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Table 1 Normalization Process Theory: the work of implementation - four interrelated generative mechanisms

From: Developing and implementing an integrated delirium prevention system of care: a theory driven, participatory research study

Generative mechanism Explanation
Coherence Individually and collectively: how the work that defines and organises a practice/intervention is understood as meaningful and invested in, in respect of the knowledge, skills, behaviours and actions required to implement it.
Cognitive participation How the work is perceived as something worthwhile and appropriate to commit their individual time and effort [signing up] to bring about the intended outcome.
Collective action How work practices and the division of labour through which these are carried out are modified or adapted to implement the change/intervention.
Reflexive monitoring How participants’ individually and collectively appraise the intervention and its benefits for participants, in relation to individual and organisational goals.
  1. After May [33]; May and Finch [34].