106 Chapter 4 A CRE can be negatively affected by organizational aspects such as funding, administrative tasks, and legal regulations, which can differ internationally. Participants think it is important that an organization has a shared vision on rehabilitation and there is sufficient time for implementing a CRE. Implementing a complex concept such as the CRE should be based on an understanding of the behaviors that need to change, the relevant decision-making processes, and the barriers and facilitators of change. Monitoring during and after the implementation is crucial.29 The literature confirms the idea mentioned by participants in this study regarding the complexity and barriers to implementing a CRE: successful implementation of a CRE on a ward requires a strategy and sufficient time for the implementation process. Participants stressed the importance of practicing meaningful tasks in a rehabilitant’s own environment and thus of rehabilitation in the home situation as quickly as possible. However, some are in doubt as to whether a longer stay on the rehabilitation ward is better if there is a good CRE. As the effectiveness and efficiency of CRE have not yet been studied, no statement can be made about the benefits of inpatient rehabilitation in a good CRE versus outpatient rehabilitation at one’s own home. This needs to be the subject of further research. The 11 themes that were identified form a rather complex concept. In general, the rehabilitation process should be individually tailored and optimized to achieve all the goals of the rehabilitant. Currently, all principles of CRE are used internationally in GR. However, the rehabilitation ward may not work according to all of the themes that are important for a CRE. Therefore, new interventions should be implemented and adapted. The strength of this study is the number of participants. We interviewed more than 200 individuals, and data saturation was reached. Secondly, all professionals participating in this study had experience in the field of rehabilitation. The occupation of the participants was taken into account in the composition of the focus groups. Therefore, hierarchical differences did not prevent participants from discussing their ideas, although it also limited the exchange of ideas between groups. In the workshops, participants were mixed in smaller groups regardless
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