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La quête de rationalité : le cas de la standardisation de la prise en charge des malades

Etienne Minvielle Claude Sicotte 1, 2, 3
1 EA MOS - EA Management des Organisations de Santé
EHESP - École des Hautes Études en Santé Publique [EHESP] : EA 7348 MOS , PRES Sorbonne Paris Cité
Abstract : Over-rationality is addressed in this article in terms of excessive standardization of the process of care delivered to patients. In this specific case, standardization can be observed in the definition and implementation of operational procedures, in the definition of best practices based on evidence-based medicine, and in the introduction of performance standards (e.g. an optimal delay). A deep analysis of the organization of work required by the process of care reveals that the goal of this organization is to determine a balance between standardization and adaptation, depending of the occurrence of unforeseen situations to face in the daily activity. Then, an excessive standardization can limit the flexibility required in the organization of work. We illustrate this phenomenon of over-rationality through two cases: the use of operational procedures, often named “protocol”, and the implementation of information systems. Last, we identify reasons of this trend, and, in return, affirm the need to acknowledge an autonomous actor able to assess the best attitude to adopt for managing the variety of working situations to face during the delivery of care.
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https://hal.ehesp.fr/hal-03028826
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Submitted on : Friday, November 27, 2020 - 5:36:28 PM
Last modification on : Saturday, November 28, 2020 - 3:21:03 AM

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Etienne Minvielle, Claude Sicotte. La quête de rationalité : le cas de la standardisation de la prise en charge des malades. Revue internationale de psychosociologie et de gestion des comportements organisationnels, ESKA, 2018, XXIV (58), pp.69-90. ⟨10.3917/rips1.058.0069⟩. ⟨hal-03028826⟩

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