Abstract
BACKGROUND: Support for NHS staff was vital during the COVID-19 pandemic and Team Time was developed as an adaptation of Schwartz Rounds™ - a well-evidenced, facilitated group intervention. Building on the existing evidence base for Schwartz Rounds implementation, this study aims to understand the key factors associated with Team Time implementation and sustainability in this context. METHODS: Twenty semi-structured interviews were conducted within 10 NHS acute, community and mental health organisations that ran Team Time during the pandemic: six with no prior experience of Schwartz Rounds and four that ran Schwartz Rounds prior to the pandemic. Additionally, three Team Time mentors who provided support to these organisations were also interviewed. Data analysis was underpinned by the Consolidated Framework for Implementation Research (CFIR). Data were analysed thematically, and key implementation factors were mapped onto CFIR constructs using the Framework method to explore patterns. RESULTS: Implementation of Team Time was challenging in organisations that did not run Schwartz Rounds previously. Facilitating factors included having incentives in the outer setting (wider context of the organisation), the adaptability of the intervention, and wide ownership across the organisation. However, barriers to implementation were the perception that the intervention was complex and resource intensive and an unsupportive organisational culture and communication difficulties which hindered engagement. In those organisations which already ran Schwartz Rounds the burden of setting up the organisational infrastructure for Team Time was smaller and the implementation climate more supportive. CONCLUSIONS: Similar to Schwartz Rounds, Team Time needed broad and sustained organisational support for implementation to become embedded in organisations and deliver benefits. Implementing it as an entirely new and stand-alone online intervention during the pandemic was challenging. Team Time should therefore be considered as an addition to Schwartz Rounds and as part of a long-term organisational investment in staff psychological wellbeing, not as a short-term intervention in a period of crisis.