Facing the challenges of absenteeism and budget constraints in public hospitals. Contribution of management tools in a context of institutional pluralism

Public hospitals are facing two pernicious challenges: increased budgetary constraints on the one hand, and exacerbated absenteeism and scarcity of paramedical human resources on the other. Healthcare managers are faced with this dual challenge, which they must manage by taking into account two institutional logics in tension: the care logic and the managerial logic. We examine how the use of workforce management tools can enable managers to manage this institutional pluralism in public hospitals, and these contradictory issues. It appears that the instrumental uses of these tools enable managers to embody the managerial logic alone, while the socio-political uses of these tools, implemented in multi-professional discussion forums, promote the hybridization of institutional logics. We detail the conditions that foster the hybridization of institutional logics through the uses of management tools, and the spaces in which it can occur.