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Chapter 128Implementing innovations to improve care practices in care organisationsCoherence Building(sensemaking)Cognitive Participation(commitment)Collective Action(work effort)Reflexive Monitoring (evaluation and appraisal)Innovation implemented in care organisations/ practicesSocial mechanisms during implementation Figure 1. Social mechanisms in the black box of implementation. This figure was based on the articles of May et al., 2009, and May, 2013 concerning the development of Normalisation Process Theory and adapted for intellectual disability care. Coherence building, also known as sense-making, relates to the innovation itself. It involves questions about how the innovation differs from existing practices, whether it is understandable and appropriate, and whether it offers advantages over alternative interventions or methods. Cognitive Participation focuses on the commitment and engagement of care professionals to implement the innovation. It involves questions concerning enrolment, legitimation, and activation. Collective Action refers to the actual application of innovations within an organisation and the efforts people make to work with the innovation. It also refers to how innovations are integrated within existing work processes in an organisation. Reflexive monitoring involves evaluating and appraising the innovation, either individually or collectively. This entails making suggestions to improve procedures and working routines related to the innovation or to improve the innovation itself (May et al., 2009). Many factors can determine the outcomes of implementation processes (Damschroder et al., 2009; Damschroder et al., 2022; Fleuren et al., 2004). NPT takes two important determinants of implementation into account. The first determinant is the context in which an innovation is implemented and the second determinant is the fit of the innovation within a certain context. Concerning the first determinant, in intellectual disability care, context refers not only to a %u2018place%u2019, such as a care home or activity centre where care is provided to clients, but also to the %u2018processes%u2019 (May et al., 2016). Processes happen within collaborations between professionals with different roles, interactions, and relationships and ensure that organisations continue to