Health systems integration: Competing or shared mental models?

Figure 1 summarizes the conceptual thinking that emerged from the three studies. The construct of ‘Integration Mindsets’ is at the heart of Figure 1 and (Figure Presented) is defined as an individual’s way of thinking about integration that is based on knowledge and beliefs regarding the strategy for achieving integration (i.e., Strategy Mental Model) and the roles and relationships of those involved in the integration process (i.e., Relationships Mental Model) [5]. The similarity of Integration Mindsets is shaped by contextual factors at multiple levels [4]. The similarity of Integration Mindsets, in turn, influences strategic processes and proximal outcomes. The relationships among Integration Mindset similarity, strategic processes, and proximal outcomes are moderated by mental model type (strategy and/or relationships) and mental model content (knowledge and/or beliefs). Both formal and informal feedback from integrative processes and performance continually shape integration strategy content (i.e., what is decided) and the similarity of Integration Mindsets. Thus, shared Integration Mindsets are not a static ‘state’, but rather a dynamic process in which knowledge and beliefs are continuously modified and negotiated.