Altering Frontiers

Corinne Grenier is Professor of Strategy and Innovation at KEDGE Business School, France, and is the director of the Center of Expertise Health & Innovation. She is also the scientific director of the MSAIS (Mastere Specialise Management des Structures et Activites Innovantes en Sante) program.Ewan Oiry is Full Professor in HRM at Ecole des Sciences de Gestion – Universite du Québec a Montreal (ESG-UQAM), Canada. His research focuses on competence management. He is co-lead of the AGRH Thematic Research Group "Competency Management - Didier Retour".

• Foreword by Jean-Louis Denis: Adaptation, Trust and Methodology xiJean-Louis DENISForeword by Norbert Nabet : The Challenges of Altering Frontiers: For Other More Collaborative Approaches xviiNorbert NABETIntroduction: The Challenges of “Altering Frontiers”: The Multiple Facets of Boundaries to Cross and Articulate xxiCorinne GRENIER and Ewan OIRYPart 1. Innovations as Seen by Stakeholders 1Introduction to Part 1 3Chapter 1. Recognition of Patients’ Experiential Knowledge and Co-production of Care Knowledge with Patients and Citizens in the 21st Century 7Luigi FLORA1.1. Introduction 71.2. From “empowerment” to the “patient revolution”, an international trend 81.3. From paternalism to different forms of participation and partnership with patients 141.4. Innovative practices 141.5. Conclusion 251.6. References 26Chapter 2. Innovative Organizations and Professional Strategies: The Nursing Professional Space 29Philippe MOSSÉ2.1. Introduction: experimenting experimentation 292.2. Participatory evidence-based policy: a new conceptual framework? 312.3. Article 51: a full-scale test 342.3.1. Experimenting for recognition 342.3.2. An expression of interest 362.4. The nursing space: a controlled extension 382.4.1. Asalée: a fragile experiment 392.4.2. The nurse in advanced practice: spearhead or first in line 412.5. Conclusion: new ways of doing things 462.6. Appendix: examples of emancipatory innovations in the 1990s 472.6.1. Nursing specialization versus the place of the manager 472.6.2. Stubborn labor relations 482.7. References 48Chapter 3. Managed Communities of Practice in the Gerontology Sector: Case of a CoP of Gerontology Volunteers in Sweden 51Bertrand PAUGET3.1. Introduction 513.2. Context and questions 523.3. Conceptual framework 533.3.1. Volunteering 533.3.2. Communities of practice 533.3.3. Managed communities of practice 543.3.4. The interpretative framework of a piloted community of practice 553.4. Illustrations 553.4.1. The Swedish context 553.4.2. A community of practice piloted in the field of gerontology 563.5. Conclusion 583.6. References 59Part 2. Innovations on the Collective Side 61Introduction to Part 2 63Chapter 4. Moving from Partitioning to Transversality in Operating Rooms using Robot-assisted Surgery 67Delphine WANNENMACHER4.1. Introduction 674.2. The context of operating rooms mobilizing the surgical robot 684.3. The issue of technical and non-technical skills in the context of robotic surgery 694.4. The effects of new technologies in terms of individual and collective skills 704.5. Viewing at the heart of robot-assisted surgery in urology 714.5.1. A pragmatic approach to analyzing the activity of an operating theater 714.5.2. A configuration of the operating room and an installation of the patient constrained by the surgical robot 724.5.3. A spatiotemporal separation and limited communication between team members 744.5.4. The impoverishment and disarticulation of individual and collective skills in the operating room, mobilizing the surgical robot 754.6. Discussion 774.7. References 79Chapter 5. Clinical Poles of Activity, an Opportunity for New Cooperation Between the Actors? The Case of a Hospital 81Christelle HAVARD5.1. Key elements and objectives of polar reform 825.2. Improving cooperation and better articulating the logics present in the hospital: challenges and theoretical identification 835.3. Context and methodology of the study 865.4. Modalities of cooperation permitted by the establishment of the clinical poles 865.4.1. The articulation actors 865.4.2. Tools supporting articulation work 885.4.3. The instances of exchange and articulation 905.5. Conditions for the use of articulations 925.6. Cooperation in a polar structure, some research avenues 945.7. References 96Chapter 6. Learning from Reforms Aiming to Disseminate Innovative Organizational Models: The Case of Family Medicine Groups in