Table 4

Summary of mechanisms identified by clinicians at the conclusion of the programme, with example quotations

Public hospital services N=10Residential and community aged care N=4Private practitioners N=2
Motivation and confidence to engage in changeStructured and supportive process assisted engagement
‘I just felt motivated throughout the process because I knew I had the support of your team, so the expertise and leadership’ O13
‘OTs love structure. The structure was very good, so that was great’ O09
Structured and supportive process was flexible and assisted engagement
‘…it made it more appealing, and easier to engage with’ O04
‘…the confidence of having other people check your work and give you the seal of approval’ E13.
Relevant and useful approach made steps practical
‘…could go in and do parts of it and then come back to it, that made it a lot easier to fit it in to work’ C05
Accountability strengthened
commitment to change
Fitted in with organisational and time requirements
‘it crosses over many of the domains from the organisational point of view and accountability point of view’ C06
Maintained engagement and accreditation
‘I was much more motivated to do it, I felt like it had work outcomes and a personal outcome’ C07
Maintained engagement and accreditation
‘It was actually you guys kind of driving us to get the work done. Which is a good motivating factor for people like me who get distracted easily’ E13
Sense of identity reinforcedProfessional evidence-based practice
‘having an external auditor to come through and look at that and feel that it was a good project. And having great outcomes is really positive to hear too’ S13
Advocate for improved quality of services for people with dementia
‘…chose to work in aged care. I knew I was doing it for my residents, and to help support the staff’ E11
Professional competence in dementia
‘even though I’ve sort of worked within an ageing population for a long time, I really wanted to know what best practice was’ O07
Doing it together/collective learning increased confidenceValue of sharing perspectives and learning from others for improvement
Initial learning from others increased confidence
‘I think we kind of talked a lot at the beginning and then you kind of found your feet and you knew what you were doing’C01
Overcoming isolation and gaining support
Motivating by working with like-minded others
‘It’s nice to have people who … have similar mindsets and being able to bounce ideas off of them’ O04
Sense of community and overcoming isolation
Confidence in practice it’s always good to get other people’s ideas and feedback. Working in a private practice, if that’s all you are doing, it can be quite isolating’ O07
Credibility built trust and
confidence in process
Trustworthy, evidence base, aligns with organisation needs
Research accepted by professional bodies
Voice of experts by experience of dementia respected
‘I think the value to an organisation with the quality improvement expertise, the training, the contact, the researchers and the PD development I think is extremely valuable’C06
Evidence based
CPD points through a work project
Perspective of people with dementia useful
‘I think it was helpful to see that evidence of there being different types of experts’ E10
‘you're getting your CPD points and you're learning while you're at work, in work time’
Evidence base and acceptance by professional body
Validity of improvements and connection with research
‘It was incredibly important for me’ C05
Reflection on efforts helped recognise achievementsAlignment of organisational goals and improvement in services
‘I think it’s the thing of linking it back to the different strategic visions and values’ C06
Influencing wider service change
‘…take my knowledge and my actions and my words, and influence others around me’ E11
Satisfaction with competence and professional value
‘…that’s improved my practice and sense of empowerment I guess, working with clients with dementia and their carers’ C05
  • CPD, continuing professional development.