Staff engagement is key to implementing change, especially for tracheostomy care, where leaders influence multidisciplinary teams from different specialties and sites. Improving Tracheostomy Care Quality Improvement program guided 20 diverse UK sites in implementing the resources of the Global Tracheostomy (QI) Collaborative. The NoMAD instrument is a theorybased validated research instrument that measures implementation processes from the perspective of professionals directly involved in implementing complex healthcare interventions.

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