# data[].attributes.body
...by email by a member of the patient safety / risk management team or equivalent

# data[].attributes.body
Facilitator (not involved in the incident) – introduce the task and assist participants, keep track of time, take notes and record key points for learning

Anyone involved in the PSI being reviewed, aiming to gain as broad a perspective as possible from the MDT

May be a member of the patient safety / risk management team

Lead investigator (may also be the facilitator)

Additional people for support/advocate as needed (eg ES, DME, College Tutor, other senior colleague)

# data[].attributes.body
Usually last up to 1 hour

# data[].attributes.body
In person in a suitable space free from interruption or may be virtual. You should not be expected to attend unsupported online from home.

# data[].attributes.body
Should be as close to the incident under review as practically possible given notice required for attendance. Should be conducted during standard work hours and not following the end of a shift

# data[].attributes.body
Read the notes and familiarise yourself with your involvement

Consider if you would like someone, and who, present for support

Be on time

If virtual, have the link ready and have camera turned on

Give your bleep to someone else

Inform your clinical supervisor or rota co-ordinator that you will be absent for an hour or so

# data[].attributes.body
Principles agreed at the start :

● Leave hierarchy at the door

● Everyone should contribute and everyone’s contribution should be respected

● Open and honest sharing of views and experience

● The purpose of the AAR is learning, not accountability

● equal contribution by all without fear of blame or retribution

● Everyone will have a different truth to share of the same event

● Contributions should be through what people know, feel and believe

● Respect time pressures but all must be fully present - no use of mobile phones

● Make no assumptions, be open and honest

Introductions of each person, role

• What happened that we want to learn from? Creating a common understanding of the experience under review: • What did we set out to do? • What actually happened? • Why were there differences? • What went well? Why? Reflecting on the successes and failures: • What could have gone better? Why?

# data[].attributes.body
The key learning points should be summarised from the discussion held, focussing on what lessons have been identified, how to share them and whether there are any immediate actions that should be taken forward and by whom.

Notes from the session should be shared with all participants to check for accuracy. This reduces the need for interviews and statements as part of the process. The notes will be used to inform any further report or investigation process. It may still be necessary to discuss aspects of the PSI with individuals after the AAR.