Learning tool | Structure measures | Process measures | Outcome measures | Safety culture (Outcome) |
AAR | 5–10 min62 | Improved team performance, team efficacy, team communication and cohesion after training scenarios;70 Improved safety norms72 | Improved psychological safety72 | |
Debrief or huddle | Approximately 30 min for team86 | Effective mechanism to reflect on staff performance after an adverse event74 | Improved 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 tool | Associated with decreased nurse turnover when used as part of CUSP104 105 | CUSP improved teams’ ability to identify risk and solutions.104 | Implementation of CUSP teams was associated with a decrease in length of stay and medication errors105 | Improved safety culture and climate when used as part of CUSP102 104 105 |
SWARM | Suggested 1 hour for multidisciplinary team106 | 75% of SWARMS occur within 16 days of event106 | Decrease in pressure ulcers during treatment; decrease in the observed-to-expected mortality ratio; improved staff culture106 | Improved safety culture106 |
CIA | Measured average of 11 person-hours for multidisciplinary team107 | 89% 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 Framework | The 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 Analysis | Measured average of 87.5 person-hours; median and mode are 60 person-hours (N=697).122 | 61.4% of the recommended actions were implemented114 | Decrease 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.