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Insights from knowledge exchange in Communities of Practice753up that aren%u2019t going well, (%u2026) I think, let%u2019s have people from the work floor start working on it in the initial phase, to do such an implementation or such an innovation, because they know what is feasible in practice and what is not. (Support staff worker, meeting 1C)Another issue that came up as disadvantage in top down implementation was the gap between guidelines, policies and innovations developed by policymakers, especially in large organisations, and their use in practice. Over the past few years, I%u2019ve come across a lot of people who like to develop things and then, once it%u2019s developed, think: so, we%u2019ve done that nicely. And then it ends up in the cupboard. People just don%u2019t like translating and securing it within the processes. Developing something is really the start. But implementation often takes much longer. (Manager, meeting 2p)Finally, top-down implementation, might generate resistance when support staff feel overwhelmed or experience a lack in facilitation. For example, the Board of one organisation decided to interview each individual client before filling in a questionnaire in their support plan, which is in line with the CRPD (United Nations, 2006) goal of enhancing clients%u2019 self-determination. Support staff were given a deadline by which this must be completed. This led to chaos and stress because it was not feasible to properly interview each client. Everything had to be done very quickly and all those clients had to be rounded up and conversations had to be planned with them, which didn%u2019t work at all. Which eventually led to a situation where the goal was lost. So the goal became more about filling in the lists on time than about giving clients more control over their own lives. (Behavioural consultant, meeting 2p)Bottom up implementationBottom-up implementation often started with a small enthusiastic group of care professionals who wanted to act quickly. This was found advantageous