Insider action research and the microsystem of a Danish surgical ward.

This insider action research project aimed to improve interprofessional team performance at a surgical ward. The purpose of the project was (1) to critically appraise potential deficiencies in staffs’ identification, clinical judgment, and management of deteriorating ward patients, (2) to develop an interprofessional change model, and (3) evaluate the impact of the change model and the AR process. The insider AR project took place at a large Danish surgical ward with 60 participating physicians and nurses. The study was conducted in three interconnected action and reflection cycles using mixed methods. Staff viewed the co-creation and co-inquiry as important resources in transforming the ward into a better microsystem. Microsystems as a theoretical framework was used to conceive the success of health system redesign as a matter of enabling the clinical team to meet patient needs. By combining insider AR with microsystems,
this study highlights the importance of senior leaders to recognize the nature and power of using the microsystem approach for strategy, excellence, nnovation, and research. Staff was able to formulate an overarching vision of interprofessionalism and this helped inspire changes in clinical practice for the benefit of our patients.