Proceedings of the 6th UK and Ireland implementation science research conference

BackgroundOriginating in the US Army and now in the Incident Management Framework (IMF) of the Irish Health Service, After Action Review (AAR) is a non-hierarchical facilitated approach to team learning.AAR enables groups to come to a shared mental model about what happened, why it happened and to identify learning.AAR has been linked to improved safety culture in the US fire-fighting sector.How best to support adoption of AAR in healthcare is unknown, as well its effectiveness [1].Therefore, we examined the effect of AAR on safety culture and second victim experience (the psychological/physical impact of patient safety events on staff ) and its implementation at an Irish hospital. MethodDrawing on Proctor's framework[2], we conducted a mixed-methods effectiveness-implementation study.Hospital staff completed surveys (Hospital Survey on Patient Safety Culture 2.0 and Second Victim Experience and Support Tool) before (May/June 2021), and at the end of a twelve-month AAR intervention period (Sept/Oct 2022).Core implementation strategies were the site adoption of AAR as part of the Health Service Executive IMF and the training of hospital selected staff (one in twelve) as AAR Facilitators using a simulation-based training programme.Six months after the training, using the Theoretical Domains Framework (TDF), focus groups were conducted with AAR Facilitators to explore the enablers and barriers to AAR implementation.Information about number of AAR meetings, their quality and financial costs were also estimated. ResultsFindings were triangulated using Proctor's framework [2].These demonstrate the domains of safety culture and second victim experience which improved/deteriorated at the end of the 12-month period, and the impact of the inner and outer context on AAR uptake.Recommendations for behaviour change techniques to support future AAR implementation are made. ConclusionResults will directly inform local hospital decision making and national policy approaches to incorporating AAR in hospitals in Ireland.