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Journal cover: Journal of Health Organization and Management

Journal of Health Organization and Management

ISSN: 1477-7266
Previously published as: Journal of Management in Medicine

Online from: 2003

Subject Area: Health Care Management/Healthcare

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Shared mental models of integrated care: aligning multiple stakeholder perspectives


Document Information:
Title:Shared mental models of integrated care: aligning multiple stakeholder perspectives
Author(s):Jenna M. Evans, (Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada), G. Ross Baker, (Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada)
Citation:Jenna M. Evans, G. Ross Baker, (2012) "Shared mental models of integrated care: aligning multiple stakeholder perspectives", Journal of Health Organization and Management, Vol. 26 Iss: 6, pp.713 - 736
Keywords:Health care, Health services, Health system performance, Health systems integration, Integrated care, Inter-organizational relations, Shared mental models
Article type:Research paper
DOI:10.1108/14777261211276989 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:An earlier version of this paper was presented to the Health Care Management Division at the Annual Meeting of the Academy of Management in Chicago, Illinois, August 2009. Jenna M. Evans is funded by a Vanier Canada Graduate Scholarship and the Health System Peformance Research Network.
Abstract:

Purpose – Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter-organizational and inter-professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration.

Design/methodology/approach – The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration-task, system-role, and integration-belief.

Findings – The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory-based framework of psychological factors that may influence inter-organizational and inter-professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care.

Practical implications – MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care.

Originality/value – Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.



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