Study of the composition of the various forms of coordination in the case management practice

PURPOSE: In 2004, Quebec’s Health and Social Care Ministry implemented an integrative reform aiming to systematize coordination which employed prescriptive devices. The will to systematize coordination practices is supported by formal coordination devices, such as case management. However, many obstacles lay in the path of these devices’ usage. THEORY: This presentation is based on Boltanski and Thévenot’s (1991) theory of conventions. This theory was utilized to analyze the operations that lead to the convened agreements which serve coordination in its formal and emergent aspects. METHODS: We utilized a qualitative and exploratory embedded case study design in which we employed three data collection and analysis methods: a documentary analysis of the integrative prescriptions, interviews aiming to make explicit the concrete coordination practices and direct observation of professional practices. RESULTS AND CONCLUSIONS: We identified different types of coordination systems in case management practices. Notably, the so-called ‘peri-professional’ system that grants the family caregivers the role of intermediate between the frail elder and the health and social care network, as well as the so-called ‘virtual’ system produced by the technological means of the computerized clinical files.