Facilitators to IA Practice

Strong integrated multidisciplinary leadership was the most powerful facilitator of IA practice observed in the study. Units with strong multidisciplinary leadership reliably delivered IA. Facilitative leadership behaviours included reviewing induction lists, questioning CEFM use without risk factors, and providing bedside support. Third-sector and charity partnerships were considered useful because voluntary organisations already had relationships and cultural competence with target communities. Embedding the intervention in existing community programmes was identified as a way to reduce implementation overhead. Weekly multidisciplinary education meetings that treated IA as legitimate reinforced its credibility across professional boundaries. Direct AMU admission pathways reduced default CEFM initiation at admission. A peer review support model created a supportive and non-judgmental team culture in two units. Peer champions from pilot phases were expected to increase trust and recruitment among new participants. Handheld tablets enabled real-time bedside documentation where they were available. A staged scale-up approach was strongly recommended before regional and national expa…