Page 27 - Demo

General introduction 251Qualitative thematic analyses revealed that their participation in observing involuntary care practices led to discovering a wide range of restrictive measures, including %u201cminor%u201d restrictions such as diminished freedom of choice with regard to food and beverages, not being able to go outside, not being in charge of medication, and a directive or unresponsive care attitude (Bekkema et al., 2021; van Rootselaar, 2019). Implementation challenges in intellectual disability careWith the promising results of these studies, the challenge for care organisations considering the use these methods was how to effectively implement the three innovations into their care practices. Implementation research showed that it may take as long as 17 years to implement evidencebased practices into everyday healthcare routines (Albers et al., 2020; Balas & Boren, 2000). While implementation science has gained considerable prominence in the wide healthcare field over the last two decades, there is still a notable lack of understanding regarding the factors contributing to implementation success (Albers et al., 2020; Nilsen & Birken, 2020). This knowledge gap is particularly pronounced when it comes to implementation of innovations within the realm of intellectual disability care (van Calis et al., 2023; Voss et al., 2021; Wouters et al., 2023). It is questionable as to whether insights into implementation gained in the broader healthcare sector can be directly applied to the care sector for individuals with intellectual disabilities, because of the unique context of long-term, 24/7 care and support that permeates all aspects of clients%u2019 lives. Inherent to the lifelong and integrative nature of care for people with intellectual disabilities, multiple care professionals need to collaborate and share their knowledge when providing care to one single client or a group of clients. These care professionals include not only care staff, physicians, therapists, and behavioural specialists, but also facilitators such as managers and policymakers (Kersten et al., 2018). This means that in implementation processes, all care professionals and facilitators need to adjust their behavioural patterns and habits to effect change not only on an individual level but also collectively to align care and support for clients (May et al., 2009; Nilsen et al., 2012). Achieving this alignment among multiple care professionals may be a significant challenge for implementation in intellectual disability care.