation, and the fidelity scores remained stable over an 18-month period. An active national initiative and support to implement Flexible ACT, as well as a willingness among managers and staff to implement the model, contributed to the seemingly swift and easy implementation. Despite the highly sectored Swedish healthcare context, implementation of high fidelity Flexible ACT was possible. Positive mental health professional attitudes, belief in the practice, and desire to offer the practice appear to have central roles when implementing new practice models in mental healthcare.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Evidence-based practice, implementation, integrated care, mental health, severe mental illness
in
International Journal of Mental Health Nursing
pages
15 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85025128342
ISSN
0020-7411
DOI
10.1080/00207411.2017.1345041
language
English
LU publication?
yes
id
10567aa3-b421-452b-958b-92397352d698
date added to LUP
2017-08-25 16:14:57
date last changed
2018-02-25 04:18:54
@article{10567aa3-b421-452b-958b-92397352d698,
  abstract     = {<p>Despite the lack of scientific evidence for the effectiveness of Flexible Assertive Community Treatment (Flexible ACT), the model disseminates rapidly in the mental health services in a number of countries. This is in contrast to many evidence-based practices that often face comprehensive implementation barriers. Knowledge is needed on the dissemination of Flexible ACT to understand the relative success. The aim of this study was to explore program fidelity and factors influencing the implementation of Flexible ACT in a Swedish healthcare context over a 2-year period. Seven mental healthcare teams who decided to implement Flexible ACT were included in the study. Interviews were conducted regularly with project leaders and team leaders, and steering group meeting notes and implementation progress reports were collected during a 2-year period. Flexible ACT fidelity assessments were conducted 6 and 18 months after implementation started. Data was analysed using conventional and directed content analysis and the Sustainable Implementation Scale. All teams reached at least good fidelity 6 months after implementation, and the fidelity scores remained stable over an 18-month period. An active national initiative and support to implement Flexible ACT, as well as a willingness among managers and staff to implement the model, contributed to the seemingly swift and easy implementation. Despite the highly sectored Swedish healthcare context, implementation of high fidelity Flexible ACT was possible. Positive mental health professional attitudes, belief in the practice, and desire to offer the practice appear to have central roles when implementing new practice models in mental healthcare.</p>},
  author       = {Svensson, Bengt and Hansson, Lars and Markström, Urban and Lexén, Annika},
  issn         = {0020-7411},
  keyword      = {Evidence-based practice,implementation,integrated care,mental health,severe mental illness},
  language     = {eng},
  month        = {07},
  pages        = {1--15},
  publisher    = {Wiley-Blackwell},
  series       = {International Journal of Mental Health Nursing},
  title        = {What matters when implementing Flexible Assertive Community Treatment in a Swedish healthcare context : A two-year implementation study},
  url          = {http://dx.doi.org/10.1080/00207411.2017.1345041},
  year         = {2017},
}