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General discussion1917First, the findings contribute to an understanding of implementation processes in complex intellectual disability care organisations. When organisations prepare for implementation of organisation-wide methods such as those that reduce involuntary care, they might benefit from the insights gained in these studies. For example, insights concerning implementation barriers such as the quality of care dilemma care, potential overburdening and stress, lack of information and communication, and unclarity in implementation goals or about the purpose of the innovation could help care organisations to develop implementation plans in which these barriers are addressed. Insights concerning implementation facilitators, such as engagement of clients and care staff in designing implementation plans, and providing a clear organisational vision and goals to improve quality of care may also contribute to developing these plans. Second, the results show that implementation practitioners might use the NPT-EPOC framework presented in this dissertation to choose specific implementation strategies and interventions for initiating social mechanisms as described by Normalisation Process Theory (May & Finch, 2009; May et al., 2009). Although NPT offers a rather abstract conceptual framework, the four constructs Coherence, Cognitive Participation, Collective Action, and Reflexive Monitoring proved well applicable to long-term intellectual disability care. The findings in Chapter 4 suggest how deployment of implementation interventions may affect social mechanisms of NPT. For example, Client-related implementation interventions were perceived to motivate care staff, affecting the social mechanisms Coherence (understanding what an innovation entails), Cognitive Participation (wanting to participate), Collective Action (being actively involved), and Reflexive Monitoring (valuing and evaluating). Implementation practitioners may use NPT to analyse what an organisational context needs to pursue specific implementation goals. For example, when an organisation has piloted an innovation on a small scale, the social mechanism of Reflexive Monitoring can be activated through the implementation intervention Audit and Feedback. Outcomes of this Audit and Feedback can be incorporated into implementation interventions such as Consensus Processes, Educational Outreach, and Distribution of Information, which in turn may activate the social mechanisms Coherence, Cognitive Participation, and Collection