Le rôle des cadres intermédiaires dans le transfert d'une approche humaniste de gestion, de soins et de services : une étude multi-cas au Centre de réadaptation Estrie

摘要

This thesis focuses on the role of middle managers in the transfer of a humanistic approach to management, care and services in a physical rehabilitation center.This thesis should interest decision makers and researchers who are paying attention to humanistic approaches to management, care and services. The design of this multi-case qualitative, exploratory and constructivist research includes six cases, representing the six middle managers of the studied organization. The multi-case study allows us to contrast cases of successful middle managers from the ones who were not really able to transfer the humanistic approach in their program. Data production and analysis are done with methods used in grounded theory. Here are the main findings generated by this thesis. Firstly, our analysis reveals that, in spite of top management efforts to disseminate a humanistic approach to management, care and services throughout the organizations the transfer process sometimes clashes against the absorptive capacity of the middle manager within the program. When the middle manager has the capacity to absorb the humanistic approach, often because it is compatible with his profound convictions, this capacity is first expressed through his behavioral exemplarity. In the eyes of his employees, the middle manager primarily represents an embodied example of the humanistic approach through his behavior. Therefore, the behavioral exemplarity of the middle manager came out as a sine qua non condition through which is possible the co-construction of new humanistic care and services practices to be offered to clients of the program. Secondly, our analysis sheds light on the importance, at the beginning of the transfer process, to explain to employees the necessity to adopt a humanistic approach to management, care and services and to recognize existing humanistic practices in the organization. Thirdly, the results bring to the forefront the importance of macro and micro contexts as determinant variables in the transfer of a humanistic approach to management, care and services. Lastly, an intervention model illustrating the key role of middle managers in the transfer of a humanistic approach to management, care and services emerges from the results. The model also includes contextual elements which facilitate the transfer. On a more practical note, the model can guide organizations in the dissemination process of such an approach by providing a rich description of the stages of the dissemination process, the actors involved, the dissemination strategies and the goals of these strategies.