Work

Establishment of After Action Reviews to enhance local public health responses in Saxony, Germany

Year: 2025

Type: article

Abstract: Background After Action Reviews (AAR) focus on collective institutional learning from responses to acute public health events. Although considered essential to the implementation of the International Health Regulations (2005), AAR have not been widely used among the almost 400 local public health authorities (LPHA) that form the backbone of Germany's public health system. Objectives To establish AAR at the local level, we devised a program of training and ongoing support for LPHA in the federal state of Saxony. Key questions included uptake, concrete participant expectations, and the degree of follow-through. Building on work by the federally funded project “Institutional Learning from Epidemically Significant Situations” (ILEAs) which adapted WHO and ECDC AAR guidance for the German context, we designed a training program focussed on practical aspects of conducting local AAR. Following delivery of two three-hour online sessions in March 2025, we offered LPHA conceptual and reporting support as needed. Results Fourteen participants from seven of the 13 Saxon LPHA attended the training. Participants identified starting points for concept development and practical advice for implementation as key expectations. During the workshop, definition of scope and alignment with authorities’ area of influence emerged as key challenges in the development of local concepts. Subsequently, two LPHA commenced AAR to examine local COVID pandemic responses, two intend to use AAR to evaluate the next locally significant public health response, and a further two plan to undertake COVID AAR (as of April 2025). Conclusions This project demonstrates that targeted training and support in a format that is accessible in the context of high workloads and competing priorities can foster local commitment to the implementation of AAR. Our example may guide other decentralised public health systems on how to operationalise AAR locally and ensure scalability to a variety of acute public health events. Key messages • We showed that targeted training and ongoing support enables the implementation of After Action Reviews (AAR) by local public health authorities. • The introduction of AAR as a general approach to institutional learning within public health authorities encourages ongoing use as a tool to improve responses to acute public health events.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckaf161.1631