After Action Review - Overview

The HSE’s Incident Management Framework 2020 (IMF) recognises the importance of having in place a proportionate and graduated approach to the review of incidents. To support this, the IMF introduced a more adaptive approach to the use of systems analysis and in addition introduced the concept of After Action Review (AAR). In this context the ARR has been identified as a methodology for a concise approach to incident review and as a mechanism to de-brief with staff following a Category 1 incident for which a Comprehensive review is planned.

An After Action Review (AAR) is a structured review process which seeks to rapidly identify and reinvest learning for improvement. The AAR discussion focuses on 4 questions which seek to ascertain what staff expected would happen, what actually happened, why was there a difference between these and what the service can learn from the event.

AAR works best in situations where there is a positive, psychologically safe, multidisciplinary team dynamic and an openness to discuss the event.

Since the introduction of AAR in 2018, it has been noted that apart from its use in the review of incidents, services have also found that the four questions can also be used in other situations. Most commonly cited is the use of AAR on an informal basis by both individuals and teams within the context of their working day to review their practice so as to identify learning and improve their individual and team performance.

Finally it can be used as part of a planning tool for a future event  where it is used to define plans and expectations, outline critical steps and expected results, ask “what if?” questions in order to confirm a shared understanding of the planned event.

In summary, the use of AAR can assist both individuals and teams to improve their performance and consequently their ability to deliver safer, better patient care and improved service user and staff experience.