Over the past twelve years, I have helped dozens of organisations in the NHS, higher education and in corporate contexts start using AAR to improve the quality of learning after events. Yet despite the proven value of AAR to patient safety and team performance, AAR is still not making the impact it can and should. This short article explains some of the barriers to implementation that I have encountered during this time so that you can mitigate for them in your own context.
In 2009, I joined a team at University College London Hospitals (UCLH) that had adapted the AAR concept from the
I echo Katherine's comments. Do take time to recharge. I worked for the NHS for 34 years and had "mental health" days off for myself and suggested them to my team. You do have the capacity to recover! And the system has a responsibility to support you in doing so.
Thank you for writing and sharing your insights and concerns. Pleased to hear you have found After Action Review so helpful. Ive been using it with corporate teams too to help them through the lockdown response with good outcomes. AAR is a time to make sense, to be heard and to think together about what could be improved.
Reading this dialogue made me think about the "freedom to speak up guardian" role as these people champion and advocate for the right of staff to be heard. A patient safety specialist role could have the same ethos; empowered to challenge the status quo. In other safety critical industries, they deliberately move people with this responsibility on after a fixed period so they don't "go native".
AAR is a deceptively simple process for learning from any every day or exceptional 'action', which takes the individual expectations and experiences of the same event to build a shared mental model of what happened and use this as the basis for learning and action planning. To be successful it is essential that AARs are led by a trained AAR 'Conductor' who uses a defined four-question process and a universal set of AAR 'ground rules' to create a safe learning environment. The other vital component, which is often missing, is the organisational context in which the AARs take place. This needs t