Optimising team functioning, preventing relapse and enhancing recovery in Crisis Resolution Teams (CRTs): the CORE Programme (Crisis team Optimisation and RElapse prevention) CORE Phase 4: A Cluster Randomised Controlled Trial: Evaluation of implementation of a CRT Resource Kit

ISRCTN ISRCTN47185233
DOI https://doi.org/10.1186/ISRCTN47185233
Secondary identifying numbers 16636
Submission date
14/08/2014
Registration date
14/08/2014
Last edited
16/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Crisis Resolution Teams (CRTs) have been set up across England in the last decade to provide rapid assessment and intensive home treatment for people experiencing mental health crises, and prevent hospital admission when possible. Research suggests CRTs reduce hospital admissions and healthcare costs and increase service users' satisfaction with acute care. However, their impact appears to vary between areas and service users and carers report some areas of dissatisfaction with CRT care. There is still uncertainty about how CRTs should be organised and what the critical ingredients of care are. The aim of this study is to evaluate the impact of a CRT resource kit upon service user satisfaction with CRT care. Resource kits consist of guidance, training materials, and coaching and support for service managers and staff. We think that using the resource kit will decrease hospital admissions and improve staff morale.

Who can participate?
Crisis Resolution Teams (CRTs) in the UK

What does the study involve?
Participating CRTs are randomly allocated to either receive a CRT resource kit over a one-year period, or to not receive a CRT resource kit. Service user satisfaction, hospital admission rates and staff morale are compared between the two groups.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
University College London (UK)

When is the study starting and how long is it expected to run for?
July 2014 to April 2017

Who is funding the study?
NIHR Programme Grants for Applied Research (UK)

Who is the main contact?
Dr Brynmor Lloyd-Evans
b.lloyd-evans@ucl.ac.uk

Study website

Contact information

Dr Brynmor Lloyd-Evans
Scientific

Department of Mental Health Sciences
Charles Bell House
67-73 Riding House Street
London
W1W 7EJ
United Kingdom

Email b.lloyd-evans@ucl.ac.uk

Study information

Study designRandomised; Interventional; Design type: Process of Care
Primary study designInterventional
Secondary study designCluster randomised trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleOptimising team functioning, preventing relapse and enhancing recovery in Crisis Resolution Teams (CRTs): the CORE Programme (Crisis team Optimisation and RElapse prevention) CORE Phase 4: A Cluster Randomised Controlled Trial: Evaluation of implementation of a CRT Resource Kit
Study acronymCORE: Phase 4
Study objectivesAim: The primary aim is to evaluate the impact of a CRT resource kit upon service user satisfaction with CRT care.

Hypothesis: We hypothesise that the implementation of the CRT resource kit will result in an increase in a CRTs fidelity score. Following on from this, we predict that service user satisfaction and perceived continuity of care will be greater in CRTs that receive the resource kit compared to those that do not. In terms of service measures, we hypothesise that teams randomised to receive the resource kit, when compared to those that do not receive the intervention, will have fewer hospital admissions, compulsory admissions and inpatient bed days (adjusting for population size of the catchment area). We also predict that staff morale, wellbeing and job involvement will be greater in teams that receive the resource kit.
Ethics approval(s)First MREC approval date 13/03/2014, ref: 14/LO/0107
Health condition(s) or problem(s) studiedTopic: Mental Health; Subtopic: Psychosis; Disease: Psychosis
InterventionThis is a multi-site, cluster-randomised controlled trial (with CRT service as the unit of randomisation) comparing outcomes for 15 CRTs that receive a CRT resource kit over a one-year study period, with 10 CRTs that do not.

CORE CRT Resource Kit: The CRT resource kit is a team-level intervention, designed to provide guidance and coaching to help CRT managers and staff implement sustainable changes to service organisation and practice. It will be delivered and supported by a resource kit facilitator in each service.

Follow-Up Length: 12 month(s); Study Entry: Registration and One or More Randomisations
Intervention typeOther
Primary outcome measureService user satisfaction with CRT care measured by Client Satisfaction Questionnaire; Timepoint(s): Approx. 12 months after commencement of intervention compared to baseline
Secondary outcome measures1. Patient Records Admission Data (admission rates, bed use and readmissions to acute care); Timepoint(s): Admissions and readmissions over 6 months
2. Service user experienced continuity of care measured using Continu-um; Timepoint(s): Approx. 12 months after commencement of intervention compared to baseline
3. The General Health Questionnaire- Staff; Timepoint(s): Baseline and 12 months
4. Maslach Burnout Inventory - Staff; Timepoint(s): Baseline and 12 months
5. The Work Engagement Scale - Staff; Timepoint(s): Baseline and 12 months
6. The Work-Related Acceptance and Action Questionnaire - Staff; Timepoint(s): Baseline and 12 months
Overall study start date16/07/2014
Completion date30/04/2017

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 1265; UK Sample Size: 1265
Key inclusion criteriaService user inclusion criteria:
Adults (aged 18+) who have been on the caseload of a participating Crisis Resolution Team for at least a week

CRT inclusion criteria:
UK CRT

Target Gender: Male & Female; Lower Age Limit 18 years
Key exclusion criteriaService user exclusion criteria:
1. People who lack capacity to consent to take part in the study
2. People who in the view of the clinical team at their Crisis Resolution Team present such a high risk of harm to others, it would be unsafe for researchers to contact them about participation, even just by phone or email.
3. People who are discharged to addresses outside the catchment area.
4. People who cannot understand the study information sheet or questionnaire when delivered in English.

CRT exclusion criteria:
1. CRT teams identified in a previous national survey conducted at an earlier stage of the CORE study as already operating at high fidelity (mean item score above 4) - i.e. teams with comparatively little capacity for service improvement
2. CRT teams where major change to the organisation of the service is planned during the duration of the trial
3. CRTs taking part in the concurrent CORE Phase 3 trial
Date of first enrolment16/07/2014
Date of final enrolment31/12/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University College London
London
W1W 7EJ
United Kingdom

Sponsor information

Camden and Islington NHS Foundation Trust (UK)
Hospital/treatment centre

Early Intervention Services
125-133 Camden High Street
London
NW1 7JR
England
United Kingdom

ROR logo "ROR" https://ror.org/03ekq2173

Funders

Funder type

Government

National Institute for Health Research Programme Grants for Applied Research (UK); Grant Codes: RP-PG-0109-10078
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 22/03/2016 Yes No
Results article results 01/04/2019 16/04/2019 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

16/04/2019: Publication reference added.
07/12/2016: The overall trial end date was changed from 31/12/2015 to 30/04/2017.
13/04/2016: Plain English summary added.
23/03/2016: Publication reference added.