We discuss action research healthcare as a transformative approach that continuously innovates in healthcare, attending to the "quadruple" aim. This article is shaped around a decade of evidence in Sweden. At the heart of healthcare action research is the endeavour to "learn by doing" with the participation of key stakeholders, including the patient. Experience suggests that an action research approach is particularly relevant when treating patients with chronic diseases and complex care needs. This inclusion is itself a social learning process and is key to realizing the improved outcomes. Insights from objective quantitative studies are balanced with personal and inter-subjective dialogue that aligns different parts of a system in a movement towards improvement. Close-up non-defensive self-inquiry in the company of colleagues, with trust dynamics building over time, may be a key point of leverage for such systemic improvement activities.
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