학술논문
Out of sync: a Shared Mental Models perspective on policy implementation in healthcare
Document Type
Academic Journal
Author
Source
Health Research Policy and Systems. November 27, 2019, Vol. 17 Issue 1
Subject
Language
English
ISSN
1478-4505
Abstract
Author(s): Jenna M. Evans[sup.1], Karen S. Palmer[sup.2,3], Adalsteinn D. Brown[sup.4,5,6], Husayn Marani[sup.4,7], Kirstie K. Russell[sup.2,5], Danielle Martin[sup.4,7,8] and Noah M. Ivers[sup.2,4,7,8] Introduction Recent reviews demonstrate a growing interest in establishing [...]
The impact of policy ambiguity on implementation is a perennial concern in policy circles. The degree of ambiguity of policy goals and the means to achieve them influences the likelihood that a policy will be uniformly understood and implemented across implementation sites. We argue that the application of institutional and organisational theories to policy implementation must be supplemented by a socio-cognitive lens in which stakeholders' interpretations of policy are investigated and compared. We borrow the concept of 'Shared Mental Models' from the literature on industrial psychology to examine the microprocesses of policy implementation. Drawing from interviews with 45 key informants involved in the implementation of a hospital funding reform, known as Quality-Based Procedures in Ontario, Canada, we identify divergent mental models and explain how these divergences may have affected implementation and change management. We close with considerations for future research and practice. Keywords: policy implementation, shared mental models, frames, change management, health reform, activity-based funding
The impact of policy ambiguity on implementation is a perennial concern in policy circles. The degree of ambiguity of policy goals and the means to achieve them influences the likelihood that a policy will be uniformly understood and implemented across implementation sites. We argue that the application of institutional and organisational theories to policy implementation must be supplemented by a socio-cognitive lens in which stakeholders' interpretations of policy are investigated and compared. We borrow the concept of 'Shared Mental Models' from the literature on industrial psychology to examine the microprocesses of policy implementation. Drawing from interviews with 45 key informants involved in the implementation of a hospital funding reform, known as Quality-Based Procedures in Ontario, Canada, we identify divergent mental models and explain how these divergences may have affected implementation and change management. We close with considerations for future research and practice. Keywords: policy implementation, shared mental models, frames, change management, health reform, activity-based funding