Page 74 - Demo

Chapter 372However, involving clients and their representatives took quite some time and effort. Due to their cognitive limitations, clients with intellectual disabilities were only partly able to participate and decide for themselves. However, attempts to reach, engage, and inform clients%u2019 representatives often failed. If relatives and representatives participated, ideas about good care were often specific from one client to another. Also, family members of the same client not always agreed on what was important for their relative. As a result, engaging clients and their representatives in implementation took considerable effort, reducing support staff%u2019s motivation to use innovations. Clarity on implementation goals Being aware of the need to improve care by implementing innovations, knowing the aim of innovations, and making a conscious choice for a particular innovation were discussed as conditions that facilitate implementation. I think it%u2019s important in an implementation that the people who are on the work floor can consult each other. Is this the method from which we all say, yes this is good for all our clients and we can work well with this in the long run. (Support staff worker, meeting 2d)Participants%u2019 experiences however, were that the reasons for implementing a particular innovation were not clear. Implementation processes were ad hoc, following a hype of a new popular method, and lacking careful consideration and coordination. Implementing the innovation often became %u2018a checkmark to be set by a certain date%u2019 and missed the point of actually improving clients%u2019 care. The danger here was that support staff became %u2018implementation fatigued%u2019 as they were constantly confronted with innovations they do not see any benefit in. P: %u201cPeople get change-tired, and then they no longer take it seriously%u201d R: %u201cThey are getting a little negative about possible future implementation?%u201d P: %u201cYes.%u201d (Policymaker and researcher, meeting 2p)