J L Denis
Dados Biográficos
| ID | 93580 |
|---|---|
| NOME | J L Denis |
| PRENOMES | J L |
| SOBRENOME | Denis |
| ASSINATURA | DENIS J L |
| AFILIAÇÕES | Université de Montréal |
| ORCID | 0000-0003-1295-332X |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 86 |
| TOTAL DE CITAÇÕES | 320 |
| TOTAL COMO AUTOR | 86 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1983 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 9 |
Network dynamics in public health advisory systems
This study presents a dual‐method approach to systematically analyze public health advisory networks during the COVID‐19 pandemic across four jurisdictions: Belgium, Quebec, Sweden, and Switzerland. Using network analysis inspired by egocentric analysis and a subsystems approach adapted to public health, the research investigates network structures and their openness to new actors and ideas. The findings reveal significant variations in network c…
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…
The World Health Organization as an engine of ideational robustness
The paper focuses on the role of the World Health Organization (WHO) in promoting a healthy world population as a generative and robust idea within health policy. The WHO’s health credo transcends national boundaries to promote health globally. It is embedded in norms, values, and standards promulgated by the organization and contributes in shaping the health responses of national governments. Ideational robustness refers to the ability of the WH…
Quality Improvement Support Agencies as a systemic quality strategy
In a high‐quality health and social services system, policymakers encourage action at all levels of change to ensure the consistency of quality strategies. This is especially important at the systemic level, in which the other three levels of change are nested. This study aims to present an analysis of Quality Improvement Support Agencies as a systemic strategy, which has been successfully implemented in several jurisdictions. A comparative study…
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
Employing the policy capacity framework for health system strengthening
The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries…
Network‐building by community actors to develop capacities for coproduction of health services following reforms
INTRODUCTION: Responsive, integrated and sustainable health systems require that communities take an active role in service design and delivery. Much of the current literature focuses on provider-led initiatives to gain community input, raising concerns about power imbalances inherent in invited forms of participation. This paper provides an alternate view, exploring how, in a period following reforms, community actors forge network alliances to …
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
Leadership configuration in crises
Our study examines the empirical case of the political leadership response to Covid-19 in England. It shows that, rather than the ideal configuration of leadership suggested by theory, within which individualistic and collective leadership blend, a less balanced configuration emerged that can be characterised as incoherent. In England, an individual political leader behaved in an authoritarian way, which ignored evidence about how to address Covi…
Health reforms and policy capacity
Recent work on health system strengthening suggests that a combination of leadership and policy capacity is essential to achieve transformation and improvement. Policy capacity and leadership are mutually constitutive but difficult to assemble in a coherent and consistent way. Our paper relies on the nested model of policy capacity to empirically explore how health reformers in seven Canadian provinces address the question of policy capacity. Mor…
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…
Lariisa
O grupo de colaboradores do LARIISA realiza pesquisa e desenvolvimento de soluções tecnológicas para apoio à tomada de decisão em sistemas de saúde desde 2009. Dentre as soluções produzidas está o GISSA®, sistema em nuvem resultado da evolução científica e tecnológica do projeto LARIISA. O objetivo do presente artigo é descrever a trajetória de evolução do GISSA®, ferramenta tecnológica que apoia a Estratégia de Saúde da Família no nordeste do Br…
(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…
On redesigning public health in Québec
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…
Understanding Hybridity in Public Organizations
This article explores and extends the concept of hybridity to understand current changes in public services organizations, notably as seen from an organizational studies perspective. The notion of hybridity has become more important, given that the public sector increasingly blurs with other sectors and more social actors. Previous reliance on the use of ideal‐types in characterizing public services reforms has masked expanding heterogeneity. We …
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…
The Practice of Leadership in the Messy World of Organizations
This article examines the practice of leadership in organizations characterized by ambiguous authority relationships. Drawing on three empirical case studies illustrative of a long-term research program on change in health care organizations, we examine leadership as a practical activity focusing particularly on its dynamic, collective, situated, and dialectical nature. We invite researchers on leadership to look carefully at the embeddedness of …
The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms
Drawing on a longitudinal study from the early years of implementation of health‐care networks in Quebec, this article describes how public‐sector managers deal with complex challenges when both organizational structures and organizational strategies are radically transformed simultaneously. The new organizations studied had to completely re‐shuffle roles and responsibilities of their management teams while making sense of their new mandate of de…
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…
Implementing Community Based Primary Healthcare for Older Adults with Complex Needs in Quebec, Ontario and New-Zealand
The aim of this paper is to set the foundation for subsequent empirical studies of the "Implementing models of primary care for older adults with complex needs" project, by introducing and presenting a brief descriptive comparison of the nine case studies in Quebec, Ontario and New Zealand. Each case is described based on key dimensions of Rainbow model of Valentijn and al (2013) with a focus on "meso level" integration. Meso level integration is…
Multiple Perspectives Analysis of the Implementation of an Integrated Care Model for Older Adults in Quebec
Mandated system-wide integration appears to have structural, organizational, functional, and normative transformations, but its clinical changes are more uncertain in view of the observed divergent perspectives of actors. It will be interesting to explore if the systemic changes are precursors of clinical changes or, on the contrary, explains the lack of clinical changes
