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We’re going to touch base on one of the tools that we use to establish accountability within our team, and that tool is called an after action review.

So an after action report, there’s more of a dynamic, more of a group effort, meaning maybe we had one accountable event with one person, but because of that accountable event, it led to a cascade or a chain of additional events, which may be good or they may be negative. But the idea is that as you get into the after action report, is that it’s a deliberate tool of communication between individuals.

It is not a tool to develop blame or excuses. We need to go into it with an open mind as far as what has occurred in that event, but also then to be open to any solutions that are proposed out of that event.

So if we have the opportunity to run an after action, it’s exclusively based on our ability to collaborate as a team to instill a growth mindset within the environment of our clinic.

When we look to start an after action, everyone that was involved in it must participate. Without you being there, there’s variables that are missed and it makes it impossible for us to, one, gain clarity on what has occurred, but it also will prevent us from then providing solutions moving forward. The other part of being involved in an after action is focusing both on the results, but then also the process. There are times when we can follow process and we will not have the intended result or we could not follow process, but still get an appropriate result, both of which would then institute an accountable event to make sure that we are fulfilling both sides of that.

Another part that we utilize during this after action is something called the root cause method. This is a communication tool where we really dive into what the issue is and break it down to where we can find the root of it. In doing several of these, we have found out that we are able to then target more specific plans and solutions to some of these issues. So now that we understand why we do an after action, now that we understand how we are a part of an after action.

The next thing that we need to do is set the stage for what happened. In setting up an after action review, one of the things is you will be provided a basic worksheet. What we ask is that you complete very specific questions with as much detail as you can remember in that event, so that when we go through the after action, you have these as your own notes or resources, so that should a question be asked, you have that information available to provide to the team.

In running through the questions, what was our intended results? This has a variety of questions that tag along with it. Who was involved in our team? Who is involved out of our team? What was our timeline? Now, individually, you may not know all of the answers, but if you can provide as much insight, you’ll be that much more beneficial when we do go through the after action. The next question that we have is what was our actual results?

We say an accountable event can occur either when we have a good result, but our process wasn’t fulfilled or we can have an accountable event where we did not fulfill process, but we did have a good result. So depending on the context of the after action, this either could be a very lengthy answer or it could be quite short.

So the next question that we ask is what was the cause of our results? Previously we had talked about the root cause problem solving method, this is where we use that. We basically take each of these variables and we ask why and we keep asking why until we get to the bottom of it.

So now that we’ve identified the issues and we’ve been able to identify those accountable events, the next question that we move into is what stays the same? So, for example, what did we do right in this scenario so we can look back at all of these issues and be able to pull apart the things that we did maintain appropriate procedure or process on or appropriate communications with those inside of our team and externally. The last question that we ask comes into what needs to change then for the next time?

So really, it comes back to those identified accountable events and we can start to put forward additional taskable items to either you as an individual to make changes or sometimes those taskable events go to the administrative or leadership team to provide greater clarity to yourself, but then also everyone to expand upon a policy or procedure that was not followed. So now that we’ve walked through the process of an after action review, it’s important to look at it now from another perspective.

When I go into and after action, the one thing that I want from each individual that’s involved is just to be ready to come in. So make sure that you have reviewed the case. I want you to also be willing to participate. I want you to be an engaged participant where you’re ready to answer questions.