After-action reviews: a venue for the promotion of safety climate

Interplay between Safety Climate and Emotional Exhaustion: Effects on First Responders' Safety Behavior and Wellbeing Over Time

Various job demands continuously threaten Emergency Medical Service (EMS) first responders' safety and wellbeing. Drawing on Job Demands-Resources Theory, the present study examines the effects of the organizational context-safety climate-and the psychological context-emotional exhaustion-on safety behaviors and wellbeing over time. We tested our hypotheses in a longitudinal study of 208 EMS first responders nested within 45 stations from three fire departments in US metropolitan areas over 6 months during the beginning of the COVID-19 pandemic. Multilevel modeling showed that the relationship between safety climate and safety compliance behaviors can be attenuated when EMS first responders experience high emotional exhaustion. Emotional exhaustion was also negatively associated with morale while safety climate was positively associated with morale. Additionally, EMS first responders experienced increased depression when their emotional exhaustion levels were high. Higher safety climate was associated with decreased depression when emotional exhaustion was within a low-to-medium range. Higher safety climate was also associated with lower absolute levels of depression across the entire range of emotional exhaustion. These findings suggest that promoting safety climate and mitigating emotional exhaustion can augment EMS first responders' safety behaviors and wellbeing.].

Reviewing High Reliability Team (HRT) Scholarship: A 21st Century Approach to Safety

High reliability team (HRT) theorizing emerged from high reliability organization (HRO) theory and now represents a distinct subset of HRO literature. Seeking to capture the development and range of HRT research, a comprehensive literature review was conducted. This systematic review of HRT scholarship, the first of its kind, provides a foundation from which small group and team scholars across disciplines may reflect on key lessons and chart future research. This review includes 71 articles across 21 disciplines and incorporates historical reflection on HRT theory foundations, existing empirical support, critiques and rivals, theory extensions, and ideas for future scholarship efforts.

Where to focus? Insights from safety personnel and external safety consultants on lessons learned about safety climate interventions - A qualitative approach

INTRODUCTION

Safety climate is important for promoting workplace safety and health. However, there is a dearth of empirical research on the effective ways of planning, designing, and implementing safety climate interventions, especially regarding what is going to be changed and improved. To address this gap, the present study sought to extract a comprehensive pool of compiled suggestions for safety climate intervention based on qualitative interviews with professionals in occupational safety and health management from potentially hazardous industries.

METHOD

A series of systematic semi-structured interviews, guided by a comprehensive sociotechnical systems framework, were conducted with company safety personnel (n = 26) and external safety consultants (n = 15) of 21 companies from various industries. The taxonomy of five work system components of the sociotechnical systems approach served as overarching themes, representing different areas of improvement in an organization for occupational safety and health promotion, with an aim of enhancing safety climate.

RESULTS

Of the 36 codes identified, seven codes were based on the theme of external environment work system, four were based on the theme of internal environment work system, five were based on the theme of organizational and managerial structure work system, 14 codes were based on the theme of personnel subsystem, and six were based on the theme of technical subsystem.

CONCLUSIONS

Safety climate intervention strategies might be most commonly based upon the principles of human resource management (i.e., codes based on the personnel subsystem theme and organizational and managerial structure work system theme). Meanwhile, numerous attributes of external/internal environment work system and technical subsystem can be jointly improved to bolster safety climate in a holistic way. Practical Applications: More systematic and organized management of safety climate would be available when various interrelated codes pertinent to a given context are carefully considered for a safety climate intervention.

Effect of after action review on safety culture and second victim experience and its implementation in an Irish hospital: A mixed methods study protocol

Background

After Action Review is a form of facilitated team learning and review of events. The methodology originated in the United States Army and forms part of the Incident Management Framework in the Irish Health Services. After Action Review has been hypothesized to improve safety culture and the effect of patient safety events on staff (second victim experience) in health care settings. Yet little direct evidence exists to support this and its implementation has not been studied.

Aim

To investigate the effect of After Action Review on safety culture and second victim experience and to examine After Action Review implementation in a hospital setting.

