System dynamics and action research in aged care
journal contributionposted on 05.06.2017 by Walker, Beverly, Haslett, Tim
Any type of content formally published in an academic journal, usually following a peer-review process.
This paper documents the an Action Research project undertaken to implement a Continuity of Care Model in an Extended Care Centre providing aged care and psychogeriatric, inpatient, outpatient, community and residential care in Victoria, Australia. The context of this research is a health system which has been under pressure to reduce costs. Bundoora Extended Care Centre (BECC) is one stage of a care process through which aged patients are moved as their clinical situation improves. The action research project used SD modelling and group modelling techniques to examine and improve patient stay times, specifically the period of time patients remained at BECC until they could be discharged. In the first part of the paper, the success of the project, not only in terms of reduction of patient stay times but also team work and staff morale, is documented. In the second part, the systemic adaptations of the rest of the system to the success of the project are documented. The reduction of patient stay times at BECC effectively left it with excess capacity. This capacity was filled by upstream providers who swamped BECC with intractable patients who returned BECC's patient stay times to pre-intervention levels while simultaneously reducing the up-stream providers patient stay times.