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Stepwise Success

Three or Four Steps

Published January 17, 2014 6:13 AM by Scott Warner

When we went paperless in order entry, it meant much more than just dumping paper, binders, index cards, labels, and hand-carried requisitions. Since all staff needed this information, each person had to have the right computer skills to use Access, search folders on the server, copy and paste, cut and paste, drag and drop, use wildcard characters, and print to a PDF.

Most of this was hands on learning, but a lot of it involved writing down the steps. How many says a lot about our profession. As I blogged, missing steps in a laboratory procedure can imply workarounds that can lead to error. This is true with computer software where a missing keystroke or mouse click can crash the whole shebang.

Thus, our computer procedures tend to be a literal listing of each keystroke, mouse click, entry variable, and any variations that can occur. They are written this way out of necessity, but they are a stark contrast to other procedures where most space between the steps is filled by professional judgment and experience.

Recently we had a problem downloading a report into a format correctly. I developed a workaround in which techs could pull up the correctly formatted result on the reference lab web site, copy and paste this into Notepad, and copy and paste the Notepad copy into the result format. The interim step was needed to correctly translate the web page, particularly spaces and tabs.

I showed this to techs. “It’s three or four steps,” I explained with brash sincerity.

Well, “three or four steps” turned out to be at least 29 steps (ten more and we would have a Hitchcock movie) when this procedure was written out, keystroke by mouse click, on two sheets of instructions. Everyone laughed. And while it really does take at least 29 discrete steps, I see only a handful e.g. three or four of steps. The gaps are filled in by experience. In this case, this perceptive dissonance is funny because we don’t all share the same experience.

Something to think about when writing procedures.

NEXT: Is Turnaround Time Important?

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About this Blog


    Scott Warner, MLT(ASCP)
    Occupation: Laboratory Manager
    Setting: Critical Access Hospital
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