Methods

A mixed methods study will be conducted at an Irish hospital. To assess the effect on safety culture and second victim experience, hospital staff will complete surveys before and twelve months after the introduction of After Action Review to the hospital (Hospital Survey on Safety Culture 2.0 and Second Victim Experience and Support Tool). Approximately one in twelve staff will be trained as After Action Review Facilitators using a simulation based training programme. Six months after the After Action Review training, focus groups will be conducted with a stratified random sample of the trained facilitators. These will explore enablers and barriers to implementation using the Theoretical Domains Framework. At twelve months, information will be collected from the trained facilitators and the hospital to establish the quality and resource implications of implementing After Action Review.

Discussion

The results of the study will directly inform local hospital decision-making and national and international approaches to incorporating After Action Review in hospitals and other healthcare settings.

Learning from safety incidents in high-reliability organizations: a systematic review of learning tools that could be adapted and used in healthcare

OBJECTIVE

A high-reliability organization (HRO) is an organization that has sustained almost error-free performance, despite operating in hazardous conditions where the consequences of errors could be catastrophic. A number of tools and initiatives have been used within HROs to learn from safety incidents, some of which have the potential to be adapted and used in healthcare. We conducted a systematic review to identify any learning tools deemed to be effective that could be adapted and used by multidisciplinary teams in healthcare following a patient safety incident.

METHODS

This review followed the Preferred Reporting Items for Systematic Reviews and MetaAnalyses for Protocols reporting guidelines and was registered with the PROSPERO (CRD42017071528). A search of databases was carried out in January 2021, from the date of their commencement. We conducted a search on electronic databases such as Web of Science, Science Direct, MEDLINE in Process Jan 1950-present, EMBASE Jan 1974-present, CINAHL 1982-present, PsycINFO 1967-present, Scopus and Google Scholar. We also searched the grey literature including reports from government agencies, relevant doctoral dissertations and conference proceedings. A customized data extraction form was used to capture pertinent information from included studies and Critical Appraisal Skills Programme tool to appraise on their quality.

RESULTS

A total of 5921 articles were identified, with 964 duplicate articles removed and 4932 excluded at the title (4055), abstract (510) and full-text (367) stages. Twenty-five articles were included in the review. Learning tools identified included debriefing, simulation, crew resource management and reporting systems to disseminate safety messages. Debriefing involved deconstructing incidents using reflective questions, whilst simulation training involved asking staff to relive the event again by performing the task(s) in a role-play scenario. Crew resource management is a set of training procedures that focus on communication, leadership and decision-making. Sophisticated incident-reporting systems provide valuable information on hazards and were widely recommended as a way of disseminating key safety messages following safety incidents. These learning tools were found to have a positive impact on learning if conducted soon after the incident with efficient facilitation.

CONCLUSION

Healthcare organizations should find ways to adapt to the learning tools or initiatives used in HROs following safety incidents. It is challenging to recommend any specific one as all learning tools have shown considerable promise. However, the way these tools or initiatives are implemented is critical, and so further work is needed to explore how to successfully embed them into healthcare organizations so that everyone at every level of the organization embraces them.

Meeting science meets public health: Results from the "Stress and Violence in fire-based EMS Responders (SAVER)" Systems Checklist Consensus Conference (SC3)

INTRODUCTION

In order to implement a systems-level Emergency Medical Services (EMS) workplace violence intervention, input from end users was critically needed. We convened the two-day Stress and Violence in fire-based EMS Responders (SAVER)" Systems Checklist Consensus Conference (SC3) using methods from meeting science (i.e., ThinkLets) to comprehensively and efficiently gather feedback from stakeholders on the completeness and utility of the draft checklist that would comprise the intervention.

METHODS

ThinkLets, a codified facilitation technique was used to aid brainstorming, convergence, organization, evaluation, and consensus building activities on the SAVER Systems Checklist among 41 national stakeholders during a two-day conference. A qualitative and quantitative process evaluation was conducted to measure the effectiveness of conference procedures. To verify checklist feasibility results from the conference, a second feasibility assessment was conducted with the four implementation sites.

