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La restructuration du travail chez Santé Info : du développement de l’activité d’un centre de contact spécialisé à ses incidences sur les pratiques situées

Abstract : The contributions of this doctoral thesis are to address some of the methodological and conceptual challenges arising from the use of activity theory as a theoretical framework in empirical studies. In the process, it also reveals some interesting considerations on collective competencies and on well-being in the workplace. Our research studies the organizational change at Health Info, an inbound call center for a number of mutual health insurance companies. Health Info provides users with health information and referral to help them to make better choices in healthcare and to reduce their expenses. To improve the service, the company redesigned the activity of call operators. Some of the most experienced call center agents formed a new team (referred as the social team) which had the responsibility to process the information requests of users in need of financial support and different kind of allowances, within outbound calls. This thesis analyzes the organizational change in this empirical context as a development of both the collective activity at Health Info and the local individual practices. We build upon three approaches to the study of context - activity theory, situated action and situated cognition. Our research is based on a two years of ethnographic study, which employed various data collection techniques. Those included ethnographic observation, video recordings of naturally occurring situations as well as interviews with staff members. We systematically attended and video recorded the regular staff meeting of the social team. In addition, we shadowed staff members and followed specific client cases as first identified by call operators, then processed by the members of the social team and eventually transferred for further analysis to the social worker. Our results highlight two axes of contradictions underlying Health Info’ current development. The first is defined by the tension between the integration and evolution of existing services within the mutual insurance companies, in the one hand, and the emergence of Health Info as a provider of independent counseling to the clients of the mutual funds, on the other. The second axis of contradiction is inherent to the professionals’ work perspectives: call center agents both provide information to the users and advice them on what decisions to make, provide them with social support. Furthermore, our study underlines the practical dimensions of Health Info’ restructuring. The restructuring of the social service within Health Info through the creation of a specialized team played a crucial role in transforming work practices. In addition, the new environment resulting from the restructuring necessitated that the agents redefine their duties and the scope of their actions.The analysis of situated practices shows that works perspectives are grounded on salient configurations, which are both emergent in situ and collectively elaborated cultural resources. Our analysis shows that understanding and doing one’s own work is inextricably linked to understanding and anticipating the constraints, potential difficulties, and organizational limitations of the others in a team. Throughout, we find that understanding the work of others is a crucial resource not only for the collective collaborative practices but also for the individual subjects’ understanding of their activity.
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Maria Ianeva. La restructuration du travail chez Santé Info : du développement de l’activité d’un centre de contact spécialisé à ses incidences sur les pratiques situées. Psychologie. Université Lyon 2, 2012. Français. ⟨tel-01377939⟩



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