Merging Participatory Action Research and System Dynamics as a Locus for Transformation in a Large Scale Hospital Setting

Abstract

In this paper, we report on the utility of merging Participatory Action Research (PAR) with System Dynamics (SD) as a locus for stimulating transformation in a large-scale hospital academic setting.  This is significant because it provides points of cross fertilisation whereby the two frameworks act synergistically with each other to create high leverage interventions for change, which may otherwise not have been apparent. Coupled within a SD auspice, there was a synergistic blend of uncovering an overall ecological view of the public health care system. The PAR methodology is located within the epistemological realm of critical theory and constructivism, whereby facilitating positive social change is viewed to be the key outcome of such research. This outcome has been confirmed by the researchers prioritizing the necessity for a departure from the traditional expert-led health system, evolving into one which supports the empowerment of patients and health-care workers as a necessity. However, the implementation of the improvements has not been as straightforward as initially projected. Some of the challenges included the slow assimilation of proposed solutions for planned care and paucity of key engagement from upstream stakeholders. The value of this paper can potentially serve to encourage key stakeholders in public health care systems to consider viewing health care complexity through the lens of PAR and SD.