Using Job Aids to Improve Performance

Indianapolis Fire Department rescues
Photo courtesy Indianapolis Fire Department

When job performance falls below expectations, we frequently implement a training solution without examining the cause of the poor performance or determining whether more training will correct the deficiency. If performance fails to improve, then disciplinary action becomes the default corrective action. However, training is not the only solution to poor performance, but it is the most effective solution when learning something for the first time or learning more about something that is already known.

Developing and implementing a job aid to improve performance are often an effective solution that you can implement inexpensively and quickly. Job aids will work well when personnel are trying to remember or apply what they have learned, solve problems that arise, or address complications or problems or when current work procedures change. Job aids are used routinely in high-consequence fields, such as the airline and health care industries, to improve performance and reduce the risk of failure.

Job aids provide information, support procedures, coaching, perspectives, backup for decision making, and self-evaluation. However, don’t use a job aid as a task in itself. For example, apparatus checklists are designed to support ensuring that apparatus is properly equipped and ready for emergency response. Checking boxes is not the task; assessing the apparatus is. The job aid is simply a means to ensure consistency and standardization and confirm that all the tasks have been completed thoroughly.

Alternative to Training

Consider job aids as an alternative to training when any of the following task performance issues occur:

  1. The task is performed infrequently or irregularly. Although there is no set definition of when tasks should be practiced, the more complex or critical the task, the more frequently it should be practiced.
  2. The task is performed incorrectly.
  3. The task is routine but critical.
  4. The task is complex with many factors, such as multiple steps or specific sequences, which makes confusion likely and increases the chances of missing steps or performing actions out of sequence.
  5. If the task is done incorrectly, failure is highly likely, with significant consequences.
  6. The knowledge the task requires is large or evolving and changing.

To determine if a job aid is the solution to improve performance, conduct a task assessment. Tasks that follow specific procedures or a linear sequence—e.g., medical protocols and response guidelines—readily lend themselves to job aids. To select the right job aid for the task, consider the following:

  • What is the task?
  • What experience and knowledge level does the task require?
  • How will the performer access the job aid, and what will it do?

First, examine the task—the work to be done. The job aid must incorporate the steps, the processes, and the decision points for completing the task; the tools required; describe the steps and alternatives; and the performance variations, such as options to performance or alternatives to performance based on external factors.

Once you have defined the task and its successful completion well, consider who will use the job aid. If the task is rarely performed or the users will have little or no experience with the task, the job aid will require a greater level of detail, information, and instruction.

Finally, accessing the job aid may take a variety of formats. Fire and emergency medical service (EMS) departments frequently use either tablet- or paper-based checklists to assist with the daily inventory and equipment status check. As equipment has become more complex, and in departments where personnel are frequently rotated between stations, some departments have begun to place quick-response (QR) codes or Web addresses in close proximity to power equipment for quick access to videos and manufacturers’ documents for assistance when needed. Tablet computing allows for the expanded use of job aids to improve performance in the field.

Job aids can be procedural, informational, and coaching. Procedural job aids walk users through a sequence of actions to take and are commonly found in EMS protocols and fire response action steps, such as SLICERS (Size up, Locate the fire, Identify the flow path, Cool the space from the safest location, Extinguish the fire, Rescue, and Salvage). Informational job aids provide just-in-time knowledge cues to guide further action, such as COMPaSS (Container shape and size, Occupancy/location, Markings and colors, Placards and labels, Shipping papers, and Senses), which is used for hazardous materials response, that help guide the user through specific steps at an incident. Just-in-time knowledge or training provides guidance on task performance when the performance will occur. For example, the front inside cover of the Emergency Response Guidebook provides a job aid that serves as just-in-time training, guiding responders on how to use the Guidebook during an emergency incident.

Coaching job aids provide insight, mental models, and ideas to help the user perform tasks, such as instructor notes in a train-the-trainer guide.

Procedural

Procedural job aids provide guidance on the steps and actions needed to perform tasks correctly. When building procedural job aids, concentrate on the tasks to be completed, not the background knowledge of the task. This allows the job aid to focus on actions, keeping the format simple and user-friendly. While developing the job aid, follow someone who is performing the task correctly to capture the steps and, when translating the steps, use action verbs to describe what is being done. Focus only on the most important information, and describe it only to the detail needed. If you are using a table as part of the job aid, consider adding an extra column for substeps and another for any additional notes that are needed. Use pictures and drawings to provide additional context and consider using callout boxes. Finally, test the job aid; make changes if it does not work as desired.

Informational

Informational job aids provide knowledge needed to complete processes or specific steps accurately, with a focus on helping the user remember or apply knowledge to solve a problem that he is facing. These job aids focus on what the task performer needs to know, rather than the skill, to complete a task. For example, pump operators often use both mnemonic job aids (e.g., the hand method) and reference sources (e.g., charts with hydraulic formulas and precalculated pump pressures) to assist in determining the appropriate pump pressure. When developing informational job aids, follow the lead of someone who is performing the task but focus on the knowledge steps needed to perform a skill correctly and areas where knowledge can either be applied incorrectly, may be used infrequently, or can be easily forgotten.

