DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
Health Res Policy Syst. 2019 Nov 27;17(1):94. doi: 10.1186/s12961-019-0499-x.
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.
政策模糊性对实施的影响是政策圈中长期存在的问题。政策目标的模糊程度以及实现这些目标的手段，影响了政策在实施现场得到统一理解和实施的可能性。我们认为，将制度和组织理论应用于政策实施，必须辅之以社会认知视角，在该视角下研究和比较利益相关者对政策的解释。我们借鉴工业心理学文献中的“共享心智模型”概念，来考察政策实施的微观过程。通过对 45 名参与加拿大安大略省医院资金改革（称为基于质量的程序）实施的关键知情者进行访谈，我们确定了不同的心智模型，并解释了这些差异如何影响实施和变革管理。最后，我们考虑了未来的研究和实践方向。
