title: Learning about after action reporting from the 2009 H1N1 pandemic: a workshop summary.
abstract: OBJECTIVE
  To analyze key variations in the after action report/improvement plan (AAR/IP) process used by state and local health departments following the 2009 H1N1 pandemic and identify ideas for improving that process.
  
  
  METHODS
  Workshop participants discussed their AAR findings and the methods used to prepare their reports and implications for improving the AAR/IP process in future events.
  
  
  METHODS
  Workshop participants included state and local health department personnel who had submitted AAR/IPs to the Centers for Disease Control and Prevention (CDC) for review.
  
  
  METHODS
  Workshop participants were asked to consider the question: On the basis of what you heard in this workshop, what would you do differently if you could redo your 2009 H1N1 AAR/IP?
  
  
  RESULTS
  Workshop discussions revealed wide differences in the participants' understanding of the intended uses and users of the AAR/IPs, their scope, timing, and format, and the use of external consultants in their preparation, and on the strengths and weaknesses of various approaches. The AAR/IPs also varied in the extent to which they sought to identify root causes and the methods they used to do so.
  
  
  CONCLUSIONS
  The AAR/IPs can be useful for both accountability and quality improvement, but these objectives require different foci and methodological approaches. Notably, the AAR/IPs can also be used as an opportunity to hold health departments accountable for conducting root cause analyses and making the improvements that follow from them. Federal agencies requiring the AAR/IPs should clarify the purpose and issues of scope and timing; develop training materials and exemplary cases of effective AAR/IPs, particularly of root cause analysis applied to public health emergency preparedness, professional guidelines, and standards for consultants; and consider developing a peer model for preparing AAR/IPs.
authors.affiliation: Department of Health Systems Administration, Georgetown University School of Nursing & Health Studies, Washington, District of Columbia 20057, USA. stotom@georgetown.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Stoto
authors.forename: Christopher
authors.initials: C
authors.lastname: Nelson
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Higdon
authors.forename: John
authors.initials: J
authors.lastname: Kraemer
authors.forename: Christa-Marie
authors.initials: CM
authors.lastname: Singleton
mesh_terms: D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology*; D007858:Learning; D019221:Mandatory Reporting; D058873:Pandemics; D011634:Public Health; D058996:Quality Improvement; D014481:United States