The European Centre for Disease Prevention and Control (ECDC) has published a new practical guide for designing and conducting action reviews—structured processes for capturing lessons learned during and after public health emergencies and translating them into concrete improvements for future response.
The guide, released March 25, 2026, addresses a persistent challenge in public health preparedness: the gap between experiencing a crisis and actually implementing the insights gained from it. While every public health emergency generates valuable lessons about what worked, what failed, and how systems can improve, these insights often remain scattered across individual experiences rather than becoming embedded in institutional practice.
“Learning from every public health emergency is essential if we want to improve how we respond to the next one,” said Thomas Hofmann, ECDC Head of Section, Emergency Preparedness and Response. “It’s important that the action review process does not end with simply understanding what happened—we must also identify what worked and what didn’t work, and translate these lessons into practical actions.”
Finding Practical Insights
Public health emergencies are inherently complex and novel, making lessons learned extraordinarily valuable to strengthen preparedness planning, improve coordination, and address gaps in existing systems. The challenge is doing so systematically rather than relying on informal recollection or institutional memory that disperses when staff move on or organizational structures change.
Action reviews create a formal mechanism to capture these lessons while the experience is still fresh and to convert them into actionable recommendations. This matters not just for the organization that conducted the emergency response, but for the broader public health system. Lessons about communication failures, resource bottlenecks, or coordination challenges in one country or sector can inform improvements across Europe and beyond.
The ECDC guidance distinguishes between two types of action reviews. In-action reviews are conducted during an ongoing emergency to identify immediate improvements the response can adopt in real time. After-action reviews take place once an emergency has ended, typically three to six months later, to analyze the full response and inform future preparedness planning. Both approaches use the same methodology but serve different purposes and timelines.
A Three-Phase Approach
The ECDC methodology structures action reviews into three phases: Revisit, Reflect, and Revise.
During the Revisit phase, stakeholders work together to reconstruct the timeline of events and the actions taken in response. This seemingly straightforward exercise serves a crucial function: it creates a shared understanding of what actually happened. Different stakeholders often have fragmented views of an emergency—they know their own piece well but lack visibility into what others were doing and why. Collaboratively rebuilding the timeline builds common ground and surface discrepancies in perception that themselves can be valuable learning.
The Reflect phase focuses on identifying pain points—the challenges participants encountered—and instances of good practice worth preserving. Rather than assigning blame, this phase treats challenges as system-level issues to be understood and corrected. Participants vote to prioritize which pain points warrant deeper analysis, focusing follow-up work on issues most stakeholders identified as critical.
The final Revise phase translates insights into recommendations. Using an Impact-Feasibility matrix, stakeholders categorize pain points as quick wins (high impact, achievable now), long-term priorities (high impact but requiring sustained effort), or opportunities for future consideration. For each prioritized issue, participants develop concrete corrective actions with clear objectives and implementation strategies.
Connecting to Broader Preparedness Frameworks
The guide aligns with European Union requirements for health emergency preparedness. Under Article 8 of the EU Regulation on Serious Cross-Border Threats to Health, member states undergo Public Health Emergency Preparedness Assessments to evaluate their readiness for health crises. One assessed capacity specifically focuses on recovery and lessons learned, explicitly encouraging countries to conduct action reviews as a systematic practice.
This positioning matters. It signals that action reviews are not optional post-emergency reflection but a core component of maintaining effective preparedness. Just as military forces conduct after-action reviews to improve readiness, public health systems need equivalent mechanisms to ensure that each emergency makes the system more resilient.
Implementation Support
The guide provides detailed practical support for organizations conducting action reviews. It includes templates for all major steps, guidance on assembling facilitation teams, stakeholder mapping tools, and worksheets for documenting findings. It addresses common challenges: how to facilitate discussions in a non-judgmental manner, how to handle large groups or multiple response areas, how to ensure recommendations actually get implemented.
A particular strength is the guide’s emphasis on implementation follow-up. Conducting an action review workshop and producing a report is not the end; recommendations must translate into actual change. The guidance includes provisions for developing action plans, assigning ownership of specific improvements, and monitoring progress over time.
For countries that experienced the COVID-19 pandemic or other recent public health emergencies, the guide offers a structured methodology to capture insights and improve preparedness before the next crisis emerges. For those preparing for future threats—whether pandemic influenza, novel pathogens, bioterrorism, or other health emergencies—the guide provides a framework for institutionalizing learning as a core capability.
The ECDC has conducted action reviews in multiple European countries and continuously refined this methodology based on experience. Countries that have undergone Public Health Emergency Preparedness Assessments and received recommendations to strengthen action review processes now have detailed operational guidance for implementation.
The guide reflects recognition that public health preparedness is not a static achievement but a dynamic capability that must continuously improve based on experience. By systematizing how lessons are captured, analyzed, and translated into practice, action reviews help ensure that crises become catalysts for strengthening the systems designed to protect public health.
Sources and further reading from ECDC:
Guide for designing and conducting in-action and after-action reviews