Fire Pumping Calculations: Every Pump Operator’s Basic Equation

The Importance of Apparatus Checks

COACHING TO IMPROVE PERFORMANCE

Coaching

Coaching job aids help in applying a skill where the user remembers part of the process or is dealing with something that has gone wrong. These job aids guide the user to the correct steps to address issues or complete the process. For example, many departments are printing and laminating QR codes that link to videos on how to operate and troubleshoot power equipment in the compartments where the equipment is stored. This allows personnel who are unfamiliar with the equipment the opportunity to follow the video as a form of just-in-time training. The videos commonly include starting procedures, troubleshooting, common maintenance such as changing saw blades, and equipment safety. When developing coaching job aids, focus on guiding the user through processes related to use and troubleshooting and correcting problems. When designing coaching job aids, identify areas where problems may occur and provide guidance on how to correct them.

Types and Application

A variety of job aids are available in a variety of forms that can help improve performance, including written and graphic representations, mnemonics, videos, podcasts, and computer-based simulations.

Checklists are a common job aid in emergency services, often used to ensure that apparatus inventories are complete. They ensure task performance consistency, especially before moving on to other activities such as emergency response. Many departments are combining the checklists with reference sources to provide just-in-time training. Internet links and QR codes are either placed in unit-assigned tablet computers or accessed using smartphones to provide training videos and user guides for power equipment, apparatus manuals, and other manufacturer-provided content to assist personnel with confirming the inventory and assessing the status of power tools and other mechanical equipment.

Using checklists is common in the airline and medical fields. The use of a checklist is heard in the cockpit data recording of the successful 2009 landing of US Airways Flight 1549 into the Hudson River when the plane became disabled because of striking birds. Dick Richardson, who was on Flight 1549, points out, “When the aircraft took the bird strike, Sully took control of the airplane, and he was about to ask Skiles to try and restart one of the engines when he looked over toward Jeff. He saw that Jeff already had the emergency checklist book out and was already on [that] page and was already starting to restart the engines. From the time the engines failed until the successful landing, the crew utilized the plane’s emergency checklist, engine restart checklist, communications checklist, passenger checklist, and evacuation checklist to save the lives of the passengers and crew.”

Using checklists in hospitals before surgery has been shown to improve patient outcomes by more than 8%. Surgeon Atul Gwande, author of The Checklist Manifesto: How to Get Things Right, is known for his work reducing surgical complications and deaths by 30% in eight different hospitals simply by using a checklist, shared among the surgical staff, which takes 90 seconds to complete and is done before every surgery, no matter how routine.

Step Guides

Step guides provide step-by-step instruction when subtasks must be completed in a specific order. Reminders or pocket guides are small memory prompts for quick reference for tasks that are done rarely, such as pediatric drug dosage calculations. Procedures and process maps, decision tables/trees, and flow charts are graphic representations of what is to be done and the impact that specific questions, findings, or other outside influences have on the task. Templates, forms, and worksheets are used when creativity is not required and specific information, procedures, or activities must be completed in a standardized format.

Using job aids can potentially improve individual and organizational performance and response outcomes and serve as a cost-effective means of training responders. Health care, airlines, and other critical industries have embraced them to provide just-in-time training for both critical and routine tasks while improving overall performance.

As the fire and emergency medical services face personnel transitions, increasing complexity within the operating environment, limited funding, and increased scrutiny, job aids offer a means of improving performance cost-effectively while meeting the needs and requirements of the communities served.

References

Allan, L. (2019). Use Job Aids to Improve Your Business Results. https://bit.ly/3xdI3mz.

Chainsaw Journal (2019). Chainsaw Maintenance Tips, Advice & Checklist. https://bit.ly/2RFFPMf.

Fallon, M. (2015). Checklists – Simple and Powerful Tools. Berkshire Company. https://bit.ly/3arpn91.

Gwande, A. (2005). The Checklist Manifesto: How to Get Things Right. Picador. NY, NY.

Haugen, A, Softland, E, Almeland, S, et. al. 2015 Effect of the World Health Organization Checklist on Patient Outcomes. Annals of Surgery: 2015; 261:821-828. https://bit.ly/2Qh21fi.

Russell, S. (2000). Create Effective Job Aids. InfolineATSD. Alexandria, VA.

Richardson, D. (2013). How the Miracle on the Hudson Showed the Importance of Training a Team. https://bit.ly/3sEOMCm.


Dave Donohue is a 40-year veteran of emergency services and has served with emergency services, fire departments, and EMS agencies in Florida, West Virginia, Pennsylvania, and Maryland. He resides near Hagerstown, Maryland, and is the owner of Mid-Atlantic Emergency Services Consulting. He works for a fire-EMS educational institution in Emmitsburg, Maryland; is an adjunct instructor for the Maryland Fire and Rescue Institute; and is a member of the Community Volunteer Fire Company of District 12 in Fairplay, Maryland.

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