The medico-social sector today produces a large number of management tools at the national "state" level through the ANAP (National Support Agency for Performance) and ANESM (National Agency for the Assessment and Quality of Medico-social Services and Institutions) at the national "sector" level through large associations and federations, at the regional level by the supervisory authorities which are the Regional Health Agencies, at the level of head offices of associations, or on the ground within the Medico-Social Institutions and Services (ESMS). We study the future of this management tool at the operational level: within medico-social institutions and services (ESMS). More specifically, we study the management practices of directors of ESMS' in the field of disability belonging to administrative associations. The methodology used is twofold. A first qualitative approach allows us to identify the management tools that may be seen without ESMS', to draw up an inventory of the uses of these tools and to identify key explanatory and predictive factors of the variability of statutes for the adoption and use of tools. To do this, we focus on 32 semi-structured interviews of directors of medico-social institutions and services. A second quantitative approach which allows us to confirm the importance of the attitude of the individual towards the tool, and the perceived social norms characterizing the attitude vis-à-vis the management tool of stakeholders. The pervasiveness of attitudes emphasizes the importance of meaning (or schema) carried by the tool. Within this confirmatory stage we focus on 351 responses to a questionnaire sent to ESMS directors.
