Jean-Louis Denis
Datos Biográficos
| ID | 3677912 |
|---|---|
| NOMBRE | Jean-Louis Denis |
| NOMBRES | Jean-Louis |
| APELLIDO | Denis |
| FIRMA | DENIS J |
| AFILIACIONES | Université de Montréal |
| VERIFICADO | No |
| TOTAL DE OBRAS | 53 |
| TOTAL DE CITAS | 179 |
| TOTAL COMO AUTOR | 50 |
| TOTAL COMO EDITOR | 3 |
| PRIMER AÑO DE PUBLICACIÓN | 1990 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2024 |
| ÍNDICE H | 6 |
Digital health technologies and inequalities
Digital health technologies hold promises for reducing health care costs, enhancing access to care, and addressing labor shortages. However, they risk exacerbating inequalities by disproportionately benefitting a subset of the population. Use of digital technologies accelerated during the Covid-19 pandemic. Our scoping review aimed to describe how inequalities related to their use were conceptually assessed during and after the pandemic and under…
Varieties of governance versatility and institutions
Research on governance often assumes that governance requires combinations of hierarchical, market and network co-ordination. However, governance versatility – understood as the existence of a repertoire of different modes of coordination – is not a characteristic of all instances of governance. The aim of this paper is to offer a more thorough analysis by exploring existing levels of governance versatility and how these are influenced by institu…
L’appréhension empirique du leadership normatif d’une organisation internationale
En plein essor, la recherche empirique en droit participe à la création de nouvelles connaissances et ouvre aux juristes d’autres voies pour étudier une question, un phénomène. Oser l’empirisme n’est pas chose aisée, mais les auteurs du présent article ont pris ce virage et proposent d’en exposer le récit. En construisant deux méthodes distinctes (pour deux projets), ils ont pu tester les possibilités qu’offre la recherche empirique pour appréhen…
The empirical apprehension of the normative leadership of an international organization
Empirical research in law is thriving, contributing to the creation of new knowledge and providing jurists with innovative ways to study issues and phenomena. Embracing empiricism is no easy task, but the authors of this article have taken the plunge to shed light on such research. By developing two distinct methods (for two projects), they tested the empirical potential for understanding the normative leadership of the World Health Organization …
Penser le changement dans les réformes du secteur public
Les réformes comme changement social
Comparing Health Workforce Policy during a Major Global Health Crisis
Comparative health workforce policy research may contribute new knowledge to improve health system resilience and population health during a crisis
Challenges of reforming integrated care in the context of ACO-like organizations
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021
Organising Care in a Time of Covid-19
Control rooms in publicly-funded health systems
BACKGROUND: As part of reforms in 2015, the Ministry of Health and Social Services in Quebec, Canada mandated the national implementation of control rooms, making health system actors accountable for implementing value-based performance management. OBJECTIVE: To explore how do organizational actors appropriate control rooms as managerial tools to influence value-based performance in health systems. DESIGN: Multi-site organizational ethnographic c…
Organising Care in a Time of Covid-19
(Mis)taking social responsibility? Implementing welfare state reform by private and non-profit organizations
This article relates institutional theory to the concept of organizational legitimacy with cognitive, moral, and pragmatic dimensions, to analyse how a Dutch national policy reform – aimed at expanding the social responsibility for sick leave and disability toward non-state organizations – is understood and enacted locally. Based on interviews in 52 organizations, the study highlights that implementing welfare state reform is predominantly based …
Caring for older cancer patients
Résistance organisationnelle et co-production de l’action publique
Cet article propose d’explorer les ramifications intellectuelles et théoriques du concept de résistance à partir de trois registres analytiques, soit la résistance comme un problème standard de gestion, la résistance comme antidote à l’aliénation en milieu organisé et la résistance comme une réponse contextualisée et productive. Ces représentations de la résistance méritent d’être complétées en mobilisant les travaux sur les technologies de gouve…
Transitions and Boundaries in the Coordination and Reform of Health Services
Bridging competing demands through co-leadership? Potential and limitations
Collective leadership arrangements in which two people jointly occupy a shared leadership role space are often thought to enable the bridging of competing demands and sources of expertise and legitimacy in pluralistic settings where multiple institutional logics coexist. This research investigates 20 co-leadership dyads in health care organizations to examine whether, when, and how co-leadership arrangements can enable the bridging of institution…
