[COVID-19 screening strategy in workplaces in the canton of Vaud: what lessons?] / Stratégie de dépistage du Covid-19 dans les entreprises vaudoises : quels enseignements ?

Repetitive screening in enterprises was one of the measures recommended in Switzerland in the fight against COVID-19. In the canton of Vaud, 70 companies participated in the program, 73 % of which were small and medium-sized enterprises. The SARS-CoV-2 positivity rate was 0.07 % out of 70'105 tests performed. The impossibility of teleworking and the reduction of transmission were the main motivations for joining the program. The facilitating elements were the availability of the Cantonal Medical Office, the existence of a starter kit and the support of the hierarchy within the companies. The main obstacles were the arrival of vaccination, the multiplicity of screening providers and the workload. The program was a pragmatic action tool for companies rather than a population-based strategy.

Le dépistage en entreprise était une des mesures de lutte contre l'épidémie de Covid-19 promues par la Confédération. Dans le canton de Vaud, 70 entreprises ont participé au programme, dont 73 % de petites et moyennes entreprises. Le taux de positivité au SARS-CoV-2 a été de 0,07 % sur 70 105 tests réalisés. L'impossibilité du télétravail et la réduction de la transmission ont été les principales motivations d'adhésion. Les éléments facilitateurs ont été la disponibilité de l'Office du médecin cantonal, l'existence d'un starter kit et le soutien de la hiérarchie au sein des entreprises. Les freins principaux ont été l'arrivée de la vaccination, la multiplicité des prestataires de dépistage et la charge de travail. Le programme a représenté un outil d'action pragmatique pour les entreprises plutôt qu'une stratégie à visée populationnelle.

[Home care situations : discontinuity of trajectories]. / Situations de soins à domicile : discontinuité des trajectoires.

Introduction :The aging of the population in Western Europe led to a substantial increase of home-based care services. These services are quite simple in nature, but very complex to provide in the community. Little is known about how they are actually provided.Aim :By the mean of trajectory and arc of work analysis, the aim of this qualitative sociological study is to understand how support and care activities are ran in their local context.Method :Eight home care situations where observed during a period of three months, in three different home-based centers of one French speaking canton of Switzerland. Data collection included semi-structured and ethnographic interviews, service documents, key reference documents and observation of work practices in natural settings.Results :Data analysis showed that the standardization of evaluation practices - and a common frame of reference oriented by administrative principles - limited the possibility to problematize situations as a whole, from a caring point of view. As a consequence, services are mainly delivered in a fractionated way - and work organization is presently driven by compliance concerns.Conclusion :The ongoing standardization of care processes is a challenge to individualized and community-based care.