Explaining the success or failure of quality improvement initiatives in long-term care organizations from a dynamic perspective.

The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed.

Facilitating change among nursing assistants in long term care.

In this article, the authors consider the implementation of change in long term care organizations (LTCOs) and present their study describing the process by which new nursing assistants are informally integrated into LTCOs in Quebec, Canada. The study method included 23 in-depth interviews with nursing assistants in two long term care centres. The findings enabled the authors to describe the informal process by which new nursing assistants are integrated into LTCOs and the manner in which informal work strategies enhance the work of nursing care, thus enabling the nursing assistants to manage heavy workloads.

The path dependency theory: analytical framework to study institutional integration. The case of France.

Background: The literature on integration indicates the need for an enhanced theorization of institutional integration. This article proposes path dependence as an analytical framework to study the systems in which integration takes place.

Purpose: PRISMA proposes a model for integrating health and social care services for older adults.

Is the PRISMA-France glass half-full or half-empty? The emergence and management of polarized views regarding an integrative change process.

Aim: The PRISMA-France pilot project is aimed at implementing an innovative case management type integration model in the 20th district of Paris. This paper apprehends the emergence of two polarized views regarding the progression of the model's spread in order to analyze the change management enacted during the process and its effects.

Method: A qualitative analysis was conducted based on an institutional change model.

The interdisciplinary condition of work in relational professions of the health and social care field: a theoretical standpoint.

The best-known theories on interdisciplinarity in the health and social care field seek to identify personal characteristics and organizational predispositions favourable to interprofessionnal collaboration. This paper proposes a reversal of this positioning through the theorization of interdisciplinarity in the health and social care field as a condition of the work of its professionals rather than one of their peculiar attributes. To achieve this reversal, we set out the epistemological foundations of the current debate on interdisciplinarity.

A systemwide formula for continence care: overcoming barriers, clarifying solutions, and defining team members' roles.

Objective: To seek input from long-term care (LTC) administrators and staff on solutions for overcoming established barriers to continence care and the roles each team member must play in implementing them.

Design: Cross-sectional, qualitative study using in-depth semi-structured individual interviews.

Setting: Four LTC institutions in Montreal, Quebec.