This dissertation seeks to understand what role the public plays, through CLIs (Commission of Local Information), in the governance of nuclear safety. It presents an in-depth longitudinal case from the French nuclear sector and proposes a pragmatist framework to study the construction and maintenance of the public over time. The author analyzes the circumstances in which the people potentially impacted by nuclear activities can become active participants in the governance of such high-risk industries, and how they can organize themselves and build a common voice. The dissertation establishes that when CLIs play both the role of a “Generalized Other” representing the public’s voice, and the role of a civil provider of second opinions, able to discuss the complex subjects at stake, they become a powerful and legitimate stakeholder in nuclear safety governance. In such circumstances, CLIs should be able to conduct investigations that are both commonsensical and technical. These characteristics would make CLI-led investigations all the more rich and useful for the governance of nuclear safety. The technical aspect (with the help of experts and specialists) would reinforce the legitimacy of such investigations in the eyes of nuclear actors, and their commonsensical or “layman’s view” aspect would provide an alternative view of nuclear questions in the safety debate, potentially leading to creative ways of addressing the issues and situations at stake.

PurposeThe paper aims to investigate how far the pragmatist concept of inquiry (Dewey, 1916, 1938) makes it possible to develop a processual and relational approach to accountability, moving the focus away from a representational conception of truth and subjectivist/individualist views on meaning-making, toward collective exploration and understanding of an issue by stakeholders with the aim of transforming social practices. The paper studies an accountability process in action, namely nuclear incident reporting, and its role in the construction of a community of inquiry investigating nuclear safety.Design/methodology/approachThis research opts for a case study methodology including 36 in-depth interviews, field observation and document analyses. The data are drawn from a three-year field study of a “Local Information Commission”, a body set up to represent the public living near a nuclear site.FindingsThe object of accountability needs to be constructed through a joint exploratory inquiry by accountors and accountees into reports of incidents as originally presented, to advance their understanding and capacity for action.Research limitations/implicationsIt will be important to test this processual and relational approach to accountability in other types of situation, involving different governance issues than nuclear safety.Practical implicationsTo turn theoretical stakeholders such as the public into real stakeholders (e.g. in the studied case, active participants in safety inquiries), specific social and managerial conditions must be fulfilled (concerning time, resources, commitment to open, taboo-free dialogue and legitimacy).Originality/valueThe paper argues that Dewey's concept of inquiry makes a valuable contribution to the processual and dialogical view of accountability.

The COVID crisis has put hospitals under great stress over the past 2 years and some institutions came close to their breaking points. This has often forced decision makers and the entire institutions to change their practices and the organization of the hospitals in order to continue operating despite limited resources. It has also led some hospitals to develop and implement organizational innovations. This article is based on a qualitative case study analyzing the case of a crisis unit that has implemented various innovative medical and organizational actions in order to manage the flow of resuscitation Covid patients in a large group of hospitals in Paris. This team has implemented a new evaluation scale of resuscitation needs in order to better manage quantitatively and qualitatively the patients’ flow; it has defined medical criteria to select the patients eligible for transfer; it has organized one hundred patients transfers to other hospitals’ intensive care units, in and out of the region, involving private hospitals and private ambulances for a new collaboration. The case allows us to understand innovation in the midst of an extreme situation, when material and human resources are highly constrained, and with very strong time pressure. We highlight the importance of implementing flexible organizational processes and staffing the crisis team with physicians and nurses with specific and complementary skills and experience in flow management and crisis situations.

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