Shifting Patterns in Home Care Work: Supporting Collaboration Among Self-Employed Care Actors

In this paper, we describe and analyze the work practices of an association of self-employed health and care professionals promoting a collaborative approach to home care in France. Our study shows (1) that coordinative artifacts (e.g. a liaison notebook) are central for sharing information and coordinating the work, (2) that focusing on patients’ quality of life leads care actors to address issues beyond the medical scope, and (3) that team members experience different rhythms of collaboration depending on the patient’s situation. We use the concept of knotworking proposed by Engestrom [16] to better understand the challenges faced by people involved in this innovative way of organizing work, and suggest some guidelines when designing a system to support this type of work.