Concepts and Applications of Action Research in Improving the Performance of the Health System: A Guide for Managers

Extended Abstract
Background and Objectives
Many experts believed that classic research methods have not been sufficient to help solve numerous problems faced by the health system. Thus, researchers have developed a new approach to this problem called "action research". The results of various studies in different countries have confirmed positive effects of this type of study in improving the performance of the health system. The aim of this study was to introduce the concepts and applications of action research in improving the performance of the health system.

Material and Methods

The present study is a review of the existing documents and literature. Relevant books and websites were searched through to find various approaches and methods of action research. In order to review action research studies conducted in the field of health and other sectors, valid Persian and English electronic references were reviewed by using the keywords "action research", "health system" and "health" in 2020. At first, definitions and key concepts of action research in the health system were discussed, then the model introduced by Simmons in 1995 for action research, as a comprehensive model, was described and examples of action research studies conducted worldwide, were provided.
Results
In action research, the researcher with the participation of stakeholders identifies the problems in the system and collects information to solve the problems. Then, in accordance with the conditions of the organization and the solutions provided, the researcher tries to improve the performance. Finally, the results of interventions are evaluated. For this reason, action research is known as a method to improve performance and quality. The Simmons model includes subject identification, data collection, planning, implementation, evaluation and feedback. By summarizing the information obtained, the following steps can be suggested for conducting successful action research in health system: determining the subject of the research, describing the current situation, collecting data, analyzing and interpreting data, selecting and implementing a new solution, collecting data, evaluating the impact of the new action and determining its validity, revising and presenting the final report. Action research includes looking (gathering information and describing the current situation), thinking (discovering what is happening, interpreting it and explaining why and how) and acting (planning, implementing and evaluating). FOCUS PDCA is a proposed model for action research. This model includes 9 steps: finding a problem, organizing the research team, clarifying the process, understanding the causes of change, selecting an item to improve, planning, doing, checking and acting.

Conclusion

One of the most important reasons for the success of and attention to action research is the inadequacy of traditional research in answering basic questions and problems in the field of health, and the reason for this inefficiency is the gap between traditional research and the needs of the health system, a weakness that can be properly addressed by action research. Finally, it is recommended that if health managers are looking to promote standards and improve the health system in practice and in their specific situation, it is better to continue action research. Since action research is one of the most practical and basic types of research that provides real prospects to promote standards and improve the health system by analyzing the existing issues and problems and taking action to solve them.
Practical implications of research
Action research is one of the most central and basic types of research that provides the ground for raising standards and improving the health system by analyzing existing issues and problems and taking action to address them.
Ethical considerations
The ethical and fidelity principles have been observed in the processes of selecting sources, extracting, and also reporting the content of sources and studies.
Conflict of interest
The authors of the article declare that there is no conflict of interest for the authors of the article.
Acknowledgement
The authors of the article thank the Vice Chancellor for Research and Technology of Tabriz University of Medical Sciences for approving and financially supporting this study in the form of project number IR.TBZMED.REC.1397.154.