*This post was written by Adult Protection Network Director Kristy Preston.

Earlier this year, the UNC School of Government’s Adult Protection Network held six training events known as the “2024 Adult Protection Multidisciplinary Team Booster Shot Series” in regional locations across North Carolina including Transylvania, Alexander, Guilford, Robeson, Onslow, and Beaufort counties. The series aimed to foster collaboration, share resources, and address common challenges faced by adult protection multidisciplinary teams (MDTs). An MDT is a group of professionals in a geographic region who commit to working together toward a common goal.  An adult protection MDT works to find ways to prevent and respond to adult abuse, including physical, emotional, and sexual abuse, self-neglect and caretaker neglect, and exploitation, including financial exploitation.

The meetings in the Booster Shot Series were facilitated by Kristy Preston, Adult Protection Network Director, and Margaret Henderson, retired faculty from the School of Government. Meeting participants included professionals involved in the field of aging and adult services, including adult protection MDT coordinators, MDT members, and those who sought to form or join an MDT in their communities. The format of the meetings was informal, flexible, and responsive to the needs of those in attendance.

Establishing, growing, and sustaining an effective adult protection MDT requires a strategic approach that considers both the practical and interpersonal dynamics of collaborative work. The following tips are a collection and synthesis of insights, ideas, and strategies shared by participants at the meetings. These tips focus on the key areas of engagement, meeting logistics, team building, facilitation, strategic planning, education, and creative techniques. Whether a team is just forming or is well-established, these tips offer valuable guidance to strengthen partnerships, improve outcomes, and foster a collaborative culture dedicated to protecting vulnerable adults in our communities.

Below is a summary of the ideas that may be useful to the work of other adult protection MDTs.

1. Engagement and Recruitment

• Make Active Asks. As one participant noted, “the more passive the ask, the more passive the response.”  When engaging stakeholders to join or engage with the MDT, personal and active invitations yield the best results.
• Be Strategic about Who’s at the Table. When forming your MDT, carefully consider who should be involved. Decide whether you need agency leaders or frontline professionals to ensure effective collaboration. Expect that participation will evolve over time, both in terms of the organizations and job positions. Decision-makers might be necessary to start the MDT and encourage participation, but over time the responsibility of sustaining the MDT might shift to front-line professionals.
• Engage Missing Professions. If certain professions or organizations are absent from the table, invite their representatives to speak at future meetings. This can help fill gaps in expertise. Ask those professionals to host a meeting at their site and share how they work with vulnerable adults.
• Follow Up Individually. After meetings, follow up with newly engaged participants to thank them for their contributions, debrief the meeting, and reinforce their value to the team.
• Make Personal Invitations. When inviting people to join the MDT, be specific about why their participation is needed and how they can contribute to the team’s goals.
• Assign New Team Members a Mentor. Assign new team members a mentor who is an existing team member to help them integrate into the team and understand their role.

2. Meeting Preparation and Logistics

•  Address Meeting Logistics. Make sure logistics are uncomplicated and meet the needs of team members. Is there easy parking at the location where the meetings are held? Is there food available if the meeting is over lunch? Does the time of day chosen for the meeting work for most of the members of the group? Regularly check in with team members to determine whether meeting logistics need to be adjusted in the future to accommodate more members.
• Set a Schedule. Plan meeting dates well in advance and, if running a case review MDT, assign specific agencies to bring cases for review on designated dates. This allows agencies ample time to prepare cases and distributes the workload of identifying cases among multiple organizations.
• Distribute Meeting Agendas in Advance. Include the meeting agenda with a reminder of the meeting to ensure participants are prepared and know what to expect.
• Ensure the Team Has a Clear Purpose. Every meeting should have a well-defined reason for gathering. Advertise the purpose on the meeting agenda to remind participants why their attendance matters and what the team aims to accomplish. This keeps the group focused, motivated, and aligned with the broader goals of the MDT, ensuring that meetings are productive and meaningful.
• Use Name Tents at Every Meeting. Providing name tents with each person’s name and agency makes it easier for members, especially new members, to engage with one another.
• Pre-Fill Meeting Case Review. If the MDT is going to review a case at the meeting, the MDT coordinator should meet with the person bringing the case to the MDT before the meeting. Make sure they have the information they need to present the case and are given a clear plan as to how to present the case to the team, including understanding any legal limitations on their ability to share identifiable information with the team.
• Draft a List of Case Review Criteria. If using a case review MDT model, draft a list of case review criteria that guide MDT members and others about what types of cases the team will review. For example, if the team is focused on financial exploitation, include that as one of the criteria that must be met for a case to be reviewed by the MDT.

