Page 210 - Demo

Chapter 8208Chapter 5 The e-tool Needs Assessment Framework (NAF) was developed to stimulate care staff and client representatives to take clients%u2019 perspectives into account when considering involuntary care. To implement the NAF in care organisations a Community of Practice (CoP) was set up in which care professionals of four organisations worked together to design implementation plans. Within the CoP the ItFits-toolkit was used to provide a work routine for choosing three overarching implementation strategies and tailoring these to the specific needs of organisations. The study in Chapter 5 described the effect of the participation of care professionals in a CoP on the implementation of NAF in care homes for people with intellectual disabilities, and on the awareness among care staff of considering clients%u2019 perspectives in involuntary care decisions (the intervention group). This was compared with the results in care homes of three organisations in the control group. These organisations implemented NAF without participation in a CoP (implementation as usual). Participants in the CoP evaluated working together positively to exchange knowledge, experiences and ideas for designing an informational, motivational, and educational implementation intervention. The ItFitstoolkit was appreciated for providing a structured work routine. No statistical differences in implementation and awareness among care staff were found between the intervention and control groups. Possible hindering factors influencing the outcomes of the study included Covid-19, illnesses, absences, and departures of care professionals. Another barrier might have been that questionnaires were only sent to care staff, rather than including intermediate disciplines responsible for implementing the NAF to care teams. Because the implementation interventions designed in the CoP were often targeted at intermediate disciplines, the effects of the implementation interventions might not have been fully captured. To conclude, a multi-methods study design in which implementation is both qualitatively and quantitively evaluated offers unique insights for in change processes in daily practice around involuntary care.