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Using Rapid Improvement Events for Disaster After-Action Reviews: Experience in a Hospital Information Technology Outage and Response

  • Charles M. Little (a1), Christopher McStay (a2), Justin Oeth (a3), April Koehler (a3) and Kelly Bookman (a2)...
Abstract

The use of after-action reviews (AARs) following major emergency events, such as a disaster, is common and mandated for hospitals and similar organizations. There is a recurrent challenge of identified problems not being resolved and repeated in subsequent events. A process improvement technique called a rapid improvement event (RIE) was used to conduct an AAR following a complete information technology (IT) outage at a large urban hospital. Using RIE methodology to conduct the AAR allowed for the rapid development and implementation of major process improvements to prepare for future IT downtime events. Thus, process improvement methodology, particularly the RIE, is suited for conducting AARs following disasters and holds promise for improving outcomes in emergency management.

Little CM , McStay C , Oeth J , Koehler A , Bookman K . Using Rapid Improvement Events for Disaster After-Action Reviews: Experience in a Hospital Information Technology Outage and Response. Prehosp Disaster Med. 2018;33(1):98100.

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Corresponding author
Correspondence: Charles M. Little, DO, Department of Emergency Medicine University of Colorado 12401 E. 17th Ave B215 Aurora, Colorado 80045 USA E-mail: Charles.Little@ucdenver.edu
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Conflicts of interest: none

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References
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1. Savoia, E, Agboola, F, Biddinger, PD. Use of after action reports (AARs) to promote organizational and systems learning in emergency preparedness. Int J Environ Res Public Health. 2012;9(8):2949.
2. Baird, L, Henderson, JC, Watts, S. Learning from action: an analysis of the Center for Army Lessons Learned [CALL]. Human Resource Management (1986-1998). 1997;36(4):385.
3. The Joint Commission. Emergency Management Standards. 2017; https://e-dition.jcrinc.com/ASearch.aspx. Accessed April 1, 2017.
4. US Department of Homeland Security. Homeland Security Exercise and Evaluation Program (HSEEP) Volume I: HSEEP Overview and Exercise Program Management. Washington, DC USA: US DHS; 2007.
5. Donahue, A, Tuohy, R. Lessons we don’t learn: a study of the lessons of disasters, why we repeat them, and how we can learn them. Homeland Security Affairs. 2006;2(4).
6. Martin, SC, Greenhouse, PK, Kowinsky, AM, McElheny, RL, Petras, CR, Sharbaugh, DT. Rapid improvement event: an alternative approach to improving care delivery and the patient experience. J Nurs Care Qual. 2009;24(1):17-24; quiz 5-6.
7. Centers for Medicare & Medicaid Services. Electronic Health Records (EHR) Incentive Programs. 2017. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/. Accessed June 13, 2017.
8. Sittig, DF, Singh, H. A socio-technical approach to preventing, mitigating, and recovering from ransomware attacks. Appl Clin Inform. 2016;7(2):624-632.
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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Keywords

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after-action review
  • emergency department
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    emergency department
  • Homeland Security Exercise and Evaluation Program
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    Homeland Security Exercise and Evaluation Program
  • information technology
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    information technology
  • process improvement
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    process improvement
  • rapid improvement event
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    rapid improvement event

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