Defining the ‘public’ in a public healthcare system
Using data from a larger study on public participation in the Quebec healthcare system, we draw on the sociological theory of Bourdieu to analyze speakers’ in-use definition of ‘the public’ in some 100 interview and observation notes. We found that the definition of ‘the public’ is the subject of a vigorous struggle at the symbolic level. Many actors share a common, but often conflicting, interest in the elaboration and objectification of a given…
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…
Health reforms and policy capacity
Recent work on health system strengthening suggests that a combination of leadership and policy capacity is essential to achieve transformation and improvement. Policy capacity and leadership are mutually constitutive but difficult to assemble in a coherent and consistent way. Our paper relies on the nested model of policy capacity to empirically explore how health reformers in seven Canadian provinces address the question of policy capacity. Mor…
On redesigning public health in Québec
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…
Employing the policy capacity framework for health system strengthening
The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries…
Incorporating Public Health More Closely Into Local Governance of Health Care Delivery
Governance Structures and Political Processes in a Public System
Debates about the form and nature of changes in the management of public systems have for some time now been articulated under the theme of governance. All definitions of governance are related to the problems of securing convergence among a diversity of actors and organizations, of redistributing power in an organizational or social field characterized by a high level of heterogeneity and of gaining sufficient legitimacy to act in the name of th…
The struggle to implement teaching‐hospital mergers
This paper presents some initial results from a longitudinal study of two major hospital mergers (involving three large institutions each). After examining the context of the two mergers and the cultures that must be integrated, we describe the processes of pre‐merger negotiation, leadership development, strategic framing and operationalization. Despite very different processes that seem on the surface smoother in one organization than in the oth…
How do values shape technology design? An exploration of what makes the pursuit of health and wealth legitimate in academic spin-offs
By actively supporting cooperation between academia, clinical settings and industry, several policy initiatives assume that the two policy agendas of health and wealth can be reconciled through the development of health technology. Our goal in this article is to shed light on the way the concurrent pursuit of health and wealth operates in practice by examining the valuation schemes, actions and decisions that shaped technology development in thre…
Organizational and environmental determinants of the performance of public health units
Network dynamics in public health advisory systems
This study presents a dual‐method approach to systematically analyze public health advisory networks during the COVID‐19 pandemic across four jurisdictions: Belgium, Quebec, Sweden, and Switzerland. Using network analysis inspired by egocentric analysis and a subsystems approach adapted to public health, the research investigates network structures and their openness to new actors and ideas. The findings reveal significant variations in network c…
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 …
Les recherches anthropologiques sur le vieillissement
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…
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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…
La performance des départements de santé communautaire du Québec
Francois Champagne, Nicole Leduc, Jean-Louis Denis, Raynald Pineault, La performance des départements de santé communautaire du Québec: le point de vue du réseau, Canadian Public Policy / Analyse de Politiques, Vol. 17, No. 2 (Jun., 1991), pp. 155-172
Les contraintes à l'efficience allocative dans le système de santé
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 …
The struggle to implement teaching‐hospital mergers
This paper presents some initial results from a longitudinal study of two major hospital mergers (involving three large institutions each). After examining the context of the two mergers and the cultures that must be integrated, we describe the processes of pre‐merger negotiation, leadership development, strategic framing and operationalization. Despite very different processes that seem on the surface smoother in one organization than in the oth…
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…
The Dynamics of Collective Leadership and Strategic Change in Pluralistic Organizations.
La diffusion d'une innovation portant les germes de son plafonnement
Sommaire: L'objectif de cette recherche est d'identifier les facteurs de diffusion d'une innovation ‐ la réutilisation des hémodialyseurs (rh) ‐ ainsi que de son plafonncment marqué par la controverse, à travers les motivations et stratégies des groupes d'acteurs clés. Plus particulièrement, cette étude vise à situer le rôle de la “ médecine fondée sur des données probantes ”dans la dynamique de la diffusion de cette innovation. Nous partons du c…
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
Governance Structures and Political Processes in a Public System
Debates about the form and nature of changes in the management of public systems have for some time now been articulated under the theme of governance. All definitions of governance are related to the problems of securing convergence among a diversity of actors and organizations, of redistributing power in an organizational or social field characterized by a high level of heterogeneity and of gaining sufficient legitimacy to act in the name of th…
Defining the ‘public’ in a public healthcare system
Using data from a larger study on public participation in the Quebec healthcare system, we draw on the sociological theory of Bourdieu to analyze speakers’ in-use definition of ‘the public’ in some 100 interview and observation notes. We found that the definition of ‘the public’ is the subject of a vigorous struggle at the symbolic level. Many actors share a common, but often conflicting, interest in the elaboration and objectification of a given…
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…
Political science (74 obras) · Public relations (42 obras) · Sociology (37 obras) · Business (33 obras) · Computer Science (32 obras) · Health care (28 obras) · Social Sciences and Governance (23 obras) · Healthcare Systems and Practices (20 obras) · Economics (19 obras) · Knowledge management (19 obras)