La mecanique du Care : Cas d'un EHPAD associatif

Benevolent management (Rodet, Desjacques 2017; Bruyère 2022), humanist management (Brasseur, Yanat 2010), alternative management (Barlatier et al. 2017), etc. are all expressions that have gained momentum in the last decade. Behind these various names is a questioning of traditional hierarchies and the need to rethink the relationships between actors in organisations, to develop a 'caring' approach to employees, users and themselves, and to encourage traditional companies to adapt and transform. We see the development of liberated companies, teleworking, autonomous teams, co-working spaces and so on. New ways of collaborating, new workspaces and new timeframes need to be invented. These developments are no strangers to healthcare organisations, which are subject to the constraints of productivity, quality, traceability and safety. Against this backdrop of work intensification, care theories (Gilligan 2008; Tronto 2008; Molinier, Laugier, Paperman 2009; Brugère 2021) lay the foundations for organisational care or management, which would certainly involve organising work to produce results, but even more so, caring for work (and those who produce it) to achieve sustainable performance. In a 'care' approach, this performance could be measured by the organisation's ability to respond to the concrete needs of its various stakeholders. Care as a continuous process invites us to think about work in a necessarily systemic way, with actors who depend on each other to make themselves socially and economically useful. Care also makes it possible to recognise a form of vulnerability in the organisation: a manager is a vulnerable being who accompanies and/or leads other vulnerable beings. An exploratory case study (phase 1), carried out in an EHPAD association, enabled us to demonstrate that managerial practices centred on ‘care', or more precisely, which are part of a constant concern to take care of employees and users and to recognise the interdependence of all, whatever the hierarchical level, have created conditions favourable to COVID-19 crisis management (Bruyère, Massard, 2021). Recognition of everyone's vulnerability (management, carers and users), transparency, incentives for collaborative working and transdisciplinary project management are all provisions and practices that make stakeholders recognise their interdependence. In this commission, we propose to take the case study (outside the COVID period, phase 2) a step further by questioning and analysing the organisational and managerial arrangements in place in this care-focused establishment, with regard to users, staff and the local area. Semi-structured interviews are currently being carried out with the various stakeholders (4 interviews out of a planned 12): board of directors, carers, users, administrative staff and management. The aim here is to understand the extent to which the managerial systems in place contribute to sustainable performance (overall health), and to question the conditions (or dispositions) necessary for care in order to contribute to the theoretical foundations of organisational care (Meyronin, Grassin, Benaven, etc.).