Page 184 - Demo

Chapter 71822020; Powell et al., 2015). Implementation interventions aimed at changing behaviour of professionals, as described by the Cochrane Effective Practice and Organisation of Care (EPOC) Review Group (Cochrane Epoc, 2002), may activate social mechanisms that lead to the implementation of innovations in daily practice of care professionals (Johnson & May, 2015). The study described in Chapter 4 qualitatively analysed professional implementation interventions (Cochrane Epoc, 2002) used in one intellectual disability care organisation, during a previous trial by Schippers (2019) in which the MDET method was found effective in reducing involuntary care. Implementation interventions most frequently used to change professionals%u2019 behaviour included Consensus Processes and Local Opinion Leaders. Consensus Processes were defined as discussions with those directly or indirectly involved in providing care to clients to achieve consensus about, in this case, involuntary care reductions. Local Opinion Leaders were defined as professionals who have a significant influence on care teams, for example care staff coordinators, team leaders, physicians, managers, or behavioural specialists22. The fact that these implementation interventions were most prominent reflects the integrative and collaborative nature of intellectual disability care, in which many care professionals from different backgrounds need to work together to provide care, support and treatment. The importance of the implementation intervention Local Opinion Leaders was also underscored in the study described in Chapter 3. Based on their experiences and tacit knowledge, care professionals mentioned the use of %u201cimplementation champions%u201d to bring innovations further as a potential useful implementation intervention. With implementation champions they meant professionals with a significant influence on care teams. They also noted, however, that these individuals must be well chosen and facilitated, and their mission must be clear, to prevent this strategy from backfiring.Client-Related Interventions as an implementation intervention also appeared to be key in motivating care staff. Although involving clients%u2019 2%u2003 Behaviour specialists include psychologists focusing on treating clients' problem behaviour and \ with a background in Clinical Child and Family Studies, focusing on contextual determinants such as group dynamics in care homes and parenting and educational contexts that may contribute to the challenging behaviour in question and should be treated for that reason.