Compliance with basic rules: The challenge of dialogical, enabling ans disciplinary management

Abstract

Lying between two traditions of thought, one of which states that rules must always be respected (Weber, 1921), and the other that they can never be respected, this research suggests a third possibility, a contingent approach that distinguishes two types of rules: complex ones that cannot be scrupulously respected, and basic ones that are supposed to be strictly observed. Since the first type has been extensively studied, most of this article is devoted to basic rules and how they can be managed. In connection with collaborative management research carried out in a hospital in Île-de-France, we studied three activities: monitoring of peripheral venous catheters, sorting of healthcare waste and costing of hospital stays. After analysing breaches of basic rules for these activities, we propose corrective action of various kinds according to function, level of innovation and level of application. Regarding the latter, we have applied the recommendation of Reason (1997) which involves dealing with the problem of non-compliance with rules at three different levels: the organisational, engineering and individual levels. Whereas interventions carried out at the individual level have been widely discredited by studies of complex technological systems, our research shows their value when the relative simplicity of the situation makes it possible to formulate basic rules. Based on the observations made before and after implementing our proposed actions, we suggest adopting an approach to managing breaches of basic rules that we describe as dialogical, involving two complementary and antagonistic aspects: an enabling aspect and a disciplinary aspect.