On the same page? A qualitative study of shared mental models in an interprofessional, inter-organizational team implementing goal-oriented care

Figures & data

Table 1. Goal-oriented care tools and techniques.

Tool/Technique	Objective
Chart review	To understand the patient’s medical history and healthcare needs
Motivational interviewing	To lead strength-based conversations that help to gain patients’ trust
Eco-mapping	To identify all formal and informal team members who are involved in the patient’s care including family members
Camden domain cards(Camden Coalition, 2016)	To elicit patient-identified goals to understand what is important to the patient
Backwards planning boards (Camden Coalition, 2016)	To prioritize the patient-identified goals and create a list of actionable goals to work toward
Shared care plan	To co-create a plan of care that works for team members and patients

Table 2. Definitions of shared mental models of goal-oriented care adapted from (Cannon-Bowers Et Al., 1993; Mohammed & Dumville, 2001).

Concept	Definition
Shared mental models of goal-oriented care	When multiple individuals develop overlapping knowledge and beliefs regarding the tasks and team involved in delivering goal-oriented care, we refer to this as a “shared mental model of goal-oriented care”
Task-related mental model of goal-oriented care	An individual’s knowledge and beliefs regarding the purpose of goal-oriented care as well as how it is delivered (e.g., procedures, tools, action sequences, environmental constraints, contingency plans, and equipment/technology related to the delivery of goal-oriented care)
Team-related mental model of goal-oriented care	An individual’s knowledge and beliefs regarding teamwork in general as well as team member characteristics (e.g., expertise, skills, preferences), respective roles, and team interactions required to deliver goal-oriented care (e.g., communication patterns, coordination strategies)

Table 3. Shared task-related mental model content and degree of sharedness.

Task-related mental model content	Frequency (percent shared)
Delivering goal-oriented care involves the following tasks:
Operationalizing goal-oriented care (e.g., identifying a lead care coordinator, utilizing goal-oriented care tools, developing shared care plans)	18/18 (100%)
Adopting a person-centered or whole-person approach to care (e.g., getting to know patients as individuals, prioritizing patient-identified goals over provider goals for their patients)	16/18 (89%)
Developing trusting relationships with patients (e.g., through motivational interviewing)	14/18 (78%)
Undergoing intensive training and education on goal-oriented care as a philosophy and practice on an on-going basis	10/18 (56%)
Establishing a supportive context for goal-oriented care (e.g., dedicating time and the necessary financial and human resources)	7/18 (39%)
Applying qi methods (e.g., rapid cycle testing, case finding, performance measurement)	4/18 (22%)

Table 4. Shared team-related mental model content and degree of sharedness.

Team-related mental model content	Frequency (percent shared)
Delivering goal-oriented care involves the following team processes and interactions:
Engaging in formal and informal communication (e.g., digital communication platforms, regular meetings, e-mail, phone calls, fax)	17/18 (94%)
Taking a team approach to care planning and delivery (e.g., working collaboratively, supporting each other, sharing the responsibility of care)	16/18 (89%)
Building knowledge of and trusting relationships with each other (e.g., learning about respective areas of expertise, experience, and backgrounds)	16/18 (89%)
Clarifying respective roles in care delivery	15/18 (83%)
Working with supportive leaders within and across partner organizations who enable teamwork (e.g., facilitate a shared vision, dedicate time for inter-organizational meetings, leverage champions)	10/18 (56%)
Engaging primary care physicians (e.g., including physicians in a consultative role, securing physician buy-in, addressing differences in care philosophy between physicians and other team members)	5/18 (28%)

Camden Coalition. (2016). Create a backwards plan: Instructional guide. Retrieved November 29, 2020, from https://camdenhealth.org/wp-content/%0Duploads/2016/12/Backwards-Planning_Instructional-%0DGuide-Board-Domain-Cards.pdf

 Google Scholar

Cannon-Bowers, J. A., Salas, E., & Converse, S. (1993). Shared mental models in expert team decision making. In N. J. C (Ed.), Individual and group decision making: Current issues (pp. 221–246). Erlbaum.

 Google Scholar

Mohammed, S., & Dumville, B. C. (2001). Team mental models in a team knowledge framework : Expanding theory and measurement across disciplinary boundaries</ac>. Journal of Organizational Behavior, 22(2), 89–106. https://doi.org/10.1002/job.86

 Web of Science ®Google Scholar

Data availability statement

The data that support the findings of this study may be available on request from the senior author, CSG, and approval from research ethics boards. The data are not publicly available because they contain information that could compromise the privacy of research participants.