The purpose of this poster is to provide a visual representation of the planning phase of an initial action research cycle (in particular, outcomes from a stakeholder workshop and systematic review). The broader aim of the action research study is to determine the feasibility of implementing a nurse-led clinic within a multidisciplinary ambulatory consulting service (MACS) for people living with multimorbidity, and provide continuity of care across the acute and primary health care settings (Adelaide metropolitan health sector). This poster presentation will focus on the planning phase and relevant methods of one action research cycle, however to provide context, the overall research methodology is also briefly discussed below.
Methods:
For the broader action research study and in line with pragmatism a mixed methods concurrent strategy will be used within the action research cycle(s), incorporating both qualitative and quantitative methods and tools (Saunders M 2015). A concurrent approach will allow the separate use of quantitative and qualitative methods within a single cycle of data collection and analysis. Using both qualitative and quantitative methods within an action research cycle will allow the researcher to compare how data sets support one another. This will allow both sets of data to be interpreted together, providing a richer and more comprehensive response to research questions (Saunders M 2015). This concurrent triangulation approach, and the mixed methods used, increases the generalisability and credibility of the study (Saunders M 2015).
The tools to be used in the broader research study include: systematic review, questionnaire, workshop(s) and semi-structured interviews. For the purposes of this poster presentation the stakeholder workshop will use an ‘Action Evaluation’ practice approach (Bradbury-Huang 2015). A questionnaire will be administered prior to workshop(s) to understand participants’ motivation and build a shared vision and united/committed NLC reference group. Pre and Post-workshop questionnaires to evaluate workshop outcomes will also be administered. The workshop questionnaires will be validated tools identified from the literature. The workshop planning and evaluation process and outcomes will be visually presented on the poster.
Although a systematic review can be considered a methodology, for the purposes of the broader study it will be used as a tool in the planning phase of the first action research cycle. The rationale for a systematic review is twofold. Firstly, it will enable the identification of best practices to inform the implementation of the NLC, and secondly the assessment of appropriate questionnaires/ measurement tools, for data collection within the action research cycles.
The research cycle(s) will take place from 2017 – 2019. The first action research cycle will commence with a workshop as discussed above (or series of workshops if required) of invited stakeholders to nominate a reference group to support implementation of the NLC. The stakeholders will be presented with findings from the systematic review and commence planning for how the NLC will be operationally implemented. The number of research cycles required will be determined by the implementation and progress of the NLC.
Results:
This research project is presently in progress (until end 2019). Stakeholders’ workshop and action evaluation outcomes will be visually displayed on the poster. Anticipated results will include: systematic review outcomes, barriers and enablers to implementing a nurse-led clinic across the acute and primary health care sectors, the process of selecting a reference group and the reference group outcomes and work to date.
Conclusion:
It is anticipated that the broader research outcomes will include changes in professional and structural boundaries resulting from the nurse-led clinic, initially from a metropolitan tertiary referral hospital, but with the potential to inform future nurse-led clinics both nationally and internationally.