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The implementation of financial tools in the context of healthcare reform: when organisational members use tools because that is the proper thing to do
The implementation of financial tools in the context of healthcare reform: when organisational members use tools because that is the proper thing to do, Bonnier, C. , Flachère, I., Saulpic, O., Zarlowski, P.

BONNIER, C., FLACHÈRE, I., SAULPIC, O., ZARLOWSKI, P. (2013), « Le déploiement d'outils financiers dans le cadre de la réforme du système de soins : quand les acteurs utilisent les outils parce que c'est ce qu'il convient de faire », Colloque 2013 de la revue Politiques et Management Public, 25-26 octobre, Paris

ABSTRACT

French hospitals have recently been the theatre of numerous reforms leading to the widespread introduction of new performance management tools. Few empirical studies have been carried out on the implementation of these reforms, and conclusions cannot be drawn from these studies about the use of the tools in the daily operations of hospitals, particularly the way they impact the representations and practices of administrative, medical and nursing personnel. We endeavour to contribute to this question through a case study. Our observations reveal a strong commitment on the part of hospital personnel in implementing the new management tools, even though these tools seem to have no significant impact on their operational practices. In our analysis, we suggest that healthcare personnel do not use these tools because they are deemed useful and effective, but because it is the proper thing to do - what March and Olsen (1976, 2004) term the "logic of appropriateness". Such behaviour makes it necessary to alter the way   that management control tools are deployed in hospitals.

 

 Keywords : management control tools, hospitals, logic of appropriateness, consequentialism

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