August 2015 | Shufrans TechDocs Home // August 2015 | Shufrans TechDocs

Addressing human errors in the healthcare industry

Addressing human errors in the healthcare industry

It is important that operation and management information be understandable to the target audience. Sometimes, operation information is conveyed through a less-than-optimum selection of words. The manufacturer’s technical language can result in incomprehensible operation documentation.

Governance of Picture Archiving and Communications Systems: Data Security and Quality Management of Filmless Radiology, Carrison K.S. Tong, Eric T.T. Wong, Human Factors & Culture, 2009

English is the de facto language for almost all industries, including healthcare where communication is crucial to ensure operational efficiency and accuracy. Without good communication among healthcare professionals such as referring medical doctors, technologists, radiologists, clinicians, nurses, suppliers, maintenance and service engineers would imply that high quality standards become impossible to maintain.

 

Human errors can be expensive, lead to accidents, and risk product quality

More often than not, operation information is conveyed through a less-than-optimum selection of words. To cite a real-life example of a maintenance procedure where a certain step was ‘proscribed’ meaning prohibited, the technical personnel who read this instruction decided that the procedural step was ‘prescribed’ and hence recommended. Regrettably, he proceeded to carry out the prohibited action with dire consequences.

New manuals, job cards, operations and maintenance service bulletins are prime examples of documentation that must be proofread and beta-tested before being widely circulated. Proportionately, the labour costs involved in such documentation management processes can be immensely high.

 

Document complexity & volume

With the latest medical products and technology made available on the market, the increasing complexity and volume of medical data and healthcare information that must be created, recorded, integrated and managed cannot be avoided. Indeed, voluminous and complex writing that read very differently since they must have been supplied by various product manufacturers can negatively impact hospital’s operations when misread or misinterpreted. Volumes of user manuals from various sources with at times overlapping information also seem impossible to store and manage usefully.

A popular example in the aerospace industry is the well-known paper stack from aircraft manufacturers that supposedly exceeds the height of Mount Everest. Paper documentation support the work of aircraft operators. Airlines used to afford warehouses full of such paper stacks that document historical records of their aircraft maintenance. All of which proved too expensive to maintain later on.

Consequently, unmanageable volumes of text, document complexities, time-critical operations, as well as the growing proportion of healthcare workers whose first language is not English, all point to the need for a unifying English language standard that would allow the community to speak with one voice and convey critical information using fewer words.

Create manuals that speak with one voice

Safety begins with quality. Even the best product is only as good as its documentation and technical data, which allow the customer to use it safely and effectively.

Many incidents identified in the healthcare industry revealed poor technical understanding and communication due to missing user manuals, inadequately described operating instructions, and badly maintained  equipment that add to the series of errors and accident occurrences.

Let’s take a close look at the following case study excerpt. Our customer is a manufacturer of mobile X-ray based imaging solutions. They created an operator manual and a service manual in Standard English that was subsequently edited in a controlled language known as Simplified Technical English (STE).

Standard English: inconsistent tone and excessive use of words

Control Panel Both the C-arm stand and the monitor cart have a control panel. The two control panels always show the same screen, enabling you to use them for system operation.Depending on the selected function, other controls (buttons, input boxes, displays, etc.) will appear on the control panel screen.The Vision Center control panel is designed as a touch screen. For system operation, just press the desired button or option directly on the touch screen.

STE: uniform tone of voice and standardised sentence structure

Control Panel The C-arm stand and the monitor cart each have a control panel screen. These screens show the same control panel. Each panel lets you operate the system. The panels have different controls for different functions.The control panel is a touch screen. To operate the system, touch the correct button or option.

At the time our customer was writing a range of user and maintenance manuals  for their X-ray imaging equipment. Although the manuals were created and edited by more than 10 technical writers in a team, our customer wanted all manuals to read like they came from one single source. STE provided a cost-saving and easily implemented solution as evidenced by the rewritten STE sample text highlighted above.

ste_casestudy_chart.001

Say it better with fewer words

The implementation of STE in the healthcare sector proved to be a great success. Using a smaller number of words with defined meanings and parts of speech, while adopting a simplified English language structure meant that user manuals now provide a highly consistent and unambiguous tone of voice with a 20% reduction in text volume. Above all, healthcare professionals depend on reliable documentation to operate medical devices and equipment safely and efficiently. STE therefore helps medical equipment manufacturers meet documentation compliance requirements, and can also increase the efficiency and productivity of their employees.

To summarise, an instruction found in a technical procedure must never become a case of interpretation. Work instructions communicated in technical manuals must be concise and let the user or maintenance personnel do their jobs properly, putting patient safety first and foremost.