CONCLUSIONS

The quantitative conference evaluation results indicated most participants viewed the conference process favorably. Emergent themes reflecting on conference effectiveness and suggestions for improvements are described. The re-evaluation of the checklist's feasibility completed by the SAVER study sites confirmed prior feasibility findings. SAVER study sites cast 45.5% of votes on checklist items to be most feasible, 34.9% as less feasible, and 19.6% as extremely difficult. Practical Applications: Multidisciplinary collaboration between public health, occupational health psychology, and meeting science led to the development of the SAVER Systems Checklist. The checklist underscores important needs for EMS policy and training development critical to responder safety as identified and supported by over 41 diverse subject matter experts. The incorporation of a widely used meeting science method, ThinkLets, into public health intervention design proved an effective and well-received approach to bring assessment, evaluation, and consensus to the SAVER Systems Checklist. These methods may hold benefit for other industries and disciplines that may not be familiar with such facilitation and consensus-building techniques.

Moving FOCUS - The Fire Service Organizational Culture of Safety survey - From research to practice

INTRODUCTION

FOCUS, the Fire Service Organizational Culture of Safety survey, has evolved from a research to practice enterprise within the United States fire and rescue service. The FOCUS tool was developed through a FEMA Assistance to Firefighters Research & Development grant. Then it moved to practice in the field. To date over 35,000 firefighters have participated. A current FEMA Fire Prevention & Safety grant can support FOCUS assessment in up to 1,000 fire departments, with the potential of nearly 120,000 respondents. With each funding cycle, the goal of the FOCUS program is to grow and measure its research to practice impact.

METHODS

We describe how FOCUS safety culture results are disseminated to fire service stakeholders. By utilizing customized reports and a training curriculum we demonstrate how FOCUS is moving research to practice by: (1) illustrating how survey results can be delivered effectively to practitioners, (2) providing examples of how fire departments are using results, and (3) sharing the reactions of the fire service to the FOCUS instrument, reports, and our flagship data training curriculum - Culture Camp. Results' Conclusions: Qualitative and quantitative data are analyzed to demonstrate the impact and acceptance of the FOCUS report and Culture Camps. Stakeholders reflect on the report and the experience of having quantitative safety culture data. Culture Camps are evaluated qualitatively and quantitatively using a matching game exercise, pre/post-test, a fire department teach back, and a Qualtrics evaluation. Practical Applications: Traditionally, the fire service has focused on reducing negative safety outcomes. FOCUS is helping shift their attention further upstream in the prevention pathway through the measurement of important organizational outcomes. The research to practice evolution of the FOCUS program may hold utility for other occupational groups when considering how to steadily move occupational health and safety research to practice in the field for measurable impact.

Mitigating Violence Against First Responder Teams: Results and Ideas From the Hackmanathon

First responders are on the front line of patient care and service, but research has shown that they are also on the front line of exposure to violence. Currently, there is a lack of evidence-based interventions that prepare first responders to handle violence on the job. With the increase in emergency medical services (EMS) call volume and reports of at least 57% of the EMS responders having experienced workplace violence, there is a need to develop scientifically systematic solutions to improve emergency responder safety. Using an adapted version of the hackathon method, academic scholars and practitioner conference attendees at the Interdisciplinary Network for Group Research (INGRoup) Conference were deployed into three multidisciplinary teams to analyze the issue and develop specific solutions. These solutions offer unique interventions to improve first responder safety.

Getting the most from after action reviews to improve global health security

Background

After Action Reviews (AARs) provide a means to observe how well preparedness systems perform in real world conditions and can help to identify – and address – gaps in national and global public health emergency preparedness (PHEP) systems. WHO has recently published guidance for voluntary AARs. This analysis builds on this guidance by reviewing evidence on the effectiveness of AARs as tools for system improvement and by summarizing some key lessons about ensuring that AARs result in meaningful learning from experience.

