The obligation to inform patients: institutional dynamics and work practices.

The obligation of informing patients is part of the institutional dynamics for increasing patients' safety and comfort. A survey conducted by the auth or along with the Paris Public Hospital System is used to see how this obli gation, which augments the place of written documents as a way to transmit information and homogenizes the contents of this information, fits into the actual activities of health-care professionals in hospitals. These activit ies involve many interactions with patients and those close to them, intera ctions that can be understood and interpreted in various ways. They occur i n a context where professionals with various statuses must simultaneously p erform several assignments. In order to implement the rule about informing patients, the conditions must be evaluated that are necessary for anchoring this obligation in hospital practices, which have to be adapted case by ca se even though institutional prescriptions, along with their legal conseque nces, entail standardizing them. (C) 2000 Editions scientifiques et medical es Elsevier SAS.