Quebec 99Frédéric GILBERT6.1. Introduction 996.2. Conceptual framework 1006.2.1. The impact of intervention precision on the ability to learn 1006.2.2. The impact of evaluations on learning capacities 1016.3. Illustration of the analytical framework: the reflexive processes related to the implantation of family medicine groups in Quebec 1036.3.1. Method and context of the study 1036.3.2. Results of the analysis 1046.4. Discussion 1086.4.1. A brief overview of intervention theory 1086.4.2. Evaluations that support rather than question 1086.4.3. Evaluations that are not well integrated into the GFM policy 1106.4.4. Improvements to increase learning potential in primary care reforms 1106.5. Conclusion 1106.6. References 111Chapter 7. Variety and Performance of Innovative Organizational Structures: The Emergence of Territorial Support Platforms 115Matthieu SIBÉ, Sandrine CUEILLE and Tamara ROBERTS7.1. Introduction 1157.2. Context of the study 1187.2.1. Organizational forms for the care and support to complex patients: an overview of the literature 1187.2.2. Territorial support platforms: a new organizational arrangement in the French healthcare system 1197.2.3. Context of the study, expected empirical observations on organizational forms and performance of PTAs 1207.3. Conceptual framework 1227.3.1. Analytical framework and concepts from structural contingency theory 1227.3.2. The adhocratic structural configuration: an innovative organizational form to carry out complex tasks in dynamic environments 1237.4. Empirical analysis 1257.4.1. Analysis of contingency factors (situational elements) and expected organizational form of PTAs 1257.4.2. Organizational congruence and PTAs performance 1337.5. Conclusion 1367.6. Acknowledgments 1377.7. References 137Part 3. Reflective Insights on Organizational Innovations in Healthcare 141Introduction to Part 3 143Chapter 8. Proposals for New Approaches to Contributory Evaluation of Healthcare Pathways from Interface Organizations 147Jessica GHELLER, Christian BOURRET and Gérard MICK8.1. Introduction 1478.2. Context and research questions 1488.2.1. Background 1488.2.2. Positioning for the method 1508.2.3. Methodology 1518.3. Framework for analyzing the processes of diffusion of organizational innovations: definition and principles (conceptual framework) 1528.4. Empirical illustrations of the innovation diffusion processes supported by coordination platforms 1538.4.1. A community of “expert” stakeholders, resulting from dynamic processes of territorial construction 1548.4.2. Territory of practices as a framework for the intelligibility of processes for disseminating organizational innovations 1568.4.3. Learning process 1588.4.4. Process of building collective standards 1618.5. Conclusion 1658.5.1. Lessons 1658.5.2. Perspectives 1668.6. Acknowledgments 1678.7. References 167Chapter 9. Innovation and Absorptive Capacity of Organizations in the Healthcare Field 169Corinne GRENIER and Christine DUTRIEUX9.1. Introduction: absorbing to innovate 1699.2. Context and questions: the challenge of openness 1709.3. Theoretical framework: the notion of organizational absorption capacity 1729.4. Responses to the three OAC pitfalls: illustrations 1759.4.1. Entering the absorption process 1759.4.2. The quality of what is absorbed 1779.4.3. The transition from potential to realized 1809.5. Conclusion 1839.6. References 184Chapter 10. Quality Management in Hospitals: The Two Faces of Rationalization Through Indicators 187Hugo BERTILLOT10.1. Introduction: are quality indicators a managerial innovation? 18710.2. Context and issues 18810.2.1. An institutional response in the context of a confidence crisis 18810.2.2. From cautious indicators to equivocal uses 18910.3. Management tools and organizational rationalization dynamics 19010.3.1. What rationalization of professional organizations? 19010.3.2. Investigating rationalization induced by quality indicators 19110.4. A dynamic of professional rationalization? 19210.4.1. Standardization of professional practices 19210.4.2. Traceability of hospital activities 19310.4.3. The local rooting of evidence-based medicine 19510.5. A dynamic of managerial rationalization? 19710.5.1. Control and competition 19710.5.2. Rationalization and bureaucratization 19910.5.3. A certain disenchantment with the hospital world 20010.6. Conclusion: rationalizing through indicators to rationalize “softly” 20210.7. References 203List of Authors 205Index 207