Results

Empirical evidence from a variety of fields suggests that AARs hold considerable promise as tools of system improvement for PHEP. Our review of the literature and practical experience demonstrates that AARs are most likely to result in meaningful learning if they focus on incidents that are selected for their learning value, involve an appropriately broad range of perspectives, are conducted with appropriate time for reflection, employ systems frameworks and rigorous tools such as facilitated lookbacks and root cause analysis, and strike a balance between attention to incident specifics vs. generalizable capacities and capabilities.

Conclusions

Employing these practices requires a PHEP system that facilitates the preparation of insightful AARs, and more generally rewards learning. The barriers to AARs fall into two categories: concerns about the cultural sensitivity and context, liability, the political response, and national security; and constraints on staff time and the lack of experience and the requisite analytical skills. Ensuring that AARs fulfill their promise as tools of system improvement will require ongoing investment and a change in mindset. The first step should be to clarify that the goal of AARs is organizational learning, not placing blame or punishing poor performance. Based on experience in other fields, the buy-in of agency and political leadership is critical in this regard. National public health systems also need support in the form of toolkits, guides, and training, as well as research on AAR methods. An AAR registry could support organizational improvement through careful post-event analysis of systems’ own events, facilitate identification and sharing of best practices across jurisdictions, and enable cross-case analyses.

Group and Organizational Safety Norms Set the Stage for Good Post-Fall Huddles

We explored group and organizational safety norms as antecedents to meeting leader behaviors and achievement of desired outcomes in a special after-action review case-a post-fall huddle. A longitudinal survey design was used to investigate the relationship between organizational/group safety norms, huddle leader behavior, and huddle meeting effectiveness. The sample included healthcare workers in critical access hospitals (N = 206) who completed a baseline safety norm assessment and an assessment of post-fall huddle experiences three to six months later. Findings indicate that organizational and group safety norms relate to perceived huddle meeting effectiveness through appropriate huddle leader behavior in a partial mediated framework. In contrast to previous research showing after-action reviews predicting group and organizational safety norms, the longitudinal study presented here suggests that group and organizational safety norms set the stage for the enactment of post-fall huddles in an effective manner.

The impact of post-fall huddles on repeat fall rates and perceptions of safety culture: a quasi-experimental evaluation of a patient safety demonstration project

BACKGROUND

Conducting post-fall huddles is considered an integral component of a fall-risk-reduction program. However, there is no evidence linking post-fall huddles to patient outcomes or perceptions of teamwork and safety culture. The purpose of this study is to determine associations between conducting post-fall huddles and repeat fall rates and between post-fall huddle participation and perceptions of teamwork and safety culture.

METHODS

During a two-year demonstration project, we developed a system for 16 small rural hospitals to report, benchmark, and learn from fall events, and we trained them to conduct post-fall huddles. To calculate a hospital's repeat fall rate, we divided the total number of falls reported by the hospital by the number of unique medical record numbers associated with each fall. We used Spearman correlations with exact P values to determine the association between the proportion of falls followed by a huddle and the repeat fall rate. At study end, we used the TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ) to assess perceptions of teamwork support for fall-risk reduction and the Hospital Survey on Patient Safety Culture (HSOPS) to assess perceptions of safety culture. We added an item to the T-TPQ for respondents to indicate the number of post-fall huddles in which they had participated. We used a binary logistic regression with a logit link to examine the effect of participation in post-fall huddles on respondent-level percent positive T-TPQ and HSOPS scores. We accounted for clustering of respondents within hospitals with random effects using the GLIMMIX procedure in SAS/STAT.

RESULT

Repeat fall rates were negatively associated with the proportion of falls followed by a huddle. As compared to hospital staff who did not participate in huddles, those who participated in huddles had more positive perceptions of four domains of safety culture and how team structure, team leadership, and situation monitoring supported fall-risk reduction.

CONCLUSIONS

Post-fall huddles may reduce the risk of repeat falls. Staff who participate in post-fall huddles are likely to have positive perceptions of teamwork support for fall-risk reduction and safety culture because huddles are a team-based approach to reporting, adapting, and learning.

