Table 1.

Normalisation Process Theory (NPT)—constructs, components and definitions (based on the NPT Online Toolkit at www.normalizationprocess.org)

Constructs	Components	Definition
Coherence—the sense-making work	Differentiation	Whether the intervention is easy to describe to service providers and whether healthcare professionals can appreciate how it differs or is clearly distinct from current ways of working.
	Communal specification	Whether healthcare professionals have or are able to build a shared understanding of the aims, objectives, and expected outcomes of the proposed intervention.
	Individual specification	Whether individual staff have or are able to make sense of the work—specific tasks and responsibilities the proposed intervention would create for them.
	Internalisation	Whether healthcare professionals have or are able to easily grasp the potential value, benefits and importance of the intervention.
Cognitive participation—the relational work	Initiation	Whether or not key healthcare professionals are able and willing to get others involved in the new practice.
	Enrolment	The capacity and willingness of healthcare professionals to organise themselves in order to collectively contribute to the work involved in the new practice.
	Legitimation	Whether or not healthcare professionals believe it is right for them to be involved, and that they can make a contribution to the implementation work.
	Activation	The capacity and willingness of healthcare professionals to collectively define the actions and procedures needed to keep the new practice going.
Collective action—the operational work	Interactional workability	Whether healthcare professionals are able to enact the intervention and operationalise its components in practice.
	Relational integration	Whether healthcare professionals maintain trust in the intervention and in each other.
	Skill set workability	Whether the work required by the intervention is appropriately allocated to healthcare professionals with the right mix of skills and training to do it.
	Contextual integration	Whether the intervention is supported by the host organisation, management and other stakeholders, protocols, policies and procedures.
Reflexive monitoring—the appraisal work	Systematisation	Whether healthcare professionals can determine how effective and useful the intervention is from the use of formal and/or informal evaluation methods.
	Communal appraisal	Whether, as a result of formal monitoring, healthcare professionals collectively agree about the worth of the effects of the intervention.
	Individual appraisal	Whether individuals involved with (healthcare professionals), or affected by (patients), the intervention, think it is worthwhile.
	Reconfiguration	Whether healthcare professionals or services using the intervention can make changes as a result of individual and communal appraisal.