3. Team Building and Sustaining Relationships

•  Establish a “Baton Passing Culture.”  When agencies participating in an MDT have high turnover, work with the leadership of those agencies to ensure that there is a plan for succession. As staff transition, they may pass their work with the MDT to a new person taking over their position. Ask that the responsibility of participating in the MDT be written into job descriptions when feasible.
• Incorporate Networking Opportunities Allow scheduled time at the MDT meeting for informal networking, perhaps over snacks. Even if you can’t do this at every meeting, consider it once or twice a year to build relationships and introduce new members.
• Set up the Room for Engagement. Arrange the meeting space in a way that fosters interaction and participation among team members. If your MDT includes eight or fewer participants, sitting around a table is optimal. If your MDT is larger, consider having people sit at tables in groups of four to better enable conversations.
• Celebrate Successes and Support Each Other. Use MDT meetings as an opportunity to recognize and celebrate each other’s successes, reinforcing positive outcomes and team morale. Similarly, use the MDT to debrief the emotional impact of any disappointing cases or challenging personalities.
• Address Turnover Head On. When there is turnover in a specific position on the team, proactively engage with the new person joining the MDT. Share with them the purpose of the MDT, why it exists, and what role that agency or professional serves on the team.
• Address Problematic Relationships Separately. If certain agencies participating in the MDT have strained relationships, consider holding separate meetings outside the regular MDT sessions to address and resolve those issues.
• Rotate Meeting Locations. Consider hosting meetings at different agencies, especially those with new or lesser-known facilities, to showcase their work and foster a sense of shared ownership.
• Encourage Continuity Through Alternates. Invite participants to bring an alternate co-worker to MDT meetings when possible. This can introduce new members to the team’s work and help build continuity if someone misses a meeting. Having an alternate ensures that the agency’s voice and perspective are always present in the MDT and prepares future team members for successful participation.

4. Facilitating Effective Meetings

•  Ensure Well-Organized Meetings. Set a focused agenda with clear objectives. Keep meetings on time and ensure equitable participation without any single member dominating or disengaging from discussions. Express the clear outcomes expected for each meeting.
• Define Desired Outcomes at the Start. Begin each meeting by outlining the desired outcomes for the meeting. This helps keep discussions focused and goal-oriented.
• Develop Vision, Mission, and Value Statements. Create and display these statements on your meeting materials and review them at the start of each meeting to keep the team aligned with its core objectives. At the end of the meeting, assess how well the group practiced its values.
• Facilitate Complex Case Discussions. For a case review MDT, identify a skilled facilitator to guide discussions on especially complex cases, ensuring thorough and balanced input from all members.
• Address Confidentiality Proactively. Make sure confidentiality issues are clearly addressed and understood by all participants, including any limitations imposed by applicable confidentiality laws on the ability of MDT members to share identifiable client information with each other.
• Conduct Tabletop Case Reviews. Engage in tabletop reviews of fictional cases, similar to emergency management preparedness exercises, to explore different approaches and improve team responses.
• Discuss the “Building Multidisciplinary Teams” E-Learning Modules at a Meeting. Consider showing one of the Adult Protection Network’s thirteen MDT training modules at a meeting or ask participants to view it as pre-work to provide ongoing education and reinforce key concepts available on the Adult Protection Network website.
• End the Meeting with Reflective Feedback. Conclude each meeting by capturing participants’ reflections on what the group did well together, what they might want to strengthen in the future, or a topic they hope to focus on next time. This allows the team to identify successes, areas for improvement, and goals for future discussions, ensuring continuous growth and engagement.