Multi-level safety climate associations with safety behaviors in the fire service

INTRODUCTION

Limited research associated with safety climate has been completed within the fire service. Given this dearth of information, the present study sought to identify a valid and reliable measure of safety climate at both the workgroup and organizational levels within the fire service.

METHODS

Researchers surveyed 994 firefighters in two large metropolitan fire departments. Preliminary analyses including psychometrics, confirmatory factor analyses, and shared perception analyses were completed. A linear mixed model analysis was then completed to assess the relationships between workgroup safety climate, organizational safety climate, and safety behaviors, including both safety compliance and safety citizenship behaviors.

RESULTS

Measures of safety climate at the workgroup (WGSC) and organizational levels (OSC) were derived. WGSC factors include supervisor support (α = 0.92), vertical cohesion (α = 0.89), and horizontal cohesion (α = 0.94). OSC factors include management commitment (α = 0.91), safety programs/policies (α = 0.89), perceived fairness (α = 0.86) and incident command (α = 0.90). Confirmatory factor analyses confirmed our multi-factor models were a good fit to the data. The linear mixed model analysis found that WGSC positively predicted safety compliance behavior (B = 0.13, p < .001) and safety citizenship behavior (B = 0.22, p < .001) and OSC positively predicted safety compliance behavior (B = 0.16, p < .001) and safety citizenship behavior (B = 0.15, p < .001).

CONCLUSIONS

This work presents reliable and valid measures of both workgroup and organizational safety climate, which have positive relationships with safety behavior outcomes. Practical application: The measures, which were developed through an extensive multi-method process, provide a means for researchers and practitioners to assess safety climate in the fire service and provides guidance for future safety climate research, including informing intervention research, which could potentially bolster safety climate and enhance safety in the fire service.

Good Catch! Using Interdisciplinary Teams and Team Reflexivity to Improve Patient Safety

Interdisciplinary teams play an important role implementing innovations that facilitate the quality and safety of patient care. This article examined the role of reflexivity in team innovation implementation and its association with an objective patient safety outcome, inpatient fall rates (a fall is an unintended downward displacement of a patient’s body to the ground or other object). In this study, we implemented, supported, and evaluated interdisciplinary teams intended to decrease fall risk in 16 small rural hospitals. These hospitals were part of a collaborative that sought to increase knowledge and facilitate reflexivity about fall event reporting and fall risk reduction structures and processes. We assessed team reflexivity at the start and at the end of the 2-year intervention and innovation implementation at the end of the intervention. The 16 hospitals reported objective fall event data and patient days throughout the project, which we used to calculate comparative rates for assisted, unassisted, and injurious falls. The results suggest that teams benefited from the intervention, increasing reflexivity from the start of the project to the end, which was related to innovation implementation and decreases in fall rates. Theoretical and practical applications of the results are discussed.

Slides in the Tray: How Fire Crews Enable Members to Borrow Experiences

Experiential learning is essential for many high-performing teams, yet there are also challenges to its incorporation into team training. Using an interpretivist lens, this study explores how members of wildfire crews are encouraged to appropriate the experiences of their teammates to improve team process. First, we offer a tripartite argument for how experiential learning is inhibited. Then, based on our findings, we argue that a key practice of critical teamwork is the ability of team members to “borrow” experiences or learn from the experiences of others. We examine how firefighters interpret the concept of experience; the delineation between experiences and personal experiences was often blurred, as some firefighters spoke about experience as something that could be gained through activities that are not specifically firefighting. We delineate five training interactions through which firefighters are encouraged to appropriate the experiences of their colleagues. We then discuss how this extends the principles of the Nested Phase Model for critical teams and suggest areas for future research. These findings have implications for all types of critical teams—including military units and medical teams—as well as high-reliability organizations.

