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Chapter 8210Chapter 7 %u2013 General DiscussionIn this chapter the main findings of this dissertation are discussed and integrated. The Care and Coercion Act (CCA) that came into effect in the Netherlands on January 1, 2020, enhanced the rights of clients with intellectual disabilities to make decisions about their care. The CCA mandates that care organisations and care professionals strive to provide voluntary care to clients. However, involuntary care measures are still employed in situations involving a significant risk of harm or danger to both clients and care staff. The CCA introduced a step-by-step plan with multidisciplinary consultations for evaluating involuntary care practices. Care organisations are mandated to document involuntary care and report these recordings to the Dutch Health Care Inspectorate. The findings in this dissertation revealed that care professionals began preparing for the CCA in 2019, leading to a drop in involuntary care recordings that continued into early 2020. There was a temporary increase in the second half of 2020, but the decline resumed in 2021 after full implementation of the CCA. Overall, the study showed that the new CCA was effectively implemented in this organisation, even during the pandemic.Concerning implementation processes in intellectual disability care organisations, the results in this dissertation highlighted various determinants that may hinder or facilitate implementing methods that reduce involuntary care. For example, hindering factors mentioned were the quality of care dilemma, feelings of overburdening and stress, a lack of implementation plans, poor communication and unclear visions from organisations. Factors such as stakeholder engagement, tailoring implementation plans, and organisational commitment were mentioned to facilitate implementation processes. Implementation interventions tailored to the needs of care teams and care professionals might initiate social mechanisms in implementation processes to improve outcomes. These social mechanisms are described by Normalisation Process Theory. Implementation interventions such as Consensus Processes, Local Opinion Leaders, Client-related Interventions, Educational Outreach, and Audit and Feedback may activate the social mechanisms of Coherence (understanding what an innovation entails), Cognitive Participation (wanting to participate), Collective Action (being actively involved) and Reflexive Monitoring (valuing and evaluating).