Anyone who is familiar with my work or my publications knows that job aids are near and dear to my heart. My third book (Job Aid Basics) is about the subject. Any serious performance student or consultant knows about the power of job aids—about how they are a cheap and effective way of improving performance. Well, there is a great new book out by Surgeon Atul Gawande called The Checklist Manifesto.
Checklists are just one example of a job aid. What is a job aid? A job aid is a device or tool used to improve memory or confidence on the job and thus overall performance. A wrench is not a job aid (it’s just a tool). But a checklist (which reminds us of what to do), a recipe with steps (so we don’t add the eggs too soon), a trouble-shooting guide on how to figure out why the car doesn’t start—these are all job aids.
Gawande writes about a number of examples in this great book but his first primary examples involves healthcare. He examines the case of the Johns Hopkins ICU where using a simple 5 bullet checklist, the staff reduced central line infections from 11% to 0% saving an estimated 43 infections, 8 lives and 2 million dollars per year. Gawande and a team then went to a number of hospitals around the world and tried the same approach from rural Tanzania to Seattle. Using a 19-point checklist for surgery, they found that EVERY hospital experienced a significant drop in post-operative complications and deaths. In the 6 months after the checklist was introduced complications fell by an average of 36% and deaths fell by an average of 47%. This was no new technology, no other major changes or influx of talent or resources—just the use of the checklist during surgery.
Performance consultants know about job aids. Joe Harless gets credit for having coined the term. Job aids are often a faster, cheaper alternative to training. They’re an underutilized way of improving performance and a useful tool in the performance consultant’s tool box.
Gawande has done us performance consultants a tremendous favor. He’s got a significant following (staff in the Obama White House look at his writings, both this book and his previous one Better about improving performance). Dr. Gawande has provided very specific, tangible and quantifiable examples about how performance can be radically improved with even just simple tools or approaches. For all the clients out there who want to throw training at the problem or rehire a work force or change the bonus structure, Gawande’s work is a useful tool to help us make the case for a performance-based approach to improvement.