QVCT des soignants : Rôles et responsabilités du système de santé, des professionnels et des usagers

Quality of working life in critical care: Roles and responsibilities of the health system, professionals and users

Abstract

Objective
To analyze determinants of quality of working life (QWL) in intensive care, focusing on interactions between healthcare organization, professional practice, and patient-related expectations.

Patients and Methods
Narrative and conceptual analysis based on existing literature and a systemic approach to intensive care organization, using the “triangle of responsibilities” framework and examining limits of institutional indicators.

Results
In intensive care, QWL arises from the interplay between organizational constraints, professional commitment, and patient and family expectations. In a context of high acuity and uncertainty, these interactions require frequent adjustments by frontline teams. A substantial part of real work (emotional burden, end-of-life care, family interactions, informal regulation) remains insufficiently captured by standard indicators. Fragmented governance and lack of explicit criteria to adapt activity to workload lead teams to assume implicit regulatory roles.

Conclusion
Improving QWL in intensive care requires better recognition of real work and clearer decision-making frameworks to support organizational sustainability.