Page 113 - Demo

Implementation interventions through the lens of Normalisation Process Theory1114processes and foster collaboration between various disciplines (Carney, 2007). This also underscores the need for Collective Action across various care disciplines. The importance of Collective Action is reflected in the amount and diversity of implementation interventions acting across this social mechanism, especially when relative to the NPT-EPOC framework of Johnson and May (2015). Collective action is about how to perform a practice (May et al., 2009). Since MDET is a complex method, based on a broad domain of evidence based knowledge and treatment, advices on how to implement the method and how to reduce restrictive measures need to be tailored to the specific circumstances in an organisation, in a group home and to their clients individual needs. Within each phase of MDET components of the method can be mould to fit these specific circumstances and needs, which is referred to as the plasticity of the method (May et al., 2016). However, the core components of the method MDET must remain intact to guarantee effectiveness of the method and to work collectively towards the same goals and outcomes (Chambers & Norton, 2016). Therefore, all involved professionals of various disciplines need to align their support and behaviour. In order to make collective action possible, changes in interpersonal interactions and group processes throughout all layers of a long-term care organisation might be needed, which is referred to as the elasticity of relations within an organisation (May et al., 2016). The degree to which professionals within a long-term care organisation are prepared to restructure their relations, and adapt their individual and collective behaviour to the requirements of the new method and its goals determines the outcomes of an implementation process (May et al., 2016). The relational work that the coordinator researcher, MDET-experts, local opinion leaders and support staff did to collaborate, engage in the new method, and pursue the shared goals regarding reduction of restrictive measures is captured in the social mechanism Cognitive Participation (Hall et al., 2017).