Conducting After Action Reviews

1
Conducting After Action Reviews

• Kristina Engeseth
• University of Wisconsin Hospital and Clinics
• Organ Procurement Organization
• Madison, WI
• Amy Schmidt
• Saint Josephs Hospital
• Marshfield, WI

Wednesday 1045 C6 Breakout
2
Questions to Run On

• How has the implementation of AARs lead to
  success?
• What are the first steps in implementing AARs?
• How can we ensure the success of AARs?
• What is the hospitals perspective?

3
Success!

• Best practices are spread in real time
• Clinical staff, who are members of our
  multidisciplinary HD teams are actively involved
  as facilitators and not just participants
• Hospital/OPO relationships are stronger than ever
• All teach/all learn environment is strong and
  healthy

4
First Steps

• Include AARs as an action item in HD plans
• Set the target date as the next case
• Identify hospital partner willing to organize on
  the hospital end
• Have names of hospital staff involved in case
  readily available

5
Ensure Success

• Offer an AAR in real time
• Frame the AAR as a positive experience
• Conduct the AAR within 2 weeks of the case
• Set a standing day/time for the AAR
• Follow up on action items and share learning
  points
• Identify a hospital partner who is willing to
  facilitate on the hospital end
• Use a standard form to record results

6
Hospital Perspective

• AARs bring issues to the forefront
• Hospital issue vs. OPO issue vs. Combined issue
• Timeliness
• Saint Josephs Hospital is committed to the
  Tuesday morning following a case
• All Teach, All Learn
• True collaborative style
• Safe environment

7
Hospital Perspective (cont.)

• Reflect and Debrief
• Unresolved issues are not brought into the next
  donation case
• Celebrate!
• Positive outcomes of organs transplanted

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PDSA andQuestions