By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
A leader recently described to me her experience with staff redeployment from her unit during COVID-19. It had been somewhat of a disaster for various reasons, mostly related to a lack of planning. Given the possibility of a second COVID resurgence in her geographic area this Fall, there is a strong likelihood that staff could again be redeployed. I asked her what was being done to learn from what happened. The answer was nothing. It seemed like a perfect opportunity to do some reflection. I recommended to her that she propose an After Action Review. She was unfamiliar with the concept, as are most nurse leaders outside of the military, where it is a commonplace occurrence.
The After Action Review (AAR) was developed by the United States Army in the 1970s to help its soldiers learn from both their mistakes and achievements as close to real-time as possible. The use of AARs has expanded into the corporate environment. The goal is a reflection about what strategies were successful and what were the pitfalls. It is a simple but powerful way to conduct a post-initiative assessment.
An AAR is centered around four key questions:
- What was expected to happen?
- What actually occurred?
- What went well, and why?
- What can be improved upon, and how?
Formal reviews are ideally conducted by a facilitator, not part of the team who has no stake in the outcome. The discussion should take place as soon as possible when the initiative (in this case, redeployment) has taken place. They are best done face to face, but during COVID, this may not be possible. A videoconference would be the next best approach. Good note-taking is vital, so the report is complete.
Blame, position rank, and ego should be left at the door when having these discussions. An agenda should be planned that carefully allocates how much of the group time should be spent on each question. Ideally, the most time is spent on what can be improved moving forward and how. The overall goal is organizational learning. Discussion ground rules could include the following:
- An understanding that the AAR is not designed to grade success or failure but is instead focused on learning.
- Recognition that there is always room for improvement in any initiative.
- Participants should share honest perceptions without the assignment of blame or praise.
- No one has all the information or answers.
- Active participation is an expectation.
- Everyone’s views have value.
- Be open to new ideas.
- Consensus will be sought where possible.
- Yes, and thinking will be used.
- Quotes are not attributed to individuals without permission.
A well-conducted after-action review should include actionable recommendations to improve the process. In a situation like COVID, where leaders have worked without a playbook, these AARs have the potential to provide some excellent lessons learned about strategic decisions made during the crisis.
References
VA Center for Implementation Practice. Guide to the After Action Review
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