Summary of mechanisms identified by clinicians at the conclusion of the programme, with example quotations
| Public hospital services N=10 | Residential and community aged care N=4 | Private practitioners N=2 | |
| Motivation and confidence to engage in change | Structured 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 reinforced | Professional 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 confidence | Value 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’ C01 | 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 achievements | Alignment 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.