[Healthcare manager and project management of quality improvement : analysis of managerial action using a professional hands-on training in project management].

Introduction : project management is on the expected proficiencies for head nurses. Context : The work on the organizations’ improvement carried out by head nurses, is rarely covered in the literature. Objectives : to follow the implementation of actions from projects led by head nurses and to analyze the parameters of success. Method : for a year, an intervention study has followed 17 projects initiating improvement measures. Semistructured interviews were conducted with health-care teams and managers. All of them reported the results of the implementation of each measure as an operational improvement. A mixed analysis containing a logistic regression investigated associations between the result of the action and the various contextual characteristics. Results : this study involved 111 actions. 71 % of them concluded an operational improvement. The organizational and supporting actions had a high success rate, which decreased when hazards were not managed by healthcare managers. Discussion : this study highlights the place of strategies through the implementing methods and the chosen actions. Recommendations are made in order to promote a collective assessment. Conclusion : scientific approaches are proposed to discuss the organizational work.