Depiction of Health. 2021;12: 273-285.
doi: 10.34172/doh.2021.27
  Abstract View: 259
  PDF Download: 110

Health Care System Management

Original Article

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

Saber Azami Aghdash 1 ORCID logo, Ahmad Mousavi 2 ORCID logo, Salar Mohammaddokht 3 ORCID logo, Hojatolah Gharaee 4* ORCID logo

1 Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Health and Community Medicine, Dezful University of Medical Sciences, Dezful, Iran
3 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
4 Health Center of Hamadan City, Hamadan University of Medical Science, Hamadan, Iran
*Corresponding Author: Email:


Background and Objectives

Action research has become popular in health system research and problem solving. The aim of this study was to introduce the concepts and applications of action research in health system.

Material and Methods

This study reviewed the related documents and literatures in Persian and English Language through a comprehensive search in web-based resources.


This study compares the Simmons model and other methods and provides a successful model for the use of pilot research in the health system.


This study recommends utilization of action research in solving health system problems in practice and also for learning in the field.

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 revie 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.


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 information, analyzing and interpreting data, selecting and implementing a new solution, collecting information, 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.


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 realprospects 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.


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.

Keywords: Health Services Research, Action Research, Administrative, Quality Improvement, Immune System
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Submitted: 12 Feb 2021
Revision: 28 Apr 2021
Accepted: 08 May 2021
ePublished: 06 Sep 2021
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