System dynamics and action research in aged care.

This paper documents an Action Research project undertaken to implement a Continuity of Care Model in an Extended Care Centre. System Dynamics modelling and group-modelling techniques were used to examine and improve patient length of stay (LOS). Several indicators of success of the project are noted. They included the reduction of LOS, improvements in teamwork and staff morale, and various systemic adaptations in other parts of the health care sector. Upstream providers responded to the reductions in patient numbers by swamping the Centre with intractable patients. This effectively reduced up-stream providers' LOS, and returned the Centre's LOS to pre-intervention levels.