Interactional Workability: People operationalize a DST when they engage in work that characterized by specific patterns of conduct (congruence), and expectations about their outcomes (disposal). |
Congruence requires shared expectations of the normal conduct and purpose of the clinical encounter; the roles of participants; and the legitimacy of shared decision-making. |
Disposal of participants' problems requires agreement about the meaning and consequences of the shared decision; and expectations of the goals and possible outcomes of the clinical encounter |
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Relational Integration People organize a DST through working to share knowledge and practice (accountability), and beliefs about its value and meaning (confidence). |
Accountability requires agreement about the knowledge and expertise that underpins the shared decision; beliefs about their validity and significance; and agreement about the interpretive contribution of participants. |
Confidence requires agreement about the authority and credibility of the knowledge and expertise through which the shared decision is framed; or beliefs about the utility of this knowledge and the criteria by which it is evaluated. |
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Skill-set workability People distribute the work connected to mobilizing a DTS according to specific formal or informal roles (allocation), and evaluated by reference to shared beliefs about action (performance). |
Allocation requires agreement about the assignment of shared decision-making tasks to participants; beliefs about the ownership and appraisal of the skills; the distribution of resources and rewards; and mechanisms to record participation. |
Performance requires agreement about the content of shared decision-making tasks assigned to participants; shared beliefs about the boundaries of their responsibility; and mechanisms to decide the degree of autonomy available to them. |
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Contextual Integration People enact a DST by working to assign the necessary intellectual property, personnel, and material resources (execution); and to seek to link it to its operational contexts by sustaining the allocation of these resources (realization). |
Execution is made possible by participants' agreement about distributing responsibility for the conduct of shared decision-making; policies for allocating intellectual and capital resources to participants; and mechanisms for linking participation to organizational structures. |
Realization is made possible by participants' agreement about the value of shared decision-making; policies about the procurement and delivery of personnel and equipment; and mechanisms for modifying organizational objectives. |