The Efficacy of SSM-Based Action Research in Nursing Care Improvement

The purpose of this study was twofold. The first was to analyze the effectiveness of soft systems approach (SSM) activities in Japanese medical institutions as a method to promote the quality improvement of nursing care. The second objective was to verify the validity of SSM, which has already been developed in English-speaking countries, by translating it into Japanese and implementing it in Japan, a country with a different cultural background. A workshop that introduced SSM as an action research program was conducted with 12 long-term care hospital nurses with the aim of improving their nursing care. By conducting two cycles of SSM activities, which consisted of seven stages each, it was revealed that the participating nurses were able to: (1) clarify the tasks associated with hospital function reform; (2) change their awareness toward their own nursing care; and (3) as a result, change their nursing behavior. These changes were considered to effectively accommodate worldviews within the SSM activities. New ideas were inspired by learning based on behavioral changes, and continuous and autonomous care improvement was observed. Such findings verified the usefulness of SSM activities.