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Using Military Review in Healthcare Can Translate to Process Improvements

By Joanne Kaldy / December 12, 2018

Taking a page from the military, an After-Action Review (AAR) can help your organization identify and implement “lessons learned” and promote a culture of quality improvement.

The AAR is generally defined as a “professional discussion of an event, focused on performance standards, that enables soldiers to discover for themselves what happened, why it happened, and how to sustain strengths and improve on weaknesses.” It enables leaders and teams alike to maximize the benefit of any task or effort.

In healthcare organizations, AAR can help provide:

  • Candid insights into how each team member performed and help identify strengths, opportunities for improvement, and the need for additional education/training.
  • Feedback and insights that can be implemented in future training.
  • Details that may be absent from policies, documentation, or reporting.

The AAR centers on four questions:

  • What was expected to happen?
  • What actually happened?
  • What went well and why?
  • What can be improved and how?

For the AAR to succeed, it requires a laser focus on the event or project being addressed. Every relevant player on the team should participate and have an open and honest discussion. While the AAR is designed to identify opportunities for improvement and ways to overcome obstacles, it also is important to identify ways to retain and strengthen what was done well. Ideally, the AAR should be conducted soon after the event, while all of the details are fresh in everyone’s minds.

Depending on how formal an AAR process you are prepared to conduct, either an independent/objective facilitator or a team leader can guide the discussions. A formal review may take hours, while an informal AAR can be conducted in 30 minutes or less.

A formal AAR isn’t practical or necessary for every program or effort and should be used selectively to minimize the burden on leaders and staff. Consider a formal review to address high-level issues or concerns, such as maximizing emergency preparedness and response after a disaster, shoring up cybersecurity efforts after a breach, addressing an uptick in turnover, and quality improvement after a survey citation.

Ultimately, the AAR will contribute to culture of quality improvement. It also encourages teams to focus on root cause analysis instead of finger pointing.

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