From Incident to Insight: After Action Reviews Driving Learning in the NHS
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After Action Reviews (AARs) are a structured way for teams to reflect on events and turn real experiences into meaningful learning. In this blog, we explore how AARs are used across the NHS to strengthen patient safety, support continuous improvement, and embed a culture of openness.
You’ll learn what an AAR is, how the process works in practice, the four key questions that guide every review, and how AARs align with the Patient Safety Incident Response Framework (PSIRF). We also highlight real-world results and how technology can support organisations to track themes and drive system-wide learning.
What is an After Action Review?
An After Action Review is a process used to evaluate both positive and negative outcomes in various settings, including health and social care. AARs do not focus on blame, but aim to understand what was expected, what actually happened, why there were differences, and what can be done to improve outcomes in the future.
In the NHS, this approach is particularly valuable because it encourages open discussion among multi-disciplinary teams, helping staff learn from both successes and challenges. By turning real experiences into actionable insights, AARs support continuous improvement and safer patient care.
How to Conduct an After Action Review
To conduct an effective AAR, follow these four steps:
1. Engage Leaders
Leadership involvement is essential for creating a culture that values learning and improvement. When leaders actively support AARs, it reinforces their importance and encourages participation across teams.
2. Train Facilitators
Facilitators play a key role in guiding discussions and ensuring they remain constructive. Providing training helps them lead sessions effectively and maintain a focus on learning rather than blame.
3. Educate the Workforce
Staff need to understand the purpose of AARs and how they contribute to patient safety and service improvement. Clear communication and education build confidence and openness during reviews.
4. Establish a Clear Structure
A consistent framework for recording and analysing insights ensures lessons are captured accurately and shared across the organisation. This structure turns reflection into actionable change.
In the NHS, following these steps helps ensure AARs lead to meaningful improvements in patient care and operational processes.
“The fundamental principle of the After Action Review is that it flattens the hierarchy and enables people to learn together from the richness of their different experiences, and the research on this is really powerful.”
What are the 4 Parts of an After Action Review?
An AAR is guided by four key questions that help teams reflect and learn from an event:
- What was the expected outcome?
Participants describe what they would expect to happen in situations such as this.- What actually happened?
Participants describe what they did, saw or experienced during the event.- What went well and why?
Participants explore what got in the way of expectations being met and what enabled expectations to be achieved or exceeded. This includes consideration of the work environment, technology and tools, tasks, people, organisation and external influences.- What can we learn and how can we improve?
Participants describe what they have learnt – this may be about themselves, about the team(s) and/or the wider organisational context that influenced the event.These questions provide a structured framework for understanding events in detail. By answering them, teams can create a lessons-learned log that captures successes, identifies areas for improvement, and shares best practices across the organisation.
AARs in Healthcare and PSIRF
AARs are embedded within the NHS’ Patient Safety Incident Response Framework (PSIRF) as a method for learning from patient safety incidents. AARs provide a structured, time-saving approach that encourages open discussion and collaborative problem-solving.
Within the NHS, AARs help deliver PSIRF’s core principles by:
- Engaging compassionately with those affected by patient safety incidents
- Applying system-based approaches to learning from incidents
- Responding proportionately to incidents
- Providing supportive oversight to improve system functioning
“We must have the senior leaders, senior clinicians, and culture leaders completely on board with after action review because it devolves power down the chain of command.”
How AARs can help you to improve patient safety outcomes
Brighton and Sussex University Hospitals NHS Trust published a study on how AARs help reduce the number of hospital falls. They saw some incredible results after routinely using After Action Reviews after every patient fall, making sure to include the patient, family members, and all staff who were directly involved. Over a five-year period, they reduced falls by 49%, saving thousands of patients’ lives and 1.3 million pounds.
Being able to map out themes that are emerging is extremely important. Radar Healthcare’s system enables you to keep a finger on the pulse by monitoring which teams have the most AAR activity. This, in turn, gives you a sign of where the healthy behaviours are and what key issues are developing.
Radar Healthcare’s experience in understanding the importance of patient safety means we work in collaboration with our NHS partners to ensure our software works around for what they need to achieve, we don’t have a ‘one-size fits all’ approach, it’s about the objectives of the organisation.
Implementing AARs can significantly improve processes and outcomes by fostering a culture of continuous learning and improvement. By following structured steps and engaging all relevant parties, organisations can effectively learn from past events and enhance future performance.
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