When starting a new project, implementing a change, or planning an event, teams often focus on what needs to be done. But how often do we stop and ask what we can learn before we begin?
The Before Action Review (BAR) is a simple but powerful knowledge mobilisation tool from the NHS Knowledge Mobilisation Framework. It helps teams draw on existing knowledge, experience and expertise before starting a piece of work, increasing the chances of success and avoiding the need to reinvent the wheel.
What is a Before Action Review?
A Before Action Review is a short, structured conversation that takes place before a task, project or activity begins. It encourages team members to share knowledge, identify potential challenges and learn from previous experiences.
Rather than asking "What went wrong?" after an event, a BAR asks, "What can we learn before we start?"
The process is quick, easy to facilitate and can be used for projects of any size, from implementing a new service to planning a meeting, training session or quality improvement initiative.
Four Simple Questions
A Before Action Review centres around four questions:
- What are we trying to achieve?
- What have we learned from similar situations in the past?
- What success factors and challenges should we consider?
- What actions will help us achieve our goals?
These questions prompt discussion, surface valuable insights and help ensure that existing knowledge is used effectively.
Why Use a Before Action Review?
Taking just a few minutes to conduct a BAR can deliver significant benefits:
- Avoid repeating mistakes or duplicating effort.
- Identify risks and opportunities early.
- Build on previous successes.
- Capture and share valuable tacit knowledge.
- Improve team communication and collaboration.
- Increase confidence and preparedness before starting work.
For NHS teams working in busy environments, BARs provide a practical way to make the most of collective experience and ensure that learning informs action. Want to learn more? Explore the NHS Knowledge Mobilisation Toolkit and the Before Action Review postcards for practical guidance on using BARs in your team.
Worked Example: Planning a New Falls Prevention Education Programme
A community therapy team is preparing to launch a new falls prevention education programme for older adults.
Before Action Review (BAR)
Project/Activity: Falls Prevention Education Programme
Date: 15 January 2027
Participants: Physiotherapists, Occupational Therapists, Falls Nurse Specialist, Service Manager
1. What are we trying to achieve?
- Deliver a six-week education programme for patients at high risk of falls.
- Increase patient confidence in managing falls risk.
- Reduce avoidable falls-related admissions.
- Achieve high attendance and positive patient feedback.
2. What have we learned from similar situations in the past?
What worked well?
- Interactive group sessions generated good engagement.
- Providing printed resources improved information retention.
- Inviting carers increased attendance and support at home.
What didn't work so well?
- Sessions scheduled during school run times had lower attendance.
- Referral criteria were unclear, leading to inappropriate referrals.
- Some patients struggled to access online resources.
Who else has relevant experience?
- The neighbouring community team delivered a similar programme last year and reported strong outcomes.
- The Trust's Patient Experience Team has guidance on producing accessible patient information.
3. What success factors and challenges should we consider?
| Success Factors | Potential Challenges |
|---|---|
| Clear referral criteria | Low attendance |
| Accessible patient materials | Transport difficulties for patients |
| Engagement from carers | Limited staffing capacity |
| Support from community teams | Last-minute cancellations |
| Suitable venue and equipment | Digital exclusion |
4. What actions will help us achieve our goals?
| Action | Owner | Timescale |
|---|---|---|
| Review lessons learned from previous programme | Falls Nurse Specialist | This week |
| Agree referral criteria with referrers | Service Manager | Within 2 weeks |
| Develop patient handbook | Occupational Therapist | Within 3 weeks |
| Contact Patient Experience Team for accessibility review | Physiotherapist | Within 3 weeks |
| Create attendance monitoring process | Admin Lead | Before launch |
Key Takeaways
- Previous programmes showed that carer involvement improves attendance and engagement.
- Clear referral criteria are essential to ensure the right patients are enrolled.
- Printed information should be available alongside digital resources.
- Early engagement with stakeholders will reduce implementation challenges.
What Happened Next?
By spending just 15 minutes conducting a Before Action Review, the team identified several issues before the programme started. They clarified referral criteria, adjusted the session times, involved carers from the outset and ensured that printed resources were available.
Without a BAR, these lessons may only have emerged after the programme had begun. Instead, the team was able to use existing knowledge proactively, reducing risks and increasing the likelihood of success.
This is the essence of knowledge mobilisation: making the most of what we already know so that every project does not have to start from scratch.
Top Tip: BARs work best when they are short, informal and focused. Most can be completed in 10-15 minutes and can save hours of rework later. As the saying goes, "Learn before, not just after."
Watch this video on Knowledge Mobilisation: Before Action Reviews (BARS) produced by the Somerset NHS Knowledge & Library Service
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