Gouvernance et accompagnement du changement : le cas de la phase expérimentale du Plan Alzheimer du Québec
Bibliographic record
Abstract
Les écrits scientifiques montrent que l’implantation des politiques visant la transformation des systèmes sociosanitaires est souvent freinée en raison d’une forte centralisation de la gouvernance et d’un manque d’accompagnement du changement. Cet article propose une analyse de l’implantation du Plan Alzheimer du Québec, caractérisé par la décentralisation de responsabilités aux acteurs locaux et par la mise en place d’un important dispositif d’accompagnement du changement. L’analyse découle de huit entretiens réalisés auprès d’acteurs ayant exercé des fonctions aux niveaux national et régional, ainsi que 15 focus groups regroupant des cliniciens et des gestionnaires. Les résultats montrent l’importance de la bonne articulation entre les divers paliers de gouvernance et la nécessité de mettre en place des dispositifs d’accompagnement du changement, dès la phase de conception de l’innovation, afin de favoriser l’équilibre entre l’adaptation des changements aux réalités locales et le respect des principes fondamentaux qui guident la politique. Codes JEL : I80
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".