Page 209 - Demo

Summary2078Also, in Chapter 3, the reflections on collaborating in a CoP were described. Working together facilitated discussions about difficulties and dilemmas concerning involuntary care reduction. Collectively becoming aware of these issues invited participants to critically think about implementation processes for methods aiming to reduce involuntary care. This led to indepth conversations and new ideas. Chapter 4The complex contexts of long-term care organisations for people with intellectual disabilities in which multiple care professionals need to align their care, support, and treatment for clients complicates implementing innovations. These care organisations usually are seeking for stability, and change is perceived as challenging for both clients and care professionals. In the study described in Chapter 4, implementation interventions were explored that were used during a previous trial of the Multi-Disciplinary Expertise Team (MDET) method. These implementation interventions were analysed through the lens of Normalisation Process Theory (NPT) to understand the social mechanisms at play in implementation processes.Implementation interventions most frequently used to change professionals%u2019 behaviour concerning involuntary care included Consensus Processes and Local Opinion Leaders. Consensus Processes were defined as discussions with those directly or indirectly involved in providing care to clients. 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 specialists. ClientRelated Interventions as an implementation intervention appeared to be key in motivating care staff. These three implementation interventions affected the social mechanisms of NPT: Coherence (understanding what an innovation entails), Cognitive Participation (wanting to participate), Collective Action (being actively involved), and Reflexive Monitoring (valuing and evaluating). The NPT-EPOC framework may help implementation practitioners to analyse what an organisational context needs to pursue specific implementation goals.