L'action publique en faveur de l'usager: de la dynamique institutionnelle aux pratiques quotidiennes de travail

The obligation of informing patients is part of the institutional dynamics for increasing patients'safety and comfort. A survey conducted by the author along with the Paris Public Hospital System is used to see how this obligation, which augments the place of written documents as a way to transmit information and homogenizes the contents of this information, fits into the actual activities of health-care professionals in hospitals. These activities involve many interactions with patients and those close to them, interactions that can be understood and interpreted in various ways. They occur in a context where professionals with various statuses must simultaneously perform several assignments. In order to implement the rule about informing patients, the conditions must be evaluated that are necessary for anchoring this obligation in hospital practices, which have to be adapted case by case even though institutional prescriptions, along with their legal consequences, entail standardizing them.