NEW YORK NURSE: June 2009
I think my hospital did pretty good responding to the A-H1N1 flu emergency and now our health and safety committee wants to do an after-action review. Do you have any suggestions on how to conduct this efficiently?
An after-action review (AAR) is conducted after events to identify what went right and what could have been done better. The actual event actions are recounted and each component is benchmarked against the established standards, policy, or procedure. Where no benchmark exists, the standard of the industry or guidelines from an authoritative agency should be used. In this case the U.S. Centers for Disease Control, World Health Organization, or New York State Department of Health are used.
The process should be fact-based and designed to identify the strengths and weaknesses of the system, rather than trying to find fault and place blame.
To start, the committee should ask key personnel to write down how they saw the event unfold and cite shortcomings or problems encountered. These accounts are then reviewed for commonalities and unique findings. Simultaneously, a few committee members should create an ideal account of a response as if everything was done according to policy, procedure, and benchmark standards. Next the AAR account and the ideal account are compared and the differences are noted. Further discussions on those differences should be held to identify what improvements or changes need to happen. These then become our “lessons observed.”
The real benefit of an AAR is realized when lessons observed become “lessons learned.” That happens through identifying the changes that are needed, educating the staff about those changes, implementing the changes, and putting the changes into practice. An evaluation should be conducted regularly on revisions made when necessary.
Congratulations on your hospital’s efforts and good luck on your AAR!
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