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After Action Review in Healthcare: Driving Continuous Improvement

Course Overview:

This course introduces healthcare professionals to the After Action Review (AAR) process—a structured debriefing method that encourages reflective learning, identifies gaps, and drives actionable improvements. Participants will learn to facilitate AARs in diverse clinical and administrative settings to enhance patient safety and operational outcomes.

An After Action Review (AAR) is a structured discussion conducted after an event to analyse what occurred, why it happened, and how improvements can be made, based on the perspectives of those involved. AARs serve as both an investigative and learning tool within the Patient Safety Incident Response Framework (PSIRF). There will be an increased emphasis on informing and involving patients in AARs, aligning with national guidance. NHS England highlights the importance of engaging patients, families, and staff appropriately following a patient safety incident and ensuring their involvement in any subsequent investigation.

This course is aimed at those who wish to facilitate and gain better understanding of AAR reviews and those who are part of an AAR team.

“An after action review method of evaluation usually takes the form of a facilitated discussion following an event or activity. It enables understanding of the expectations and perspectives of all those involved, and it captures learning, which can then be shared more widely.” NHS England

“AAR is a structured facilitated discussion of an event, the outcome of which gives individuals involved in the event understanding of why the outcome differed from that expected and the learning to assist improvement. AAR generates insight from the various perspectives of the MDT and can be used to discuss both positive outcomes as well as incidents.” - Patient Safety Incident Response Framework supporting guidance NHS England 2022

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After Action Review in Healthcare: Driving Continuous Improvement

Accredited by:CPD

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Learning Objectives:

  • Understand the Fundamentals: Define AAR, its origins, principles, and relevance to healthcare.
  • Master the Methodology: Learn the step-by-step process for planning, conducting, and following up on AARs.
  • Apply Best Practices: Identify strategies for creating a safe, blame-free environment conducive to honest reflection.
  • Implement Action Plans: Develop actionable improvements based on AAR findings and monitor their effectiveness.
  • Foster a Culture of Learning: Recognise the role of leadership and team culture in sustaining continuous improvement efforts.

Course Content

 Introduction to After Action Reviews (AAR)

  • 1.1 What is an AAR?
    • Definition and history (military origins vs. modern applications)
    • Comparison with other debriefing and quality improvement methods
  • 1.2 The Need for AAR in Healthcare
    • Current challenges in healthcare (e.g., patient safety, clinical errors)
    • How AARs drive learning and system improvements

AAR Framework and Methodology

  • 2.1 Key Components of an AAR
    • Purpose, scope, and intended outcomes
    • Roles and responsibilities (facilitators, participants, observers)
  • 2.2 The Step-by-Step AAR Process
    • Pre-AAR: Preparation, data collection, and setting objectives
    • During AAR: Structured discussion using guided questions (What was expected? What occurred? Why did it happen? What can we do differently?)
    • Post-AAR: Documentation, feedback, and development of action plans
  • 2.3 Tools and Techniques
    • Facilitator checklists, templates, and data collection tools

Preparing for a Successful AAR

  • 3.1 Identifying Appropriate Events for AAR
    • Types of events: clinical incidents, simulation exercises, emergency responses
    • Criteria for selecting AAR-worthy events
  • 3.2 Setting the Stage
    • Establishing a psychologically safe, non-punitive environment
    • Preparing participants and securing leadership support
  • 3.3 Involving patients and Families
    • Strategies for involvement in AAR

Conducting the AAR Session

  • 4.1 Facilitating Open Dialogue
    • Techniques to encourage candid discussion
    • Managing group dynamics and handling sensitive issues
  • 4.2 Guiding Questions and Discussion Flow
    • Structuring the conversation around key questions:
      • What did we expect to happen?
      • What actually happened?
      • What went well and what could be improved?
      • How can we improve performance going forward?
  • 4.3 Overcoming Common Barriers
    • Dealing with defensiveness and blame culture
    • Strategies to ensure balanced participation
    • Human Factors

Post-AAR Activities and Action Planning

  • 5.1 Documenting Findings
    • Best practices for recording insights and lessons learned
    • Utilizing templates and digital tools for documentation
  • 5.2 Developing and Implementing Action Plans
    • Converting observations into measurable, actionable steps
    • Assigning responsibilities and setting timelines
  • 5.3 Monitoring and Follow-Up
    • Establishing metrics to assess the impact of changes
    • Scheduling follow-up reviews to evaluate progress

 

Applying AAR in Various Healthcare Settings

  • 6.1 Simulation Exercises and Role-Playing
    • Hands-on practice sessions to simulate AAR scenarios
    • Debriefing simulations to reinforce learning

Leadership, Culture, and Sustainability

  • 7.1 The Role of Leadership in AAR
    • Encouraging a culture of openness and continuous learning
    • Leadership strategies for overcoming resistance to change
  • 7.2 Embedding AAR in Organisational Culture
    • Aligning AAR with quality improvement and patient safety initiatives
    • Continuous training and reinforcement for long-term success
  • 7.3 Evaluating the Impact of AAR
    • Setting benchmarks and key performance indicators (KPIs)
    • Using feedback loops to drive ongoing improvement