Background: Person-centered research has advanced science and practice, highlighting the crucial role of organizational management, values, and structures in implementation. To safeguard the rights and dignity of persons with Serious Mental Illness (SMI) in Supported Accommodations (SA), robust programs are essential for regulatory compliance, ehics, evidence-based practice, adaptability to resident sensitivities and preferences, staff resource management, program fidelity, high quality collaboration, fostering compassion, etc. Given health inequities and the low status of residents and staff in SAs, Everyday Life Rehabilitation (ELR) was developed and evaluated to provide integrated, long-term, collaborative person-centered rehabilitation, focusing on personal recovery through meaningful activities. Methods: Alongside a four-year pragmatic cluster-RCT, showing strong effects of ELR on recovery and quality of life (Sjöberg, Liv & Lindström, 2025) and cost-effectiveness (submitted), we examined implementation strategies within 14 participating municipalities. Process data were collected from senior- and housing managers. Results: Implementation efforts varied widely among the municipalities. Eight elements were identified as critical for successful implementation of ELR: (1) management signaling values and long-term goals of implementing ELR; (2) organizing steering groups with clear timeframes and responsibilities; (3) leadership commitment and support; (4) monthly staff reflection sessions for collegiate learning; (5) dialogue on roles and expectations aligned with program components; (6) structures and prerequisites for person-centered and intersectoral collaboration; (7) recognition of `Culture of Compassionate Collaboration´ (CCC); and (8) continuous dissemination of best practices. Conclusions: Despite strong effects and cost-effectiveness of ELR, organizational responsibility is critical for long-term implementation success. Findings emphasize the need to create and sustain a Culture of Compassionate Collaboration (CCC) through collegiate learning and leadership support. Reference: Sjöberg A, Liv P & Lindström M. Effect of Everyday Life Rehabilitation on recovering quality of life in individuals with serious mental illness in supported accommodation: a pragmatic cluster randomised controlled trial. BMJ Mental Health, 2025; 28(1).
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