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. 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. 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.

中文翻译：

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从事后审查中获取最大收益，以改善全球卫生安全

行动后回顾（AAR）提供了一种手段，可以观察备灾系统在现实世界中的运行状况，并有助于发现并解决国家和全球公共卫生应急备案（PHEP）系统中的差距。世卫组织最近发布了关于自愿AAR的指南。该分析基于此指南，它回顾了有关AAR作为系统改进工具的有效性的证据，并总结了一些有关确保AAR带来有意义的经验教训的重要经验教训。来自各个领域的经验证据表明，AAR作为PHEP的系统改进工具具有广阔的前景。我们对文献和实践经验的回顾表明，AAR如果专注于根据其学习价值选择的事件，则最有可能带来有意义的学习，涉及适当的广泛角度，在适当的时间进行反思，采用系统框架和严格的工具（如便利的回顾和根本原因分析），并在关注事件细节与可概括的能力之间取得平衡。采用这些做法需要PHEP系统，该系统可帮助准备有见地的AAR，并且更普遍地奖励学习。AAR的障碍分为两类：对文化敏感性和背景，责任，政治反应和国家安全的关注；以及工作人员时间的限制，缺乏经验和必要的分析技能。确保AAR兑现其作为系统改进工具的诺言将需要持续的投资和思维方式的转变。第一步应该是澄清AAR的目标是组织学习，而不是怪罪或惩罚表现不佳的人。根据其他领域的经验，在这方面，代理和政治领导的支持至关重要。国家公共卫生系统还需要工具包，指南和培训等形式的支持，以及有关AAR方法的研究。AAR注册中心可以通过对系统自身事件进行仔细的事后分析来支持组织的改进，促进跨辖区的最佳实践的识别和共享，并进行跨案例分析。国家公共卫生系统还需要工具包，指南和培训等形式的支持，以及有关AAR方法的研究。AAR注册中心可以通过对系统自身事件进行仔细的事后分析来支持组织的改进，促进跨辖区的最佳实践的识别和共享，并进行跨案例分析。国家公共卫生系统还需要工具包，指南和培训等形式的支持，以及有关AAR方法的研究。AAR注册中心可以通过对系统自身事件进行仔细的事后分析来支持组织的改进，促进跨辖区的最佳实践的识别和共享，并进行跨案例分析。