An AAR is a short discussion that can be held at any time and enables the individuals involved to learn for themselves what happened, what went well, what needs improvement and what lessons can be learned from the experience.

The spirit of an AAR is one of openness and learning. It is not about problem fixing or allocating blame. Lessons are not only shared by the individuals involved but can be documented and shared with a wider audience.

An AAR can be used in an incident, for a project or at the end of the day or shift. It can be undertaken by a group or an individual as they ask themselves four questions:

• What did you expect to happen? By asking each participate about their expectations it can sometimes highlight problems in communication as individuals have different expectations.

• What actually happened? By identifying what went on an accurate picture can be built up.

• Why was there a difference? This is where participants need to concentrate on the what and not the who between expectations and actuals.

• What can we learn for next time? What learning points have been identified so that the organisation or individual continues to improve?

By using these four questions AARs improve communication and team working. Examples of where AARs have been used in the NHS include:

• At the end of a shift during handover. This identifies what went well during the shift as well as what did not go as well.

• At the end of a meeting. This ensures that meetings are focussed, efficient and productive.

• After an incident involving NHS patients and staff. This assists the investigation as an open communication process.

• After a project involving a number of different Agencies/Contractors to ensure that lessons are captured for future joint ventures.

Even if an event has gone well and according to plan, it is always useful to undertake an AAR as there is always areas for continuous improvement.

YouTube has several videos including the Wildland Fire Lessons Learned Centre simulating an AAR after a controlled burn and highlighting the basic techniques. The second video covers points to help the facilitator/conductor when leading an AAR.

Some Further Reading

Gerada, Dr Clare. Trust me…I’m a leader. March 2013. NHS Confederation.

Walker, Judy, Andrews, Steve, Grewcock, Dave, Halligan, Aidan. Life in the Slow Lane: making hospitals safer, slowly but surely. J R Soc Med 2012: 105: p283-287.

Cronin, Gerard and Andrews, Steven. After action reviews: a new model for learning. Emergency Nurse: June 2009. Vol. 17(3). p32-35

 

Content adapted, with thanks, from Basildon Healthcare Library