Page 110 - Demo

Chapter 4108(Enrolment) and collectively believe that it was justified to be involved in reducing restrictive measures (Legitimation).To pursue Reflexive Monitoring Audit and Feedback (AF) and Consensus processes (CP) were used for Individual and Communal Appraisal. Clientrelated Interventions (CRI) in the form of recordings of restrictive measures in the clients%u2019 files were used to collect quantitative information about the effectiveness of MDET (Systematization).DiscussionLarge long-term intellectual disability care organisations in the Netherlands are known to be complex systems in which both clients and care professionals seek stability and predictability. Change is perceived as difficult and challenging, which complicates implementing innovations. Within this complex context this study explored the application of EPOC%u2019s professional implementation interventions (EPOC, 2002) to understand social mechanisms, as described by Normalisation Process Theory (May et al., 2009), at work in an implementation process. EPOC%u2019s professional implementation interventions needed to be tailored to match the content of implementation actions that we observed and to enhance granularity within EPOC%u2019s professional interventions to allow more accurate classification (Mazza et al., 2013). Although adaptations of implementation interventions in this study were made in the context of implementing MDET, interventions such as Consensus Processes (CP), Local Opinion Leaders (LOL) and Client Related Interventions (CRI) may also be useful for implementing other innovations in complex long-term care organisations. In contrast to Johnson and May%u2019s (2015) findings in their systematic review, we found that Consensus Processes involving Local Opinion Leaders may be widely effective in implementation processes in longterm intellectual disability care. This might be due to the integrative nature of this type of care in which professionals of various disciplines need to