Tips for developing a pandemic after-action report

The COVID-19 pandemic has impacted the health care physical environment in ways we never imagined. Facilities have been reimagined, renovated, expanded, enlarged and underutilized simultaneously. The pandemic’s significant impact on the physical environment has offered challenges and learning experiences. Our reaction to this emergency has required agile assessments, multiple mitigations, perpetual preparation and rapid responses, and it will require a resolute recovery.

As the emergency comes to a close, its critical that health care organizations evaluate their response and not only reinforce what went right, but also correct those concerns that surfaced throughout the event. This evaluation is typically known as an after-action report or AAR. While the AAR should address much more than just the physical environment, it is vital to provide documentation of the work performed, and develop corrective actions and improvement plans to address any outstanding issues.

In a frequently asked question regarding using the current public health emergency as one of the required emergency management drills, The Joint Commission emphasizes the importance of documenting the response and recommends that at least six critical areas be addressed:

1. Communication. What worked well and what did not?
2. Resources and assets. What resources were abundant, adequate or lacking?
3. Safety and security. What issues arose and how were they resolved?
4. Staff responsibilities. What issues arose and how were they resolved?
5. Utilities. What issues arose and how were they resolved?
6. Patient clinical and support activities. What was abundant, adequate or lacking?

Additionally, ASHE recommends in the COVID-19 long-term needs recovery section, that the AAR be included as part of the emergency management program annual review and that corrective action plans will need to be documented as completed. These plans should also be included in discussions with the safety management committee and documented in the committee meeting minutes to close the loop for these plans.

Recovering from the impacts of this pandemic and documenting lessons learned are vital and will require significant planning and action. ASHE has developed a guide to assist health care facility managers in planning for and carrying out recovery measures to restore operational capabilities to appropriate post-COVID-19 pandemic levels. The guide can be accessed on the ASHE COVID-19 Recovery webpage.