Defense of Ludivine Dupont

From the proliferation of environmental indicators to the analysis of their conception process: the case of the healthcare sector

Supervised by Florence Charue-Duboc

Thesis defense is scheduled for March 18, 2026 at 2 p.m. in Palaiseau at the École Polytechnique, avenue Fresnel, 91120 Palaiseau, BEM Building.

Abstract:  This PhD thesis is situated within management studies research on éco-innovation and management tools. It starts from the observation of a proliferation of environnemental indicators - eco-design tools and ecolabels - developed insice the 1990s to make the environmental impacts of products visible and to guide the decision of firms and market actors. However, the same body of literature highlights the limited deployment of thses tools and their limited effects, both on the side of firms and on the side of markets.

The paradox at the core of this PhD thesis is therefore the following: although actors are aligned on this diagnosis, they nevertheless continue to be actively involved in new indicator conception processes, rather than appropriating existing ones. This PhD thesis thus proposes to shift the critical focus—frequently oriented toward the content of tools or their conditions of use—toward the dynamics at work in their conception processes.

To analyze this paradox, the PhD thesis relies on a qualitative, interpretive, and abductive research approach, conducted within the framework of a CIFRE industrial PhD program. The empirical field is the healthcare sector, and more specifically the medical devices sector. The empirical material is based on three longitudinal case studies, drawing on 134 semi-structured interviews, participant observation conducted during more than one hundred collective meetings, and extensive secondary data.

The results are presented in three articles, each analyzing one of the cases studied.

The first article examines the conception of a sector-level éco-score for medical devices, co-constructed by a coalition of inter-organizational actors bringing together manufacturers and hospital purchasers through professional organizations.

It shows that the éco-score design process constitutes a space in which interests are made visible and compromises are constructed between diverse logics (environmental, economic, and regulatory). In addition, the article highlights the “ghost” role of an actor—the public authorities—who strongly influence choices without participating directly in the process.

The second article analyzes the conception of an internal eco-design indicator—an éco-score—developed within a firm operating in the medical devices sector. By highlighting the dynamics of co-construction among the actors involved, as well as the successive adjustments of the tool over time, this article shows how the design process of a tool contributes to its appropriation. It identifies four central dimensions of this phase that contribute to appropriation: the projection of uses, material iteration, inter functional arbitration, and cognitive articulation.

Finally, the third article focuses on the longitudinal study of the design of an eco-design tool by an LCA expert and its use. It shows the role of the tool designer and of the conception process in the absence of appropriation by R&D teams. In particular, it specifies design and use contexts that lead to this phenomenon, namely informal structures centralized around the expert and weak formal structures.

Overall, this PhD thesis shows that the conception process of environmental tools constitutes a central space for collective action, enabling actors to project themselves, negotiate, and qualify environmental issues, despite uncertainty regarding the uses and effects of the tools.

Key words: Eco-innovation, eco-design, management tools