Organizational Ethnographic Case Studies
A growing body of literature suggests combining organizational ethnography and case study design as a new methodology for investigating complex organizational phenomena in health care contexts. However, the arguments supporting the potential of organizational ethnographic case studies to improve the process and increase the impact of qualitative research in health care is currently underdeveloped. In this article, we aim to explore the methodolog…
Understanding Multilevel Governance Processes through Complexity Theory
This paper aims to contribute to a better understanding of multilevel governance processes. We do so by focusing on the in-depth examination of the institutional changes recently implemented in the Quebec health care delivery system that require a close collaboration between interdependent actors acting at various levels of governance. Our three research questions are: (1) How does multi-level governance emerge in a pluralist institutuional conte…
Implementing public policy in a non-directive manner
Engaging patients to improve quality of care
Explaining the Policy Process Underpinning Public Sector Reform
This article provides theoretical elaboration of the policy process underpinning the emergence of public sector reform. It reviews the three predominant models for understanding, namely the Advocacy Coalition Framework (ACF), Institutional Theory Approaches (ITA), and the Multiple Streams Framework (MSF). Rather than treating these frameworks as competing, the article identifies their complementary and interdependent contributions to explaining t…
Understanding the emergence and development of medical collaboration across organizational boundaries
Our goal in this investigation was to help shed light on the very difficult process of collaboration between family physicians and specialists working at different levels of healthcare delivery. More precisely, and grounded on Giddens' structuration theory, our investigation aims to understand how medical collaboration emerges and develops around chronic patients. This was a longitudinal interpretive case study, the "case" being a continuum-of-ca…
S’organiser pour innover
rgulier CR-CHUM et imposer des innovations uniquement par les processus usuels de formulation et de planification des politiques publiques (inter-) sectorielles. Ce dfi intervenir n'pargne pas non plus les oprateurs, galement entendus comme des organisations pluri-professionnelles et pluralistes, et situes aux interstices d'enjeux multiples et contradictoires
Understanding the Attributes of Implementation Frameworks to Guide the Implementation of a Model of Community-based Integrated Health Care for Older Adults with Complex Chronic Conditions
Governança regional no Sistema Único de Saúde
O artigo consiste de ensaio conceitual orientado a subsidiar análises dos processos de regionalização implementados no âmbito do Sistema Único de Saúde, sob a ótica da governança regional. Para isso, realiza revisão bibliográfica de literatura das ciências sociais, da administração pública e da geografia crítica que aborda os conceitos de governança, governança territorial e governança regional no debate sobre o desenvolvimento. No diálogo com os…
Strategizing in pluralistic contexts
Pluralistic organizations characterized by multiple objectives, diffuse power and knowledge-based work processes present a complex challenge both for strategy theorists and for strategy practitioners because the very nature of strategy as usually understood (an explicit and unified direction for the organization) appears to contradict the natural dynamics of these organizations. Yet pluralism is to some extent always present in organizations and …
Agency at the Managerial Interface
This article draws on recent developments in institutional theory to better understand the managerial efforts implicated in the implementation of government-led reforms in public sector services. Based on a longitudinal study of a massive reform effort aimed at transforming the province of Quebec’s publicly-funded healthcare system, the article applies the notion of institutional work to understand how managers responsible for newly formed health…
Governance, Power, and Mandated Collaboration in an Interorganizational Network
This article explores the challenges of mandated collaboration among public health care organizations. This in-depth longitudinal multiple case study examines the interests and values of various organizational actors in three collaborative initiatives, focusing on the mobilization of power within the governance frameworks available to them. The authors elaborate on three alternate readings of the processes examined: The managerialist views poor i…
The Corruption of Managerial Techniques by Organizations