Naturalistic Decision Making in After-Action Review Meetings: The Implementation of and Learning from Post-Fall Huddles

The purpose of this study was to add to our understanding of Naturalistic Decision Making (NDM) in healthcare, and how After Action Reviews (AARs) can be utilized as a learning tool to reduce errors. The study focused on the implementation of a specific form of AAR, a post-fall huddle, to learn from errors and reduce patient falls. Utilizing 17 hospitals that participated in this effort, information was collected on 226 falls over a period of 16 months. The findings suggested that the use of self-guided post-fall huddles increased over the time of the project, indicating adoption of the process. Additionally, the results indicate that the types of errors identified as contributing to the patient fall changed, with a reduction in task and coordination errors over time. Finally, the proportion of falls with less adverse effects (such as non-injurious falls) increased during the project time period. The results of this study fill a void in the NDM and AAR literature, evaluating the role of NDM in healthcare specifically related to learning from errors. Over time, self-guided AARs can be useful for some aspects of learning from errors.

Understanding workplace meetings

Purpose

– The purpose of this study is to propose a taxonomy of meeting purpose. Meetings are a workplace activity that deserves increased attention from researchers and practitioners. Previous researchers attempted to develop typologies of meeting purpose with limited success. Through a comparison of classification methodologies, the authors consider a taxonomy as the appropriate classification scheme for meeting purpose. The authors then utilize the developed taxonomy to investigate the frequency with which a representative sample of working adults engaged in meetings of these varying purposes. Their proposed taxonomy provides relevant classifications for future research on meetings as well and serves as a useful tool for managers seeking to use and evaluate the effectiveness of meetings within their organizations.

Design/methodology/approach

– This study employs an inductive methodology using discourse analysis of qualitative meeting descriptions to develop a taxonomy of meeting purpose. The authors discourse analysis utilizes open-ended survey responses from a sample of working adults (n = 491).

Findings

– The authors categorical analysis of open-ended questions resulted in a 16-category taxonomy of meeting purpose. The two most prevalent meeting purpose categories in this sample were “to discuss ongoing projects” at 11.6 per cent and “to routinely discuss the state of the business” at 10.8 per cent. The two least common meeting purpose categories in this sample were “to brainstorm for ideas or solutions” at 3.3 per cent and “to discuss productivity and efficiencies” at 3.7 per cent. The taxonomy was analyzed across organizational type and employee job level to identify differences between those important organizational and employee characteristics.

Research limitations/implications

– The data suggested that meetings were institutionalized in organizations, making them useful at identifying differences between organizations as well as differences in employees in terms of scope of responsibility. Researchers and managers should consider the purposes for which they call meetings and how that manifests their overarching organizational focus, structure and goals.

Originality/value

– This is the first study to overtly attempt to categorize the various purposes for which meetings are held. Further, this study develops a taxonomy of meeting purposes that will prove useful for investigating the different types of meeting purposes in a broad range of organizational types and structures.

How perceptions of experience-based analysis influence explanations of work accidents

INTRODUCTION

This article looks into how perceptions of experience-based analysis (EBA) influence causal explanations of accidents given by managers and workers in the chemical industry (n=409) and in the nuclear industry (n=222).

METHOD

The approach is based on the model of naive explanations of accidents (Kouabenan, 1999, 2006, 2009), which recommends taking into account explanations of accidents spontaneously given by individuals, including laypersons, not only to better understand why accidents occur but also to design and implement the most appropriate prevention measures. The study reported here describes the impact of perceptions about EBA (perceived effectiveness, personal commitment, and the feeling of being involved in EBA practices) on managers' and workers' explanations of accidents likely to occur at the workplace.

RESULTS

The results indicated that both managers and workers made more internal explanations than external ones when they perceived EBA positively. Moreover, the more the participants felt involved in EBA, were committed to it, and judged it effective, the more they explained accidents in terms of factors internal to the workers.

PRACTICAL APPLICATIONS

Recommendations are proposed for reducing defensive reactions, increasing personal commitment to EBA, and improving EBA effectiveness.

An integrative model of organizational safety behavior

INTRODUCTION

This study develops an integrative model of safety management based on social cognitive theory and the total safety culture triadic framework. The purpose of the model is to reveal the causal linkages between a hazardous environment, safety climate, and individual safety behaviors.