5. Strategic Planning and Development

• Start Small and Build. Begin by addressing smaller, manageable issues within the MDT’s scope, not the larger societal challenges. Gradually expand efforts as momentum and collaboration grow within the team.
• Set Yearly Goals Based on Team Feedback. Regularly gather feedback from team members to inform goal-setting sessions at the beginning of each year. Adjust meeting logistics and substance based on this feedback to enhance overall effectiveness.
• Visit Other MDTs for Inspiration. If you are just starting a team or facing challenges, reach out to a neighboring county with a successful MDT. Ask to attend one of their meetings to gather ideas and insights.
• Educate During Meetings. Use meeting time to provide educational updates from team members on their programs, which creates a culture of continuous learning and development.
• Identify Types of Mutual Clients. Use meeting time to discuss the types of clients each profession represented in the MDT is working with. This can reveal overlapping interests, opportunities for collaboration, and emerging community trends.
• Work Old Cases First. If you are a new MDT involved in case review, initially focus on reviewing older cases instead of starting out by reviewing active cases. Identify things the MDT could have done differently or areas where the MDT could provide an effective, collaborative response. This approach helps in building cohesion within the team, identifying process improvements, and establishing effective workflows.

6. Creative Techniques for Engagement and Participation
   

• Be Intentional with Ice Breakers. Ice breakers aren’t just for opening the meeting. Ice breakers that relate to the work of the MDT can be a way to reenergize the group, refocus discussion, identify shared interests, or discover under-used resources. Consider adding ice breakers to the prepared agenda. Some group members might appreciate having the time to prepare their ideas ahead of time.
• Consider “Piggybacking” on Existing Meetings. If members of your MDT already meet regularly for another purpose, consider scheduling your MDT meeting after the other existing meeting to boost attendance and streamline schedules.
• Share the Load. Delegate roles and responsibilities among team members to keep everyone engaged and support the long-term sustainability of the effort.
• Discuss the Undiscussable. Encourage MDT members to address difficult or sensitive topics directly, as they are often the most important issues for the team to tackle. A topic that gets pushed aside multiple times during a meeting is probably a topic that needs attention. Creating a safe environment for open, honest discussion is critical to the effectiveness of the MDT’s work.
• Encourage Quiet Voices to Participate. Foster participation from quieter team members without putting them on the spot by incorporating an “around the table” check-in. Start with an easy or low-pressure question that everyone can answer, helping to ease participants into the discussion. This approach ensures all voices are heard and encourages input without singling anyone out.
• Attend a Guardianship Hearing. Arrange for team members to attend a guardianship hearing to gain insights into the legal process and enhance their understanding of the cases they review.

Connecting with Support

Perhaps you missed the Booster Shot Series and find these tips useful but still desire more support in your community on the topic of adult protection MDTs.

• Want to see if there’s an adult protection MDT in your county, or connect with others involved in this work? Our map of North Carolina shows which counties have active MDTs, along with contact information for their MDT coordinators.
• Need support for starting a new MDT or maintaining an existing one? Contact the Adult Protection Network’s Help Desk, which offers technical assistance and consultation for adult protection MDTs and professionals involved with protecting vulnerable adults.
• Need help developing a meeting agenda, recruiting new MDT members, or determining an MDT’s mission, vision, and values? Check out the Adult Protection Network’s MDT Toolkit, which contains multiple guidance documents and templates for adult protection MDTs in North Carolina.
• Want to receive regular email updates about training opportunities, resources, and insights in the adult protection field? Join the Adult Protection Network’s listserv for weekly updates.