Multidisciplinary Team Models
Are SARTs Effective?96
The current empirical literature on the effectiveness of SARTs is limited and has not assessed impact from the patient's perspective; however, the research suggests that SARTs can lead to:
- Improved multidisciplinary relationships in terms of increased cross-system contact and information exchange, understanding of one another’s roles, and collective decisionmaking;
- Improved legal factors and outcomes, such as victim participation, delays in reporting, amount of forensic evidence collected, and arrest and charging rates; and
- Increased rates of victim referrals to services, such as transportation to the hospital, and rape crisis counseling.
Similar to the traditional ED response to sexual assault that inspired the creation and implementation of SANE programs, the uncoordinated and inadequate community response to sexual assault catalyzed the creation of multidisciplinary teams (MDT), sexual assault response teams (SART), and sexual assault response and resource teams (SARRT).91 ,92 Respecting community uniqueness means accepting that the development and function of the MDT may vary significantly from one community to another. While different communities use different names to refer to their multidisciplinary coordinated community efforts, and we will alternate between these different terms in this Guide (i.e., MDT; SART; SARRT), they serve the same purpose—to improve the community response to sexual assault by bringing together multidisciplinary sexual assault stakeholders.93 Through cross-system coordination, these teams frequently aim to improve victims’ experiences when seeking help, engage in prevention education, and achieve more desired legal outcomes.94 MDTs have been widely adopted across the United States, and MDT implementation is considered a best practice in the response to sexual assault.95
While SARTs frequently operate in communities with established SANE programs,97 it does not mean that the MDT must be initiated and lead by the SANE program. While medical/forensic examiners sometimes assume the role of MDT leader, it is more common for rape crisis center advocates or staff to act as the formal leader of the SART.98 Just as a SANE program can be initiated by different community members (see section 3.6), the SART can too, and may come before, after, or in absence of SANE program implementation. Community needs assessments (see section 3.3) can help in determining how to best meet the needs of your community.
Today, there are hundreds of SARTs in operation. While there are numerous resources on SART development (e.g., see NSVRC resources), there is not a single standardized SART model. As such, SART operations, and the degree to which these operations are institutionalized, vary across communities. Table 1 lists some of the common MDT activities and the frequency with which they are implemented and institutionalized. The key goal of the MDT is to coordinate patient/victim/client/survivor services across systems; therefore, in addition to the activities listed in Table 1, MDTs will, for example, ensure that victims who report to the police are informed about medical/forensic services and are given the opportunity to have an advocate accompany them to court hearings.
What kinds of communities do SARTs serve?
| Number of Counties Served | Region Served | Community Size Served | |||
| One County | 75% | South | 31% | Rural (< 500 people/sq. mi.) | 66% |
| Partial County | 19% | Midwest | 29% | ||
| 2+ Counties | 6% | West | 25% | Non-Rural | 34% |
| Northeast | 15% | ||||
Table 1. SART Activities*99 (Greeson & Campbell, 2015)
| Collaborative Activities | % of SARTs engaging in this activity at all | % of SARTs engaging in this activity on a regular basis |
|---|---|---|
| Policy/protocol development and review | 82.5% | 31.2% |
| Multidisciplinary cross-trainings | 76.0% | 38.0% |
| Trainings conducted by non-SART members | 74.3% | 22.8% |
| Development or adoption of memorandums of understanding between different stakeholder groups | 69.6% | 23.2% |
*These data do not include MDTs that served child victims exclusively.