Write Thyself

Hyperlinks are one approach to making online procedures more interactive.  That's really the advantage of having procedures available online.  Web-based pages, forms, and references respond instantly.  I agree that's where we're headed.  Good luck with your efforts, Lori.

At the same time, the printed manual has advantages on the bench.  Paper is malleable, portable, and doesn't require an "input device."  You can tear it out, write on it, and take it anywhere at any time.  It can mold itself to the user in form and function, something computers have never done well.  It can even get wet!  Computers can't begin to match paper's ease of use in many respects.  You might be onto something, Ryan.

The NCCLS format and indeed the way most procedures are formatted doesn't suggest an interactive format.  I can imagine an online procedure with a menu bar that takes you where you want to go -- materials, QC, the procedure, in-house or reference studies, FAQ or intelligent search engine.  Eventually, the printed manual will resemble the online manual, instead of the other way around.  Document-based will become knowledge-based.

If the writing hasn't improved, of course, it's a wash.  But writing online can be easier.  For instance, a laboratory could use blogs, forums, and even a wiki to develop an online resource for really solving problems and communicating those solutions.  An online procedure could be drafted and edited real-time as a procedure is performed -- practically impossible with paper -- and "techs writing for techs" would become a reality.

Thank you so much! As a new supervisor. I give a better perspective to write procedures under our new document control. I love that we are able to attach, scan, hyperlink. Hello technology, go bye paper.

Let's be Green!

Perhaps in supplement to paper, ALSO have them accessable in shared computer drive format.  This way, they can be searchable as well as cross referenced and linked - almost like a "Web" of procedures.  

For example -

If the Potassium procedure refers to the call policy for a critical/hemolysed/unacceptable sample, you could simply click on the hyperlink(s) to take you to the call policy/acceptable sample/rejection policies, if you needed to inquire as to how to do them properly.

This isn't rocket science, but it is a step forward to becoming slightly more modernized than the 1960's.   I do agree, sometimes a paper-filled binder can be taken with you to the instrument or bench, whereas a computer monitor you cannot.  

But a policy can be printed out at a moment's notice, too.  They are easier to update - and the updates can be shown (like in MS Word) with changes highlighted and by who.  

Lela,

Great point!  Although I think paper has unique properties that have advantages on the bench.  Any "solution" needs to do better.

At one time I created true web-based policies -- written as HTML documents with links, javascript calculations, inline frames, images, and videos -- but this idea was rejected as "confusing."  The PDF was decided to be the "standard."

Given the years that web pages and web browsing has been around, it was disappointing that an electronic duplication of a printed page would be preferable.  Your point brings this home -- on the bench, it's all about speed and ease of use.  If the internet were nothing but PDF documents, no one would ever use it!

The "shared drive" concept, to be effective, needs to solve problems that paper doesn't.  Otherwise, it's just more work and won't make sense.

Glen,

I agree completely!

Back in the TRS-80 days, a computer came with pounds of manuals.  I remember a third-party vendor marketed "Manual By Jake" that reduced all those hundreds of pages of goo into simple, easy to read language.  I've always thought lab manuals should adopt this concept.

But administrators and even lab people can be pedantic souls.  Everything has to be numbered, formatted, or indexed a certain way.  Many a tech has been impaled on that NCCLS format.  For me, the telltale sign is a "cheat sheet" that tells how to run the test that people actually use day to day; there's the real procedure.  Another giveaway is when techs prefer the insert.

You're right about policies fitting specific questions, too.  This kind of spaghetti writing -- resulting in confusing, difficult to update procedures -- is rampant.  It also invites people to revert to previous behavior when policies are finally changed.  Someone on the staff will remember an arcane, bizarre policy written years ago that no longer applies.

I've suggested, on occasion, training sessions for those who write policies and procedures.  (I've even written a policy on how to write policies and procedures for our lab.)  But it's a losing battle.  It's seen as the purview of administrators and then once in print, always in print.  At best, one can anticipate endless arguing in committee meetings about this or that word, rarely content.  That's why the lab writing, I think, is interesting and unique.  Techs writing for techs is a real opportunity to create a solution, assuming they are allowed to make it work.

Please! Can't we put all the procedure manuals on a shared drive for easy access and use?  Get rid of the paper!

Good blog, Scott. I was speaking to a new lab manager recently about writing procedures and she was complaining how poorly-written the procedures in her lab were, the many different styles used etc. She thought she faced a daunting task "correcting" them all.

Something which I also found out is that most of their procedures were written in long convoluted "NCCLS" style. I use "NCCLS" deliberately instead of CLSI because they adopted the old format of including in every procedure every element required by NCCLS, although this is no longer required for procedures.

Another practice in that lab (and possibly others) is the tendency to write another policy for every unwanted behavior or every CAP deficiency. The result is a myriad of related policies saying the same things, or addressing the same subject but saying different things. I am not sure which is worse.

Policies and procedures serve a very useful function in terms of specifying desired behavior, actions to be taken, the steps in performing a procedure correctly, meeting regulatory requirements and so on.

However, they are too often overdone, stilted and entail way more effort than necessary.