Hospital Quality: from Crisis to Transparency: The Institutional Career of « Quality Indicators » in France[De la mise en crise à la mise en transparence de la qualité hospitalière. La carrière institutionnelle des « indicateurs qualité » en France]

For several decades, reforms have been implemented in the French hospital sector in order to optimize management and to control health expenses. By following the institutional career of "quality indicators" since the late 1990s, this paper focuses on the social process through which hospitals have been "put in crisis" about the quality of their care. From a careful empirical study of the genesis of these indicators, we argue that this "fallibility regime" is less a clearly formulated reform project than an "emerging effect" resulting from a complex interlacing of relations between the actors involved. We also show how this fallibility of hospital quality has been incrementally re-appropriated by State regulators in the 2000s. In transforming this "crisis" into a "transparency" project, regulatory institutions have strengthened their control on hospital activities.