Altering Frontiers. Группа авторов

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      1 1 EHPAD: Etablissement d’Hébergement pour Personnes Agées Dépendantes; retirement home.

      2 2 SAAD: service d’aide et d’accompagnement au domicile (social homecare service); SSIAD: service de soins infirmiers à domicile (home nursing service).

      Introduction written by Corinne GRENIER and Ewan OIRY.

      PART 1

      Innovations as Seen by Stakeholders

      Taking up the challenge of “altering frontiers” through organizational innovations raises the double question of the place of different individuals in this profound transformation.

      Individuals are first and foremost at the heart of this transformation because they are the driving force behind it. They are singular individuals – the innovators – who develop new interdisciplinary practices, implement decompartmentalization and transform usual routines (Gherardi 2008). They transform their practices by experimenting in “innovative spaces” typically outside the organization, sometimes protected from the rules that usually govern it (Bucher & Langley 2016). They are sometimes tired of the multiple social norms to which they cross in order to innovate (Alter 2011). However, they are clearly, for many, the heart and driving force of the organizational innovation process that enables decompartmentalization.

      As for the rest of the professionals, even if they are not exactly innovators, are they not also the target of organizational innovations that aim to decompartmentalize? In this way, they discover and experience on a daily basis the transformations that have been designed for them and that they must appropriate and implement. These innovations transform their ways of working, shake up their skills and sometimes their professional identities (Robelet et al. 2005). This can also make them more efficient and even satisfy them by giving more meaning to their work, emphasizing that a decompartmentalized organization ensures better and more effective patient care or support.

      “Altering frontiers” through organizational innovations is therefore bringing about interplay of identity dimensions as well as questions of competence or performance.

      However, silos are also a simple and relatively effective organizational solution for maintaining and deepening employee expertise (Currie et al. 2012). In a healthcare activity where expertise is crucial and where its shortcomings can have immediate consequences on the lives of patients,

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