178 Chapter 7 also of participants with different natures. In this way, an improvement plan for CRE on a rehabilitation ward can be developed with the broadest possible support, which can have a positive contribution to the implementation of this plan. Implications and recommendations Implications for practice The conceptualization of CRE originated from a narrative review and qualitative studies and the effectiveness of the total concept is not yet studied. The effects of the use of the CREATE-tool on the care process and rehabilitation outcomes are still unknown, as are the effects on the satisfaction and burden of the informal caregiver and employees. Nevertheless, many aspects of CRE have already been individually studied and proven to be effective. Hence, the concept of CRE as described in chapter 5 has a lot of potential and should be implemented in geriatric rehabilitation. This thesis (chapter 6) showed that the CREATE-tool can be used as a team improvement instrument. It can help rehabilitation wards implement and improve CRE. During the study described in chapter 6, each team identified several points for improvement related to CRE. Team members indicated that this included both quick wins and points that took more time to realize. The survey in chapter 6 showed that team members were enthusiastic about using the tool and thought it contributed to improving CRE on their ward. This thesis did not investigate the optimal frequency of using the CREATE-tool. The advice is to formulate an improvement plan for the geriatric rehabilitation ward based on the results of the CREATE-tool. If all improvement points from this plan have been achieved, the process of the CREATE-tool can be started again. If these points have not been achieved within 2 years, it is recommended to start the assessment process with the CREATE-tool again. In this way teams can identify whether new areas for improvement have raised regarding CRE.
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