Objectifs. Les objectifs de l'étude étaient d'identifier les ajustements faits durant l'implantation ainsi que les conditions favorisant ou limitant l'utilisation du système de mesure de l'autonomie fonctionnelle (SMAF). Méthodes. Un devis qualitatif multi-cas a été développé. Le SMAF a été implanté dans 11 établissements médico-sociaux franç ais. Les analyses ont été effectuées selon la méthode thématique de type mixte de Miles et Huberman. Résultats. Les principaux ajustements faits en cours d'implantation concernent l'assistance informatique et le soutien clinique. Des facteurs stratégiques, organisationnels et individuels expliquent le niveau d'adhésion des acteurs et le déroulement de l'implantation. Conclusion. L'implantation SMAF et du logiciel eSMAF ® dans les établissements médico-sociaux repose sur un certain nombre de conditions qui ont pu être identifiées lors de l'étude. Ces conditions ont permis d'élaborer des recommandations structurées pour de futures implantations. Mots clés : système de mesure de l'autonomie fonctionnelle (SMAF), évaluation de pratiques d'implantation, établissement médico-social Abstract. Objective. The objectives of the study were to identify the adjustments made during the implantation and the conditions favouring or limiting the SMAF utilisation. Methods. A multiqualitative quote was developed. The Functional autonomy measurement system (SMAF) was implanted in 11 French medico-social establishments. Analyses were made with the mixed type thematic method from Miles and Huberman. Results. Principal adjustments that have been made during implantation concern the informatics assistance and clinical support. Strategic, organizational and individual factors explained adhesion level of actors and the subsequent flow of implantation. Conclusion. Establishment of SMAF and of the software eSMAF ® in the medico-social establishments rests on a certain number of conditions which could be identified during the study. These conditions made it possible to work out structured recommendations for future implementations.
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