Implementing action research in hospital settings: a systematic review.

Abstract

Health care organizations and hospitals in particular are highly resistant to change. The reasons for this are rooted in professional role behaviors, hierarchical structures and the influence of hidden curricula that inform organizational culture. Action research (AR) has been identified as a promising bottom-up approach that has the potential to address the significant barriers to change. However, to date no systematic review of the field in health care exists. The paper aims to discuss these issues. A systematic review of the literature was conducted. Studies were reviewed with regard to the four stages of AR; problem identification, planning, implementation and evaluation. Only 19 studies were identified that fit the inclusion criteria. Results revealed significant heterogeneity with regard to theoretical background, methodology employed and evaluation methods used. Only studies published and written in the English language were included. The field of AR interventions would benefit from a theoretical framework that has the ability to guide the methodology and evaluation processes. This is the first systematic review of AR in hospitals.