METHOD

Based on primary survey data from 209 front-line workers in one of the largest state-owned coal mining corporations in China, the model is tested using structural equation modeling techniques.

RESULTS

An employee's perception of a hazardous environment is found to have a statistically significant impact on employee safety behaviors through a psychological process mediated by the perception of management commitment to safety and individual beliefs about safety.

IMPACT ON INDUSTRY

The integrative model developed here leads to a comprehensive solution that takes into consideration the environmental, organizational and employees' psychological and behavioral aspects of safety management.

Effects of the feeling of invulnerability and the feeling of control on motivation to participate in experience-based analysis, by type of risk

Experience-based analysis (EBA) refers to a set of safety-management practices consisting of detecting, analyzing, and correcting the individual, material, and organizational causal factors of accidents in order to prevent their reoccurrence. Unfortunately, these practices do not always garner the adherence of employees. This article presents a study that examines the impact of risk perceptions on agents' motivation to participate in EBA in various production sectors. The study was conducted at two sites, a chemical factory and a nuclear power plant, by means of a questionnaire administered to 302 employees. The results indicated that the feeling of control was not only positively linked to the feeling of invulnerability, but that these two factors were negatively linked to risk perception. In addition, the actors in both production sectors were more motivated to participate in EBA of accidents linked to the core processes of their industry (which were more accurately perceived) than in EBA of ordinary accidents (accidents not specific to chemical or nuclear processes). Moreover, the agents' feeling of invulnerability and feeling of control both reduced EBA motivation for ordinary accidents to a greater extent than for chemical and radiation-related accidents. Recommendations are made in view of encouraging agents to get more involved in EBA.

Do team and individual debriefs enhance performance? A meta-analysis

OBJECTIVE

Debriefs (or "after-action reviews") are increasingly used in training and work environments as a means of learning from experience. We sought to unify a fragmented literature and assess the efficacy of debriefs with a quantitative review.

BACKGROUND

Used by the U.S. Army to improve performance for decades, and increasingly in medical, aviation, and other communities, debriefs systematize reflection, discussion, and goal setting to promote experiential learning. Unfortunately, research and theory on debriefing has been spread across diverse disciplines, so it has been difficult to definitively ascertain debriefing effectiveness and how to enhance its effectiveness.

METHOD

We conducted an extensive quantitative meta-analysis across a diverse body of published and unpublished research on team- and individual-level debriefs.

RESULTS

Findings from 46 samples (N = 2,136) indicate that on average, debriefs improve effectiveness over a control group by approximately 25% (d = .67). Average effect sizes were similar for teams and individuals, across simulated and real settings, for within- or between-group control designs, and for medical and nonmedical samples. Meta-analytic methods revealed a bolstering effect of alignment and the potential impact of facilitation and structure.

CONCLUSION

Organizations can improve individual and team performance by approximately 20% to 25% by using properly conducted debriefs.

APPLICATION

Debriefs are a relatively inexpensive and quick intervention for enhancing performance. Our results lend support for continued and expanded use of debriefing in training and in situ. To gain maximum results, it is important to ensure alignment between participants, focus and intent, and level of measurement.

Safety management by walking around (SMBWA): a safety intervention program based on both peer and manager participation

"Management by walking around" (MBWA) is a practice that has aroused much interest in management science and practice. The purpose of this study is to demonstrate adaptation of this practice to safety management. We describe a three-year long case study that collected empirical data in which a modified MBWA was practiced in order to improve safety in a semiconductor fabrication facility. The main modification involved integrating an information system with the MBWA in order to create a practice that would generate safety leadership development and an organizational safety learning mechanism, while promoting employee safety participation. The results of the case study demonstrate that the SMBWA practice facilitated thousands of tours in which safety leadership behaviors were practiced by managers and by employees (employees performed five times as many tours as managers). The information system collected information about safety behaviors and safety conditions that could not otherwise be obtained. Thus, this study presents a new organizational safety practice SMBWA, and demonstrates the ways in which SMBWA may improve safety in organizations.