Page 82 - Demo

Chapter 380Second, working with motivated engaged professionals, also referred to as %u2018implementation champions%u2019, or people who use their enthusiasm to bring innovations further was discussed in the CoP as a potential useful strategy. This is also evident in a study by Kaasalainen et al. (2015) in which nurse practitioners were very successful as change champions in implementing pain protocols in long-term elderly care. However, the participants in the CoP experienced this strategy could also backfire if the use of these champions was not sufficiently facilitated and explained within a team or organisation. This is in line with the debate Albers et al. (2020) started about the role of implementation support practitioners (ISP) as a way to effectively build the implementation capacities across health care organisations. Although knowledge and attitudes required for the role of ISP were presented in a systematic review (B%u00fchrmann et al., 2022), little is known about relevant knowledge, skills, competences and attitudes required for implementation in intellectual disability care. Also, little is known about the contextual factors needed for ISP to do their work in a way that adds value to individuals and organisations engaged in implementing innovations (Albers et al., 2020). This was reflected in the dialogue in the CoP in which participants discussed that not only enthusiasm and knowledge about the innovation is important in implementation processes, but also knowledge about mechanisms of change, and being able to lead teams, clients or their representatives and other stakeholders in the process of this change. Whether implementation champions recruited from local teams or implementation support practitioners coming from outside those teams are more effective may therefore be an important empirical question.Third, the pros and cons of bottom up and top down implementation directions led to considerable debate. Although bottom-up processes had the advantage of innovations being tried out directly in daily practice, disadvantages with regard to scaling up the innovations were mentioned. Especially in large organisations, communication about successful innovations and the knowledge gap between early adopters and the vast late majority (Rogers, 2002) was discussed as barriers to wide implementation. Well thought out implementation plans and strategies, such as training, were suggested to prevent communicative problems, which is also underscored in a systematic review (McArthur et al., 2021).