Exercer son rôle stratégique dans les organisations pluralistes : le cas des cadres intermédiaires du réseau de la santé1,2

Abstract

Cet article porte sur le rôle stratégique des cadres intermédiaires dans les organisations pluralistes du secteur de la santé. Il vise à rendre compte de la complexité de leur travail stratégique en période de changements. L’analyse a permis d’établir trois attributs du strategizing3, c’est-à-dire des activités qui sont influencés par la nature imposée ou participative du changement : 1) la création d’un réseau d’alliances; 2) la négociation des valeurs; et 3) les micro pratiques quotidiennes.

Strategies Used by Middle Managers to Support Employees Carrying Out Emotionally Demanding Work: Which Strategies and Why Those Ones?

“…Regarding the strategies to adjust the workload of the staff and the steps to improve the conditions in which they carry out their work, the findings of some other investigations have highlighted the desire of managers to be open and flexible in the development of work plans and schedules (Ruiller, 2011;Sherman et al, 2007;Skagert et al, 2008). With respect to recognizing staff's work, our results echo those of some other studies (Côté and Denis, 2018;Fall, 2014;Li et al, 2011;Ruiller, 2011;Sherman et al, 2007). With respect to adopting attitudes deemed to be supportive, there is also a mention of attitudes of this kind in Lewis and colleagues' (2012) investigation in which managing emotions, remaining calm, adopting a relaxed attitude and using humour are among the skills that enable managers to prevent and reduce stress in the staff they supervise.…”

“…Support can be provided directly to staff, but it can also include some actions about which the staff may not even be aware. These findings seem consistent with the notion that middle managers have to develop both upward (directed toward senior managers) and downward (directed toward staff) strategies in their efforts to support their staff (Côté and Denis, 2018). Some other authors have also noted certain strategies that can be con-sidered indirect, for example, staff protection strategies and representations (Desmarais and Abord de Chatillon, 2010;Kramer et al, 2007;Skagert et al, 2008).…”

“…Some other authors have also noted certain strategies that can be con-sidered indirect, for example, staff protection strategies and representations (Desmarais and Abord de Chatillon, 2010;Kramer et al, 2007;Skagert et al, 2008). As well, one may consider indirect some of the strategies identified by Côté and Denis (2018) and used by middle managers during periods of health care reform, for example, the creation of a network of alliances and the negotiation of values.…”

“…Middle managers, whose responsibilities include the overall coordination of their staff's tasks and the provision of support for carrying them out, have a key role to play in reducing the risks of psychological health problems because of their direct link with those workers (Lewis, Yarker and Donaldson-Feilder, 2012;Nielsen, 2013;Skakon et al, 2010). Although many managers recognize the importance of providing adequate support, attaining this objective is not necessarily straightforward (Côté and Denis, 2018). Middle managers frequently have to juggle this support role with that of multiple, and occasionally incongruent, other responsibilities, for example, setting and evaluating performance objectives, introducing new requirements and procedures and respecting budget limits (Bolduc and Baril-Gingras, 2010;Ericson-Lidman and Strandmerg, 2009;Rivière, Commeiras and Loubes, 2013).…”