Public sector organizations are under pressure to adopt private sector tools to sustain legitimacy despite uncertainty about the compatibility of the techniques with this context. We explore the consequences of the misfit between the theories underlying two widely adopted managerial techniques (strategic planning and quality management) and the pluralistic power structure and values of public hospitals. We identify four scenarios of adaptation an…
Bridging competing demands through co-leadership? Potential and limitations
Collective leadership arrangements in which two people jointly occupy a shared leadership role space are often thought to enable the bridging of competing demands and sources of expertise and legitimacy in pluralistic settings where multiple institutional logics coexist. This research investigates 20 co-leadership dyads in health care organizations to examine whether, when, and how co-leadership arrangements can enable the bridging of institution…
How medical specialists appraise three controversial health innovations
Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why. Our qualitative study investigated the views of 28 medical specialists and experts from Quebec and Onta…
Organizational Ethnographic Case Studies
A growing body of literature suggests combining organizational ethnography and case study design as a new methodology for investigating complex organizational phenomena in health care contexts. However, the arguments supporting the potential of organizational ethnographic case studies to improve the process and increase the impact of qualitative research in health care is currently underdeveloped. In this article, we aim to explore the methodolog…
Incorporating Public Health More Closely Into Local Governance of Health Care Delivery
Organizational and environmental determinants of the performance of public health units
Implementing public policy in a non-directive manner
Conditions d'implantation d'une réforme. Institutionnalisation des champs impliqués dans le traitement du sida
L'évolution des structures et des connaissances pousse les systèmes sociosanitaires à modifier leurs régulations; aussi, mieux comprendre les processus favorisant ou contrant les changements planifiés est-il important. Cet article vise à intégrer la notion de champ à l'analyse institutionnelle du changement. Cette notion définie par Pierre Bourdeau est particulièrement utile pour cerner la dynamique de l'implantation d'une réforme, comme l'illust…
La transformation du rôle des instances régionales dans le système de santé au Québec -Le cas de Montréal-Centre
The Transformation of the Role of Regional Authorities in the Quebec Health Service. The Case of Regional Government Control in Montreal-Centre The System of health care in Quebec has undergone important changes since its reform in 1991. The reform was carried out within a legislative framework and with regard to particular political and administrative traditions. With the objective of curbing expenditure on health care, securing equal access to …
Learning in Health Care Organizations and Systems
This article presents, through the example of health care systems, a theoretically founded analysis of learning processes in the context of reform implementation. Following a critical assessment of the two most prominent approaches to knowledge management—mechanistic and organic—we propose another approach, which consists in coordinating the learning of interdependent actors. The potential of this approach is illustrated through an empirical case…
Process research in healthcare
English This article argues that process research provides a way of adding depth and perspective to our understanding of organisational change in healthcare and in other fields. We present a three-dimensional model of the research process and argue for the importance of all three dimensions in building useful process knowledge that will have relevance beyond specific settings. We use the model to illustrate our own research process, providing exa…
L'analyse de l'implantation
This article presents some theoretical and methodological tools used in conducting an analysis of intervention implementation. Following a definition of this analysis, five analytical models of organizational change are given as examples of theoretical pathways for a contextual study of intervention implementation. Some methodological pathways are also introduced. More specifically, the examples used in the article present appropriate research st…
Structural and Political Models of Analysis of the Introduction of an Innovation in Organizations
This article presents the results of a study on the introduction of sessional fees remuneration for physicians working in Quebec long-term care hospitals. More generally, this research was concerned with the determinants of the capacity of an organization to implement an innovation. Both a political and a structural model of analysis were empirically probed. We found strong support for the political model and moderate support for the structural m…
Organizational and environmental determinants of the performance of public health units
