Une innovation instrumentale de gestion et sa laborieuse mise en oeuvre: La tarification à l'activité (T2A)
An Instrumental Management Innovation and its Laborious Implementation: The Task-based Pricing (T2A)

Summary/Abstract: The main recent management innovation in the hospital environment has been the gradual introduction of the task-based pricing (T2A). This introduction led to difficulties of various kinds depending on the size or status of the institutions while the impact of this innovation was considered significant for a large majority of them. Starting with interviews with hospital officials, we wanted to firstly analyze their representations about this reform according to the position of their establishment in the hospital field. In a second phase, we approached the fact that beyond their representations, these officials are also involved in innovation which, far from applying it mechanically, perform a creative work meant to give it purpose and also limits within their institution, to obtain the desired effects but also to avoid the effects considered undesirable. Finally, in the third row, we returned to the transformations suffered by an innovation like T2A following criticism related to its effective implementation. This reframing of the innovation is it the price of its success or it leads to turn it into a "real gas plant" to use one of the qualifiers met on the field? Rather than answering this question, we will take interest in the fact that the reframing of the innovation acts on the field workers' representations and their commitment to innovation.

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