PhD Defence of Pierre-Philippe DUJARDIN from BCM team on 06/04/2018 at 1:30pm :

“Ordinary project management led by head nurse”

Supervision :
- M. le Professeur Patrice FRANÇOIS, Professeur des Universités - Praticien Hospitalier, Université de Grenoble Alpes, laboratoire TIMC-IMAG, Grenoble, Director
- M. le Docteur Thomas REVERDY, Maître de Conférence Universitaire, Université Grenoble Alpes, Grenoble, Co-Director
- Mme la Docteure Annick VALETTE, Maître de Conférence Universitaire, Université Grenoble Alpes, Grenoble, Co-director

Jury :
- Mme la Professeure Céline DESMARAIS, Professeur Universitaire, Haute Ecole d’Ingénierie et de Gestion, canton de Vaud, Suisse, Reporter
- M. le Professeur Laurent BOYER, Professeur des Universités - Praticien Hospitalier, Université d’Aix-Marseille, Reporter
- M. le Professeur Dominique VINCK, Professeur des Universités, Université de Lausanne, Suisse, Examiner
- Mme la Docteure Paule BOURRET, Enseignante-Formatrice, CHU de Montpellier, Examiner

Place : Amphithéâtre de l’Institut de Formation en Soins Infirmiers (IFSI), Bâtiment des écoles, 12 Chemin Duhamel, La Tronche (RdC du bâtiment des écoles du CHU Grenoble Alpes)

Key-words :

Head nurse ; Project management ; Hospital management ; Organization of care ; Work organization ; Learning process ; Quality

Abstract :

Literature describes hospital organisation as complex and compartmentalised. It identifies the head nurse (HN) as a pivot to translate and articulate various professional logics. Her function is usually described by their daily operational work of coordination to the detriment of a job destined to structure and improve organisation. By focusing on project management, the aim of this thesis is to identify the work of organisational coordination carried by the HN. It leans on an educational device which puts student executives in the position of a third party to explore an organisational problem delegated by a HN. After the restitution to the HN produced by a third party, research intervention has followed the implantation of 17 projects over one year. The thesis is organised around four published articles : the first one prones the benefits and limits of the third party intervention. The second presents two methods to use the third party production, revealing the link between the project, the HN and the team. The third article explores the conditions of project management carried by the HN in three relational dimensions : in relation to the medical team, in cross section with other units of care, and at institutional level with the administrative and hierarchical actors. The fourth defines, among 12 variables, the factors which influence the result of the implemented action plan. The results show that the third party allowed to re-configure the collective relations in the unit of care and relaunched the HN in his power to act. The success of the project was more frequent when it was presented to the team and discussed in meetings, that is, when the HN helped regulate debates and be referee. On the contrary, when the HN waited for institutional support, or when the project management was prescriptive, without formal communication with the nursing staff, failure was more frequent. In summary, 71 % of the actions encountered resulted in an operational improvement. The research shows that the attributes of methods and social are not all identified in the project management carried by the HN. The results permit to consider the work of coordination produced by the HN as « ordinary Project ». Recommendations are formulated. At an institutional level, it is suggested to identify a unit managerial support. The proposals underline the importance of giving visibility to the ordinary project and necessity to develop spaces of discussion. Activities of initial and continuous training are identified to accompany the future HN and the HN in their managerial practices.