title: Shared mental models of integrated care: aligning multiple stakeholder perspectives.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. jenna.evans@utoronto.ca
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Evans
authors.forename: G Ross
authors.initials: GR
authors.lastname: Baker
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006284:Health Plan Implementation; D006801:Humans; D007373:Interinstitutional Relations; D007400:Interprofessional Relations; D008960:Models, Psychological; D015279:Organizational Culture; D009936:Organizational Innovation