Page 98 - Demo

Chapter 496terminology and definitions might need to be tailored to what happened in this context. Our first research question was: Which professional implementation interventions were used to implement the MDET method in long-term care for people with intellectual disabilities?To identify the social mechanisms activated by these interventions we built on the NPT-EPOC framework developed by Johnson and May (2015) on the basis of their systematic review. Our second research question was: What social mechanisms were initiated by implementation interventions during an implementation process in long term intellectual disability care? MethodsStudy context and data collection We used data of the consultation processes of MDET in 19 residential group homes from the trial of Schippers (2019). The trial was conducted in a large long-term care organisation for people with intellectual disabilities in the Netherlands. The organisation provided a broad spectrum of care, including support for living with intellectual and physical disabilities as well as treatment for additional psychiatric problems and challenging behaviour, to approximately (at the time) 9,500 people with intellectual disabilities across all levels of severity and all ages. In the trial, group homes (N = 50) providing 24/7 care for at least four residents were randomly selected from a total of 566, and randomly allocated to an experimental (n = 25) or control condition. Only group homes in the experimental condition implemented MDET. For this present study we included data if a start had been made with implementing MDET and a consultation plan was written and discussed (phase 1 and 2). Data of 19 group homes were available, with a total amount of 178 documents. Data content Units of analysis were information letters to managers, behavioural consultants, support staff and clients or their representatives, the written consultation plans for reduction of restrictive measures, notes of discussions in care teams, e-mails and notes of telephone conversations,