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.

中文翻译：

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不同步：关于医疗保健政策实施的共享心理模型观点。

政策含糊不清对执行的影响是政策界长期以来关注的问题。政策目标的模棱两可的程度以及实现这些目标的方法，会影响整个实施站点统一理解和实施政策的可能性。我们认为，必须以社会认知的视角来补充制度和组织理论在政策执行中的应用，在这种认知中，要对利益相关者对政策的解释进行调查和比较。我们从工业心理学的文献中借鉴了“共享心智模型”的概念，以研究政策实施的微观过程。从与参与实施医院资金改革（在加拿大安大略省的基于质量的程序）的45名关键信息提供者的访谈中汲取经验，我们确定了分歧的心理模型，并解释了这些分歧如何影响实施和变更管理。最后，我们考虑了将来的研究和实践。