Top picks: 12 After Action Review resources

Summary

After Action Review (AAR) is one of the learning tools that can be used for the Patient Safety Incident Response Framework (PSIRF). First used by the US army on combat missions, AAR is a structured approach for reflecting on the work of a group and identifying strengths, weaknesses and areas for improvement.

In this Top picks, we’ve pulled together 12 hub resources on AAR, including useful templates and guidance, and blogs on how AARs can be used and have been implemented in healthcare. 

Content

1. After Action Review summary report template (HSSIB)

This AAR summary report template has been co-designed by NHS England, the Health Services Safety Investigations Body (HSSIB) and staff leading AARs in a range of healthcare organisations. It was developed to standardise the reporting of AARs. The structure is purposefully simple so that AARs can focus on reflective conversation and do not become a bureaucratic documentation exercise.

2. WHO: Guidance for after action review

The WHO guidance for AARs presents the methodology for planning and implementing a successful AAR to review actions taken in response to public health event, but also as a routine management tool for continuous learning and improvements. Four formats of AARs are described including the debrief, working group, key informant interview and mixed method AARs, and the accompanying toolkits containing materials to support the designing, preparing, conducting, and following up on each AAR format.

3. NHS England Learning Handbook: After action review

This NHS England document explains what an AAR review is and when and how to use it.

4. Patients and the After Action Review – Guidance for healthcare providers

This guidance describes how AAR can be used to ensure patients and their families and carers can and do make a significant and meaningful contribution to the learning process.

5. Accelerated learning through AAR

In this blog, AAR specialist Judy Walker shares an account of a successful AAR that took place amongst a surgical team. The AAR was called after a near-miss where the anaesthetist was prevented from injecting spinal block medication into the wrong side of a patient's spine by an operating department practitioner. The story demonstrates the benefits of AAR, including accelerated learning, a no-blame approach, flattening staff hierarchy and a significant reduction in the time it takes to investigate an incident.

6. How can After Action Review (AAR) improve patient safety?

The NHS Long Term Plan highlighted several safety issues that need to be addressed: the fear of blame and retribution which curtails reporting and learning, lack of staff understanding of patient safety matters and workforce issues. This short article from Judy Walker summarises what she has learnt about how AAR can directly address the first two of these and indirectly impact on the third. 

7. Patient Safety: Emerging Applications of Safety Science

The NHS’s approach to incident reporting in investigations, PSIRF, has given rise to new-found opportunities and freedom of investigation and incident management. This book aims to explore emerging safety sciences by leading experts and the practical application of them in differing clinical and organisational contexts. Exploring these theories, this text brings together contributors from a variety of academic and healthcare professions, alongside those with lived experience, to help you understand some of the emerging theories of safety science and their practical application, including a chapter on AARs.

8. Listening to and learning from a hospital porter

This blog describes how an After Action Review (AAR) that took place at a large London hospital following the first wave of Covid-19. As part of the AAR, Emergency Department porter Aaron described his experience of the first Covid 19 surge—wheeling large numbers of patients who had died through an empty hospital. It describes the value of staff listening to different perspectives as a way to reflect on their own experiences and understand the impact events have on different individuals. It highlights the importance of listening to the process of learning for individuals and teams.

9. Mind the potholes! Implementing After Action Reviews: A blog by the National AAR Reporting Template Team

Remember the last time you drove down a road full of potholes? Avoiding the hazards they create—burst tyres, damaged suspension and under-carriage—is like a healthcare organisation navigating potential pitfalls when implementing the learning response tools PSIRF toolkit. Using the potholes metaphor, the National After Action Review (AAR) Reporting Template Team share their reflections on implementing AAR and its challenges.

10. Why AAR Conductor training makes "every AAR count"

Judy Walker talks about improving team performance through the AAR approach and the importance of AAR Conductor training.

11. Applying an after-action review process to examine a complex public health response in New South Wales (NSW), Australia: lessons for reflective practice

AARs are used to systematically examine the functions, capabilities and barriers impacting effective pandemic responses. This paper describes the methods used for and the lessons learnt from undertaking the first formal state-wide AAR of the public health response to COVID-19 in New South Wales, Australia.

12 Routes to involvement: Patients and families in After Action Reviews

Despite growing recognition of the moral, practical, and quality-based arguments for involving patients and families in learning responses after safety incidents, their voices remain largely absent from the AAR process in healthcare settings across England. This guidance aims to change that by offering a clear, structured approach to patient and family involvement in AARs—one of the most widely used tools under PSIRF.

Share your AAR resources

If you have insights, tools or knowledge to share relating to AAR why not comment below (you will need to be a member of the hub and sign in) or get in touch with us at [email protected]. At Patient Safety Learning we are always keen to share good practice, challenges and training resources that could help support safe care more widely.