Abstract
Action Research has long been the method of choice when undertaking research in clinical practice improvement. It is a method aimed at engendering ownership by the participants in order to sustain pra ctice change. Plan, Do, Study, Act cycles (PDSA) also pro vide a cyclical approach to clinical practice improvement research and focus the clinical team ar ound a specific problem. Through focus groups and discussions with staff, the contributing factor s to a number of patient safety incidents were identified. A series of interventions were implemen ted requiring staff to intervene to mitigate patien t risk and decrease patient safety incidents. These i nterventions were introduced utilising PDSA cycles with concomitant incremental improvements in clinic al processes. Clinical practice improvement resulted in a decrease in patient safety incidents. How ever, whilst individual staff were transformed as a result of their participation in the research, th e culture in which the research was conducted did n ot change. The elements of Action Research and PDSA will be summarised and the key similarities and differences will be compared and contrasted. The in hibiting factors to using Action Research in a dynamic acute care environment will be discussed. T his study will explore how PDSA cycles, with their concurrent similarities and differences to Ac tion Research, can provide a method for researching the implementation of a system improvement solution.
Highlights
IntroductionWhen conducting patient safety research, it is incumbent on relationships between individuals in a particular to use effective methods in order to ensure that the system (Leykum et al, 2009)
At the completion of the clinical practice change, the culture of the clinical environment continued to result in instances where staff did not intervene for patients at risk leading to additional patient safety incidents relating to aspects of failure to rescue, identified as failure to elevate patient risk to ensure an appropriate response and failure to challenge a perceived risk to patient safety
Transforming the staff who are present at the time does not necessarily result in the transformation of the clinical culture and it is the combined transformation of the clinical practice, the participants and the culture in combination which is more likely to change systems in sustained, transferrable ways and result in mitigation of patient risk. It is the fundamental differences between Action Research (AR) and PDSA which has led to the use of PDSA for research into patient safety issues
Summary
When conducting patient safety research, it is incumbent on relationships between individuals in a particular to use effective methods in order to ensure that the system (Leykum et al, 2009) These individuals may development of these clinical quality programs are change over time and it can be argued that AR is more contextually applicable to the clinical setting and result feasible if the problem is owned and solutions initiated in sustained practice change. The research in which the PDSA cycles were used was conducted following several patient safety incidents which resulted in catastrophic patient outcomes These incidents were as a result of failure, by both medical and nursing staff, to recognise and respond to patients whose clinical conditions were deteriorating. Within this study these incidents are termed “failure to rescue”
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