Copyright © 2015 Shufrans TechDocs. All rights reserved. No part of this article may be reproduced or transmitted in any form or by any means whatsoever without express written permission from the author, except in the case of brief quotations embodied in critical articles and reviews.

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Simplified Technical English at the core of your documentation strategy

Simplified Technical English at the core of your documentation strategy

Why Simplified Technical English (STE)?

Whether you are looking to implement working standards such as DITA, S1000D, ATA iSpec 2200, RailDex, or ShipDex to standardise your information structure and facilitate content re-use, it is important to give due consideration to the quality of your source text when creating your technical content. Ambiguous or inconsistently worded documentation can result in non-compliant data deliveries, poor customer support, potential legal liabilities, equipment damage, as well as safety risks.

A well-written source text ensures the ease of downstream content management processes such as translations

Improved readability for your technical content

STE prescribes the use of grammar rules that are relatively more restrictive than the standard rules of the English language.

The general vocabulary has only 900 approved words while explicitly listing 1500 other non-approved words with alternative suggestions.

By introducing these grammar and vocabulary restrictions, technical authors can avoid writing overly long sentences and leave out unnecessary technical details where applicable, all of which are obstacles to the ease of readability and sound understanding.

Recommended by global documentation standards

Military defence standards (MIL-SPEC / MIL-STD) such as MIL-STD-3048, as well as technical documentation standards like S1000D and ATA iSpec 2200 recommend the use of ASD-STE100.

Although the S1000D standard was originally intended for the aerospace and defence industry, this widely successful specification has been customised for the shipping and train manufacturing and operations communities giving rise to both ShipDex and RailDex. Likewise, sound and consistent STE writing rules are highly applicable and practical for use across industries.

Simplifying or eliminating the need for translations?

STE is an international aerospace standard that helps to make technical documentation easy to understand. However, the benefits of STE have proven very highly applicable to all industries. That is why 60% of STE users today come from industries outside of aerospace & defence.

Understandably, STE was designed with non-native speakers of the English language in mind. By providing technical writers with a common set of standardised writing rules and general vocabulary, STE enables teams of writers to write technical manuals that are consistently accurate and require less proofreading and editing effort. Consequently, this does away with the need for translations altogether.

Besides the aerospace maintenance industry however, product exports are still subjected to much scrutiny in terms of their paperwork, documentation and associated product translations. Therefore, the use of STE to create technical content can support downstream translation processes in several ways:

  • A 900-word general vocabulary dictionary eliminates the need for other non-approved, and possibly uncommon synonyms. This reduces the likelihood of term-related clarifications and queries from translators, resulting in faster translation processes.
  • Enforcing STE rules strictly guarantees a high level of consistency at word-, phrase-, and sentence-levels.  This allows project managers to leverage on existing translation memories to substantially reduce translation costs.
  • With fewer technical terms to translate and a more uniform translation memory, translators can provide cheaper, faster and better translations thanks to STE.
  • Having STE content in place will result in exceptional translation quality with machine translations as well.

 

In a nutshell

For many years now, the use of STE as a controlled language authoring strategy has successfully taken off not just at large organisations, but also in small and medium enterprises.

With professional Simplified Technical English training that costs only a fraction of supposed “full implementation”, and yet achieves 75% – 85% of the benefits and results of an approach that includes checker software, getting started with STE is no longer the major and expensive investment it used to be.

Training technical writers and engineers to write in STE within two to three days may sound like a simple and straightforward undertaking. However, to change the way your technical authoring team works does require some managerial direction while the team transits to STE. Trained technical writers will experience on a more regular basis, the many benefits that STE as a controlled language writing strategy offers.


Shumin Chen

About the author

Since 2006, Ms Shumin Chen has been working as a consultant with customers in various industries worldwide: aerospace and defence, banking, consumer products, healthcare, IT, medical and fitness equipment. She has helped many companies with their documentation needs, based on standards where possible, and is widely regarded as a leading expert in ASD-STE100 Simplified Technical English training, aviation documentation and multilingual documentation.

Ms Chen now heads the ASD-STE100 training arm of Shufrans TechDocs. In her current role, Ms Chen continues to focus on the practical implementation of international standards to facilitate the efficient creation and management of multilingual documentation.

Copyright © 2015 Shufrans TechDocs. All rights reserved. No part of this article may be reproduced or transmitted in any form or by any means whatsoever without express written permission from the author, except in the case of brief quotations embodied in critical articles and reviews. 

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