[Citizen participation in efforts to improve the quality and safety of care]

Given the changing needs of the user, the model of public service administration that was once constructed in ignorance of the user and his concerns no longer finds its place. There is therefore mention of a reversal of trends and a modernization of public institutions and structures based on a reflective approach that over-emphasizes the user's place in the system as beneficiary, recipient and partner of the care service. The participation and the viewpoint of the user constitute therefore a very important stake in the improvement of the quality of the care and the evaluation of the health technologies. Convinced of the importance of involving users in efforts to improve the quality and safety of healthcare, the High Authority for Health (HAS), as a public institution for health democracy in France, has put in place cooperation projects between health professionals and beneficiaries translated into working groups and committees. Through this approach, the HAS gives the beneficiaries the role of experts enabling them, through their experiential expertise to express themselves in the process of modernization and improvement of certification and quality and safety of care. It is with the aim of understanding the various modalities and the level of involvement of users' representatives in the quality procedures in general and in the certification of healthcare institutions in particular that we will try in this contribution to highlight the obstacles and the means in the health sector in France.