Paradoxical Changes and Injunctions in an Implementation Project of the Digital Patient Record

Project‐based change management methods rely on participation to generate support. The project promotes the development of complex organizational arrangements through a “myriad of locally negotiated practices and interactions” that attempt to deal with what can be identified as paradoxical injunctions. The implementation of a new tool such as the digital patient record is an example of a project archivists are working on that is based mainly on document reviews and staff interviews. The discursive approach is concerned with the relationship between the discursive and material elements of the organization. The optimization of the organization is an important objective since its sustainability and that of its actors depends on it. Process improvement in health organizations is the dominant paradigm in most Organisation for Economic Co‐operation and Development countries. The regional authorities are leading the regional network computerization and electronic health record projects.