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Table 5 Definitions of concepts in the integration mindsets framework

From: A cognitive perspective on health systems integration: results of a Canadian Delphi study

Term Definition
Strategy Mental Model – Knowledge Content
Targets functions, services, organizations and/or systems identified for integration
External clients characteristics and needs of the populations, patients and/or caregivers who will benefit from integration, and the nature of that benefit
Goals primary aims of integration, which may be related to costs, efficiency, productivity, quality of care, patient safety and/or patient outcomes
Long-term vision how the services, programs or functions, organizations and/or systems will “look” or operate when fully integrated
Methods approaches and enablers for achieving integration – which may be clinical, technological, patient or caregiver-centered, administrative, financial, organizational, governance and/or policy-related – and timeline for implementation
Evaluation key performance dimensions and indicators for assessment of the integration initiative
Strategy Mental Model – Beliefs\Perceptions Content
Consequences of integrating the expected outcomes (positive and/or negative) of integration for one’s self, for other participating individuals and organizations, for external clients, and for the healthcare system
Appropriateness of selected strategy the extent of agreement with the selected targets, clients, goals, long-term vision, methods and evaluation approach for an integration initiative
Integrity of decision-making processes the extent to which decisions regarding integration are made in a manner that is equitable and transparent
Readiness for change the ability and willingness to implement the desired integration initiative
Relationships Mental Model – Knowledge Content
Competencies the knowledge and skill sets of each team member1
Contributions how each team member contributes to patient health and well-being
Accountabilities the activities and results that team members are individually or jointly responsible for
Interdependencies how and to what extent the work of each team member depends on or is influenced by another
Communication sources of information and how information flows between team members, including frequency and methods for contact
Relationships Mental Model – Beliefs\Perceptions Content
Appropriateness of role structure the extent of agreement with the content and distribution of roles, including relative accountabilities and communication methods
Identification with the integration initiative the extent of self-association with the integration initiative (i.e. the team, partnership, network, etc.) in addition to one’s professional group and organization
Recognition of shared responsibility a willingness to share the burden of work and act as a team to contribute to the integration process and/or to the delivery of integrated care
Importance of client involvement the extent to which the involvement of patients and their caregivers is considered necessary and beneficial to integration efforts
  1. 1The term “team member” is used broadly to refer to individuals, organizations, and patients/caregivers participating in the integration initiative; the composition of the team will depend on the nature and level of the integration activity. These teams typically span professional and organizational boundaries, may be focused on governance, management or patient care, and may be formal or informal and ad hoc/intermittent or fixed.