Abstract
Abstract
Background
After Action Reviews (AARs) provide a means to observe how well preparedness systems perform in real world conditions and can help to identify – and address – gaps in national and global public health emergency preparedness (PHEP) systems. WHO has recently published guidance for voluntary AARs. This analysis builds on this guidance by reviewing evidence on the effectiveness of AARs as tools for system improvement and by summarizing some key lessons about ensuring that AARs result in meaningful learning from experience.
Results
Empirical evidence from a variety of fields suggests that AARs hold considerable promise as tools of system improvement for PHEP. Our review of the literature and practical experience demonstrates that AARs are most likely to result in meaningful learning if they focus on incidents that are selected for their learning value, involve an appropriately broad range of perspectives, are conducted with appropriate time for reflection, employ systems frameworks and rigorous tools such as facilitated lookbacks and root cause analysis, and strike a balance between attention to incident specifics vs. generalizable capacities and capabilities.
Conclusions
Employing these practices requires a PHEP system that facilitates the preparation of insightful AARs, and more generally rewards learning. The barriers to AARs fall into two categories: concerns about the cultural sensitivity and context, liability, the political response, and national security; and constraints on staff time and the lack of experience and the requisite analytical skills. Ensuring that AARs fulfill their promise as tools of system improvement will require ongoing investment and a change in mindset. The first step should be to clarify that the goal of AARs is organizational learning, not placing blame or punishing poor performance. Based on experience in other fields, the buy-in of agency and political leadership is critical in this regard. National public health systems also need support in the form of toolkits, guides, and training, as well as research on AAR methods. An AAR registry could support organizational improvement through careful post-event analysis of systems’ own events, facilitate identification and sharing of best practices across jurisdictions, and enable cross-case analyses.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy
Reference54 articles.
1. Lederberg J, Hamburg MA, Smolinski MS. Microbial threats to health: emergence, detection, and response: National Academies Press; 2003.
2. World Health Organization. International health regulations (2005): World Health Organization; 2008.
3. World Health OrganizationH. Monitoring and evaluation framework joint external evaluation tool (JEE tool)- second. Edition Geneva, Switzerland; 2018.
4. Piltch-Loeb R, Kraemer JD, Nelson C, Stoto MA. A public health emergency preparedness critical incident registry. Biosecur Bioterror. 2014;12(3):132–43.
5. World Health Organization. Country implementation guidance: after action reviews and simulation exercises under the international health regulations 2005 monitoring and evaluation framework (IHR MEF). World Health Organization; 2018.
Cited by
29 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献