Paul Holmström - Try before you fly – smarter ways of working in healthcare helped by the interplay between action research and simulation

Link directly to the doctoral thesis

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Try before you fly – smarter ways of working in healthcare helped by the interplay between action research and simulation

Healthcare is a complex system where employees from different work together and meet patients with varying disease trajectories. Action Research ¹ (AR) is a method which engages participants and adapts work methods to local conditions. System Dynamics /SD) simulation enables testing new work methods or the effect of medical interventions in a computer before actualization and makes it possible to fine-tune without risk to patients or organizational efficiency.

– I thought I could see simulation models which were insufficiently useful as the users were not involved. I wanted to combine my experiences of working with change with my knowledge about simulations. My research touches on several research areas, System Dynamics, Action Research as well as healthcare, says Paul Holmström, Bachelor of Business Administration, nowadays a “senior citizen”, but with a long and varied work career².

The purpose of the thesis is to deepen the understanding of the interplay between System Dynamics simulation (SD) and Action Research (AR) applied to issues in healthcare. And to identify principles and patterns for how to integrate SD into AR, when working with multiprofessional groups in healthcare to find solutions to work related problems.

When the professions meld their perspectives, it leads to a secure solution that works

The potential benefits of using SD to uncover principles to prevent diseases was also studied. The method is cost efficient and enables to simulate solutions in the computer without risk for patients or efficiency. It also improves the understanding of the relation between different patient and treatment related factors for different diseases. Decision makers can e.g., be supported in selecting intervention that have the most preventive effects when they study the probable effects of different scenarios.

– The significant advantage in the methods that I describe is how participants from different professions can unite their perspectives in a simulation model. They have been able to test a multitude of solutions, discard those that do not work and feel confident that the decisions for change that they have taken will work in practise.

The main work pattern in the studied cases meant that they built multiprofessional knowledge repositories through two divergent and convergent phases, where first problems were identified and then tested solutions in the computer. The results were adapted to local conditions and compared to traditional change processes increased the probability of actualization.

Also works for medical research projects

The methods are also highly relevant in medical research projects. Through simulations the medical researcher can compress time compared to studies on patients as well as in the simulation test each influencing factor in isolation.

ADDITIONAL FACTS

1. Read more about how Action Research can work in a Swedish article
2. Article in Sjukhusläkaren 2017, in Swedish
    
3. Paul Holmström in short: Since 1988 he has been working with change and development in organizations, to a high degree in healthcare. 2005 he took a master’s degree in System Dynamics simulation at the IT University in Gothenburg. That led to becoming a research student at Chalmers and a licentiate degree 2017. After his main supervisor at Chalmers retired, Caroline Olsson at Regional Cancer Centre West supervised his doctoral studies. Many of the research projects that he has been engaged in has concerned cancer and been related to the Regional Cancer Centre.

Comments from other researchers about the results, published in the International Journal of Health Policy and Management:

1. Closing the Implementation Gap
2. A Pragmatic and Systemic Approach to Advance Research in Health Policy and Management
3. Modelling a System to Help Improve It