CFS: Action Research, Health Care

Call for Papers for a Special Issue of Action Research: Action Research in Healthcare

Deadline for submissions: May 1, 2013

Healthcare systems across the globe are facing environments characterized by major challenges (Dent, 2003). Although national and institutional contexts are complex and varied, a number of common challenges can nevertheless be discerned. Rising expectations of care by patients and politicians are prevalent in many countries. Moreover, tight budget constraints get ever tighter. In many cases increasing staff shortages in the health profession are getting worse just as political and regulatory environments become more challenging and costs of treatment and longer life expectancies increase those burdens of cost and care. Increasingly, healthcare providers are required to deliver more with less – and this means embarking on new developmental trajectories and grappling with organizational change. This is all the more so in developing countries.

Action Research for Healthcare Improvement

But how might such change be actualized? Action research as a broad approach to change has gained a growing legacy in the healthcare sector (see e.g. Fong Chiu, 2003; Mendenhall & Doherty, 2007; Koch & Kralik, 2006) and this is the focus of this special issue. We see action research as representing a transformative orientation to knowledge creation for healthcare in that action researchers seek to take knowledge production beyond the gate-keeping of professional knowledge makers to empower all stakeholders in the healthcare arena.

Action research provides a rigorous paradigm for implementing and assessing interventions to improve quality and safety in healthcare. The healthcare field is familiar with Community Based Participatory Research for Healthcare (CBPRfH) but perhaps less so with some of the more specific innovations that comes from the broader umbrella field of action research. The vast field of AR encompasses a variety of approaches including action science, participatory action research, co-operative enquiry, appreciative enquiry and so on that entail slightly different emphases in terms of relations to the actors in the field, the role of values, participatory techniques, knowledge interests and so on (Shani et al. 2004). However, at the core of AR stands the ideal of involving patients and their relatives taking part in the co-creation of actionable knowledge for the improvement of care.

AR also entails a collaborative approach thus providing innovative multi-disciplinary projects in which research traditions within medicine and care science collaborate with knowledge outside the sectors’ traditional domain, e.g. engineering, management science, design and other knowledge domains for the improvement of care. One significant development in action research has been a greater acknowledgement of the role of language in shaping and constructing change processes (Gustavsen, 1992). This has been particularly relevant to action research in healthcare given the centrality of professional groups who often share very different discourses. A further development in recent years has been an acknowledgement of the limitations of conducting change processes within the confines of a single organization (Gustavsen, 1998). The latter realization has prompted action researchers in healthcare to look more frequently at inter-organizational or network levels of analysis. For example, the implementation of process-oriented models of healthcare delivery has necessarily entailed the mobilization of an entire health system (Ekman Philips et al, 2004; Fältholm, 2005).

Our modest aspiration for this first special issue is to update Healthcare clinician-scientists about the ever growing paradigm of action research, by asserting and illustrating its practical benefit that includes scholarly results but goes beyond that to convene large scale regional and national networks for healthcare reform (Lifvergren et al., 2011), transform inter-professional cultures of power and knowledge creation (Hynes, Coghlan & Mc Carron, 2012) and innovate at the most entrenched behavioral aspects of chronic disease management (Mendenhall & Doherty, 2007).

Specific questions

Accordingly, it can be seen that healthcare researchers and practitioners have faced similar challenges yet the likelihood is that responses to these have diverged widely. Our interest in the special issue is to showcase papers that reflect such diversity in terms of institutional context, breadth of scope, philosophical underpinnings, intervention techniques as well as outcomes both for practice and the furtherance of scientific knowledge. We call especially for papers that deal with the following questions, while at the same time remaining open to pleasant surprises in papers on topics we do not list.

  • – Case studies of significant action research at first, second and third person levels
  • – Case studies of improved care delivery that highlights learning and action from a multi-disciplinary perspective, integrating knowledge from different scientific fields
  • – Tackling the issue of generating patient participation in AR projects
  • – Addressing especially the behavioral aspects of chronic illness and palliative care
  • – Transforming cultures that entrench the interests of powerful stakeholders
  • – Addressing presuppositions about how conventional healthcare research looks
  • – International networks of learning and collaboration to addresshealthcare disparities.

Papers from the developing world are especially welcome. We have two primary reasons for privileging contributions from the Southern Hemisphere: 1) ARJ is committed to inclusiveness in all its work and makes all efforts to convene a “big tent” on all matters. 2) Specific to healthcare we know that practices in the developing world where resources are scarce are of particular value to scholar practitioners in the developed world where serving more with fewer resources is increasingly a challenge. For example the Western world of corneal eye surgery has been deeply impressed and potentially revolutionized by the eye care practices developed in India where patient health outcomes are similar yet costs are but a fraction. Additionally the editors may also hope that global partnerships will arise in the process of producing this special issue that might not have otherwise.

Deadlines, Reviews and Reviewers

The special guest editors for the issue are Svante Lifvergren and Hilary Bradbury Huang. Full drafts of papers should be submitted online ( no later than May 1, 2013. Please note: all papers should follow regular ARJ submission recommendations, that is, 5000–7000 words inclusive, using APA style. Questions should be directed to the special issue guest editor, Dr Svante Lifvergren

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