La transformation du rôle des instances régionales dans le système de santé au Québec -Le cas de Montréal-Centre
The Transformation of the Role of Regional Authorities in the Quebec Health Service. The Case of Regional Government Control in Montreal-Centre The System of health care in Quebec has undergone important changes since its reform in 1991. The reform was carried out within a legislative framework and with regard to particular political and administrative traditions. With the objective of curbing expenditure on health care, securing equal access to …
Le système de santé québécois. Un modèle en transformation
Le système de santé que l'État québécois avait mis en place à la fin des années 1960 n'est plus ce qu'il était. Et l'on ne sait trop à quoi il ressemblera au XXIe siècle quand s'achèvera sa réforme. Ce second ouvrage du Réseau de recherche sociopolitique et organisationnelle en santé ne cherche pas à dresser un bilan des changements en cours, il veut plutôt soulever un certain nombre d'interrogations qui concernent tous les acteurs du système, se…
Proposition d'un modèle d'évaluation de la mise en oeuvre et des effets de la planification des programmes régionaux d'organisation des services de santé mentale au Québec
To effect changes in the health care system, the Quebec government advocates an integrated program management approach within each region. In particular, regional service organization plans (PROS) are a strategy for developing this approach. PROS are complex and dynamic tools for planning services that aim to meet the diverse needs of regional populations and to coordinate delivery of services. To assess the potential of this intervention, this a…
Organizational and Professional Characteristics Predicting External Communications in Canadian Public Health Units
The Corruption of Managerial Techniques by Organizations
Public sector organizations are under pressure to adopt private sector tools to sustain legitimacy despite uncertainty about the compatibility of the techniques with this context. We explore the consequences of the misfit between the theories underlying two widely adopted managerial techniques (strategic planning and quality management) and the pluralistic power structure and values of public hospitals. We identify four scenarios of adaptation an…
Managing Across Boundaries in Health Care
The problem of managing across boundaries is nowhere more urgent or more complex than in the health care field. On the one hand, there is wide recognition that aging populations, economic pressures, and new technologies are stimulating the need for coordination among diverse health care organizations and professionals in order to provide integrated care (Shortell et al. 1996). On the other hand, the professionals that inhabit the health care fiel…
Process research in healthcare
English This article argues that process research provides a way of adding depth and perspective to our understanding of organisational change in healthcare and in other fields. We present a three-dimensional model of the research process and argue for the importance of all three dimensions in building useful process knowledge that will have relevance beyond specific settings. We use the model to illustrate our own research process, providing exa…
Making public health programs last
La transformation des services de santé mentale et le rôle des pros
Le système québécois de santé mentale est actuellement confronté à une réorganisation importante de sa gestion et de l'offre de ses services. Cette restructuration peut être interprétée comme la deuxième phase d'une réforme, amorcée avec la Politique de santé mentale (1989) qui s'est traduite dans les régions sociosanitaires par les plans régionaux d'organisation de services (PROS) (1989-1997). À partir d'une étude de cas, cet article vise à décr…
Conditions d'implantation d'une réforme. Institutionnalisation des champs impliqués dans le traitement du sida
L'évolution des structures et des connaissances pousse les systèmes sociosanitaires à modifier leurs régulations; aussi, mieux comprendre les processus favorisant ou contrant les changements planifiés est-il important. Cet article vise à intégrer la notion de champ à l'analyse institutionnelle du changement. Cette notion définie par Pierre Bourdeau est particulièrement utile pour cerner la dynamique de l'implantation d'une réforme, comme l'illust…
Clinical leaders at the forefront of change in health-care systems
Based on lessons learned from the evaluation of the implementation of an integrated oncological services network in Québec, this paper discusses the following question: to what extent is strong clinical leadership a propitious means of transforming health-care systems, especially when the change leads to significant evolution in inter-professional and inter-organizational relations? Through a qualitative case study, we analysed the exercising of …
Évaluation de la réforme des services psychiatriques destinés aux adultes au pavillon Albert-Prévost 1
