Page 29 - Demo

General introduction 271Normalisation Process Theory Normalisation Process Theory (NPT) was developed within the field of sociology to address the observed difficulty of implementing and integrating new treatments and ways of organizing care in health service settings (May, 2013; May & Finch, 2009; May et al., 2007; May et al., 2009). Normalisation is the result of implementation. May and colleagues (2007) defined implementation as follows: Any deliberately initiated attempt to introduce new, or modify existing, patterns of action in health care or some other formal organisational care setting. Deliberate initiation means that an intervention is: institutionally sanctioned; formally defined; consciously planned; and intended to lead to a changed outcome (May et al., 2007, p. 148).NPT is a conceptual framework designed to understand and evaluate the processes through which innovations and complex interventions become embedded in everyday practice (May & Finch, 2009). NPT provides a coding manual for qualitatively explaining the social processes involved in the implementation, embedding, and integration of innovations within healthcare and other organisational contexts (May et al., 2022). NPT may also aid in designing implementation, enhancing the likelihood of effectively implementing innovations in a specific context. Moreover, within NPT it is acknowledged that providing healthcare requires multiple interactions between care professionals, clients, and facilitators. NPT might help to identify how collaborations and interactions may be affected by implementing the innovations and how the innovations might need to be adapted to support this (Murray et al., 2010). The focus of NPT is on the work that people individually and collectively do to enable an innovation to become normalised. Central to NPT are four main constructs, also referred to as social mechanisms (Figure 1). Although the social mechanisms are represented in a linear way, in practice they are in dynamic relationships with each other and the wider context such as organisational structures, social norms, group processes and conventions (May & Finch, 2009).