Graduate School of Healthcare Management, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Division of Population Health Sciences, Department of Epidemiology, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
PLoS One. 2021 Nov 18;16(11):e0259887. doi: 10.1371/journal.pone.0259887. eCollection 2021.
After Action Review is a form of facilitated team learning and review of events. The methodology originated in the United States Army and forms part of the Incident Management Framework in the Irish Health Services. After Action Review has been hypothesized to improve safety culture and the effect of patient safety events on staff (second victim experience) in health care settings. Yet little direct evidence exists to support this and its implementation has not been studied.
To investigate the effect of After Action Review on safety culture and second victim experience and to examine After Action Review implementation in a hospital setting.
A mixed methods study will be conducted at an Irish hospital. To assess the effect on safety culture and second victim experience, hospital staff will complete surveys before and twelve months after the introduction of After Action Review to the hospital (Hospital Survey on Safety Culture 2.0 and Second Victim Experience and Support Tool). Approximately one in twelve staff will be trained as After Action Review Facilitators using a simulation based training programme. Six months after the After Action Review training, focus groups will be conducted with a stratified random sample of the trained facilitators. These will explore enablers and barriers to implementation using the Theoretical Domains Framework. At twelve months, information will be collected from the trained facilitators and the hospital to establish the quality and resource implications of implementing After Action Review.
The results of the study will directly inform local hospital decision-making and national and international approaches to incorporating After Action Review in hospitals and other healthcare settings.
行动后回顾是一种团队学习和事件回顾的形式。该方法起源于美国陆军，是爱尔兰卫生服务机构事件管理框架的一部分。行动后回顾被假设可以改善医疗保健环境中的安全文化和患者安全事件对员工（第二受害者体验）的影响。然而，几乎没有直接证据支持这一点，而且其实施情况也没有得到研究。
调查行动后回顾对安全文化和第二受害者体验的影响，并研究医院环境中的行动后回顾实施情况。
将在爱尔兰的一家医院进行一项混合方法研究。为了评估对安全文化和第二受害者体验的影响，医院工作人员将在引入行动后回顾前后 12 个月完成调查（医院安全文化 2.0 调查和第二受害者体验和支持工具）。大约每 12 名员工中就有 1 名将接受基于模拟的培训计划培训为行动后回顾促进者。在行动后回顾培训 6 个月后，将对经过培训的促进者进行分层随机抽样的焦点小组讨论。这些讨论将使用理论领域框架探讨实施的促进因素和障碍。在 12 个月时，将从经过培训的促进者和医院收集信息，以确定实施行动后回顾的质量和资源影响。
该研究的结果将直接为当地医院的决策以及在医院和其他医疗保健环境中采用行动后回顾的国家和国际方法提供信息。
