AppRopRiAtion of toolS in the iMpleMentAtionof qUAlitY policieS

Abstract

The object of this article concerns the appropriation of tools in the implementation of quality policies. HRM and management play a key role as agent and guide of the changes resulting from the implementation of quality policies. Opting for a qualitative and inductive approach and considering the large number of devices elaborated by the actors, we decided to concentrate on the "key" tool of these transformations: the patient file. The study concerns two hospital services. The results show that the process of appropriation leads to a set of collective and individual realities. The collective approach corresponds to the idea of directing the usage of the tool to the patient requiring a strong coordination between the members of the team for successful completion of the task. Individual appropriation requires that the task be performed in such a way that group integration remains weak. The practices of administrative MRH seem to have few effects on the activity and the quality. Training through modalities adapted to the needs of the service and the people involved could provide considerable support to managers.