System dynamics and action research in aged care

This paper reports on an action research project undertaken to implement a continuity of care model in an extended-care centre. System dynamics modelling and group-modelling techniques were used to examine and improve patient stay times. The paper documents the success of the project, the reduction of patient stay times, improvements in team work and staff morale, as well as systemic adaptations of the rest of the system. It also demonstrates the unintended policy consequence where upstream providers responded to the reductions in patient numbers by swamping the centre with intractable patients which effectively reduced upstream providers' patient stay times and caused the centre's patient stay times to return to pre-intervention levels.