New vulnerabilities as an opportunity to reshape participation models

The paper presents the materials collected in two paths of action-research about the changes taking place in health care services, which have provided moments of the debate between management and health professional (Open Space Technology), and then moments of work in small groups; specifically the paper addresses the way in which the management and the professionals working in health care services reconstruct the conflicts between different "levels" of the organization (management, clerical, staff in contact with the users, ecc.), and between the organization and citizens. From this process emerges a complex picture of the relationships involved, arising from the end of an ideal agreement with the mission (of "public service"), a general reassessment of the professional hierarchy, a different attitude of the users, ecc. These elements call to rethink in a different way the "bridges" between the "levels" identified by witnesses; that is, to rethink the forms of mutual exchange between them, necessary if we want to maintain the provision of a "common service", and acted in the name of the community (in terms of common values and resources).

Keywords: Health care service, action-research, patient-demanding, hierarchy, distribution of work, organizational change

Gino Mazzoli, Nuove vulnerabilità come opportunità per il ripensamento dei percorsi partecipativi in "SALUTE E SOCIETÀ" 2/2011, pp 50-68, DOI: 10.3280/SES2011-002005