Cette étude de cas analyse l'implantation de la réforme du dispositif de soins destinés aux clientèles adultes du Pavillon Albert-Prévost. Le niveau de mise en oeuvre et les effets du nouveau dispositif ont été mesurés, et l'influence du contexte politique et structurel a été analysé. À la fin de la période d'observation, la mise en oeuvre de l'intervention n'était pas encore complétée mais elle avait déjà entraîné des effets intéressants, surtou…
Bilan de la mise en oeuvre et des effets des plans régionaux d’organisation des services (PROS) comme stratégies d’implantation de la réforme des services de santé mentale au Québec
Comme principale stratégie d'implantation de la Politique de santé mentale (PSM, MSSS, 1989), des plans régionaux d'organisation de services (PROS) sont mis en oeuvre dans l'ensemble des régions sociosanitaires du Québec. Cet exercice de planification des activités et des soins de santé mentale vise à démocratiser, décentraliser et reconfigurer le système de santé mentale en fonction d'une gamme plus diversifiée de services. Les PROS entendent au…
L’intégration des services sur une base locale
Cet article rend compte d'une expérience locale d'intégration des services auprès d'une clientèle souffrant de troubles mentaux. L'expérience s'est déroulée dans une région rurale entre 1998 et 2001 et a été financée par le Fonds pour l'adaptation des services de santé (FASS). Les auteurs décrivent le contexte particulier de l'expérimentation, le modèle d'intervention qui, fait particulier, comprend une intégration des services de santé au niveau…
Governance, Power, and Mandated Collaboration in an Interorganizational Network
This article explores the challenges of mandated collaboration among public health care organizations. This in-depth longitudinal multiple case study examines the interests and values of various organizational actors in three collaborative initiatives, focusing on the mobilization of power within the governance frameworks available to them. The authors elaborate on three alternate readings of the processes examined: The managerialist views poor i…
Strategizing in pluralistic contexts
Pluralistic organizations characterized by multiple objectives, diffuse power and knowledge-based work processes present a complex challenge both for strategy theorists and for strategy practitioners because the very nature of strategy as usually understood (an explicit and unified direction for the organization) appears to contradict the natural dynamics of these organizations. Yet pluralism is to some extent always present in organizations and …
Knowledge Exchange Processes in Organizations and Policy Arenas: A Narrative Systematic Review of the Literature
Incorporating Public Health More Closely Into Local Governance of Health Care Delivery
How medical specialists appraise three controversial health innovations
Medical specialists play a pivotal role in health innovation evaluation and policy making. Their influence derives not only from their expertise, but also from their social status and the power of their professional organisations. Little is known, however, about how medical specialists determine what makes a health innovation desirable and why. Our qualitative study investigated the views of 28 medical specialists and experts from Quebec and Onta…
L'évaluation
Quiconque juge évalue ; à ce titre, l'évaluation est universelle. Mais cette activité humaine peut être plus ou moins formalisée, et des stratégies peuvent être adoptées pour en augmenter la validité. Dans la pratique, la rigueur méthodologique autant que la réponse aux besoins réels des organismes demandeurs et le souci constant de l'utilisation de l'information produite sont les meilleurs garants d'une évaluation réussie. Exhaustif et pragmatiq…
Leadership in the Plural
This paper reviews the literature on forms of leadership that in one way or other imply plurality: that is, the combined influence of multiple leaders in specific organizational situations. We identify four streams of scholarship on plural leadership, each focusing on somewhat different phenomena and adopting different epistemological and methodological assumptions. Specifically, these streams focus on sharing leadership in teams, on pooling lead…
Learning in Health Care Organizations and Systems
This article presents, through the example of health care systems, a theoretically founded analysis of learning processes in the context of reform implementation. Following a critical assessment of the two most prominent approaches to knowledge management—mechanistic and organic—we propose another approach, which consists in coordinating the learning of interdependent actors. The potential of this approach is illustrated through an empirical case…
Political science (41 obras) · Business (21 obras) · Public relations (21 obras) · Social Sciences and Governance (20 obras) · Computer Science (19 obras) · Sociology (19 obras) · Healthcare Systems and Practices (14 obras) · Knowledge management (13 obras) · Management and Organizational Studies (13 obras) · Health care (12 obras)