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Role of quality indicators in the transformation of organizational practices within hospitals : a meta-narrative review
Bérard, E., Denis, J.-L., Minvielle, E., Saulpic, O., Zarlowski, P.

A common project between Emilie Berard, Jean Louis Denis (ENAP), Etienne Minvielle (EHESP, Institut Gustave Roussy), Olivier Saulpic ESCP, Philippe Zarlowski

Tripartite project (ENAP, EHESP, ESCP) part of the research project "the role of indicators in the transformation of organizational practices". 



Our article aims to produce a systematic review about the role of quality indicators in the transformation of organizational practices, within hospitals, from an inter-disciplinary approach, using the meta-narrative technique suggested by Greenhalgh et al. (2005).

A meta-narrative review is a review that takes as an initial unit of analysis « the unfolding 'storlyine' of a research tradition over time ». (greenhalgh 2005 p. 417). It stems from Kuhn's analysis of the evolution of social sciences .

Focusing on a specific topic like quality indicators is challenging because scientific literature is usually characterized through its theoretical inspiration, rather than through a given topic. Indeed, research on a given topic can be said to travel within different scientific communities at different times, generally leading any kind of synthetical attempt to the same kind of disappointing conclusion: « much has been said on the topic, and the results are not consistent ». In order to overcome this kind of difficulty, meta-narrative reviews take the research traditions as the initial unit of analysis for the review. « In other words, before identifying, evaluating and comparing data from primary research studies, [the researchers] first embark on a systematic mapping phase to collect and compare the different over-archign storylines of the rise and fall of diffusion research that [they] judge relevant to [the] overall research question ». (ibid p. 419)

The particularity of a meta-narrative approach is that it renders not only the theoretical ground of each research traditions. It also provides a sociological account for these traditions, locating their historical situation within the evolution of social sciences. Notably, a meta-narrative approach seeks to identify the key actors and events in the unfolding of the tradition, including the main findings and how they came to be discovered. By doing so, a meta-narrative review « moves from what Bruner (Bruner 1990) would call logico-scientific reasoning to narrative-interpretive reasoning ». (Greenhalgh 2005 p. 427) 


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