Observing Interoperability: A behavioural framework and analysis of multi-agency interactions in the UK emergency services

Introduction

To the authors’ best knowledge, there have been no prior attempts to operationalise measures of interoperability. As such, we chose to base our framework on our previous theoretical work, which identified that there were five core components of effective interoperability: trust, identity, goals, flexibility and communication (Power et al., 2024).

To support you we have created a list of items to consider when observing teams to assess whether they are working together effectively or not (see Table 1). Simply ask yourself whether the teams are high or low on the below components: 

(Download Guide to see Table 1. Behavioural measures of interoperability)

Behaviours during each multi-agency meeting can be observed and may help to predict whether team members are more or less siloed after these meetings (see Table 2). Try to assess whether high markers of interoperability during multi-agency meetings led to less siloed interactions post-meeting.

(Download Guide to see Table 2. Behavioural measures of interpersonal engagement)

Figure 1. Anonymised examples of affiliative touching, i.e., Physical trust (left hand image), open gesturing (middle image), closed gesturing (right hand image). Illustrations by Charlotte Betts (reproduced from Philpot et al., 2025).

Watch out for:

• Overall, responders in our study were significantly more likely to cluster with individuals from their own organisation in comparison to their multi-agency colleagues.
• Effective communication (i.e., sharing relevant information among personnel in a clear and efficient manner) was the most frequently observed interoperability component during multi-agency meetings. Yet was positively associated with individuals speaking to and displaying open gestures towards people from their own service rather than their multi-agency colleagues.
• Discussions about prioritising, aligning and achieving goals were frequent during multi-agency meetings, and were associated with a decrease in paying attention to, speaking to and showing more open gestures towards one’s own service team members, relative to members of other services.
• Markers of shared identity during multi-agency meetings were occasionally displayed and associated with a decrease in paying attention to and physically clustering with one’s own service team members, relative to members of other services.
• Trust was the least observed behavioural marker of interoperability, and flexibility was only moderately observed. 

So, what works to improve interoperability?

We found that there was less siloed interaction between team members when multi-agency meetings involved…

• …greater shared identity – such as using inclusive language (“we”, “us”, “blue lights”), sharing humour and laughter, and emphasising working as “one” team.
• …clear discussions of goals – such as aligning objectives, considering the interplay between goals, and discussing goal-relevant timescales and resources across services.

What’s next?

Our research was the first to develop a behavioural framework to measure interoperability. The next step is to refine this framework, developing a valid, reliable and simple to use psychometric scale to assess interoperability in-situ, providing robust measurement across services and contexts. In doing so, we will tackle the persistent challenge that exists around how to measure interoperability, creating a unique tool that can be used to guide future research, training and best practice.

If you have any feedback on this framework in terms of how you found it worked, what went well, or not so well, then please email Dr Nikki Power on n.power3@liverpool.ac.uk.

Download the Guide