Table 1

Learning tools: measures in the literature

Learning toolStructure measuresProcess measuresOutcome measuresSafety culture (Outcome)
AAR5–10 min62Improved team performance, team efficacy, team communication and cohesion after training scenarios;70 Improved safety norms72Improved psychological safety72
Debrief or huddleApproximately 30 min for team86Effective mechanism to reflect on staff performance after an adverse event74Improved team culture;78 Decrease in medical complications;83 Decrease in adverse drug events;86 May mitigate the ‘second victim’;95 ‘create a culture of collaboration and collegiality that increases the staff's quality of collective awareness and enhanced capacity for eliminating patient harm’;97 Reduce compassion fatigue99
LFD toolAssociated with decreased nurse turnover when used as part of CUSP104 105CUSP improved teams’ ability to identify risk and solutions.104Implementation of CUSP teams was associated with a decrease in length of stay and medication errors105Improved safety culture and climate when used as part of CUSP102 104 105
SWARMSuggested 1 hour for multidisciplinary team10675% of SWARMS occur within 16 days of event106Decrease in pressure ulcers during treatment; decrease in the observed-to-expected mortality ratio; improved staff culture106Improved safety culture106
CIAMeasured average of 11 person-hours for multidisciplinary team10789% of test sites rated tool ‘Easy’ or ‘Very Easy’ to use; 89% rated tool as ‘Effective’ or ‘Very Effective’; 67% of action items were implemented107
‘Concise tool’ from the NHS and Canadian Incident Analysis FrameworkThe Canadian Incident Analysis Framework uses the CIA tool cited above.The Canadian Incident Analysis Framework uses the CIA tool cited above
Aggregate RCA/Multi-Incident AnalysisMeasured average of 87.5 person-hours; median and mode are 60 person-hours (N=697).12261.4% of the recommended actions were implemented114Decrease in falls with injury;113 114114
  • AAR, After-Action Review; CIA, Concise Incident Analysis; CUSP, comprehensive unit-based safety programme; LFD, Learn From Defect; NHS, National Health Service; RCA, root cause analysis.