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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.

Are you ready to make STE your strategic partner?

Explore our FAQ section below.
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. 

Are you ready to make STE your strategic partner?

Attend a 2-day certified ASD-STE100 workshop at any of our worldwide locations
Optimise what is between the tags

Optimise what is between the tags

Depending on your industry and requirements, it normally is a great step forward to implement DITA or S1000D to standardise on your information structure and facilitate re-use from a technical point of view. Now, learn how ASD-STE100 Simplified Technical English can help you take things to the next level, thus preparing your content for optimum re-use, readability and translatability.

Data Protection Solutions STE

Simplified Technical English (STE) deconstructed – a textual analysis

In the textual analysis that follows, we will underline unapproved words (according to the ASD-STE100 specification) in the Standard English text and then provide the corresponding approved words in STE underlined where possible.

A general misconception might be that STE rewriting is mostly a word for word replacement. However, this is clearly not the case as illustrated in the examples here:

1a) Standard English: The main idea of Exchange clusters is to provide high database availability with fast failover and no data loss.

1b) STE: Exchange clusters have high database availability with fast failover and no data loss.

Analysis: In this above sentence pair, we removed redundant words that do not add meaning to the sentence. The result is a concise, more direct sentence.

2a) Standard English: Usually, it is achieved by having one or more copies of databases or storage groups on the members of the cluster (cluster nodes).

2b) STE: There normally are one or more copies of databases or storage groups on the cluster nodes.

Analysis: ‘Achieved by’ is a passive verb form that is not approved in STE since it hides the doer of the action. By simply stating that ‘there are one or more copies of databases or storage groups ..’ already supports the first sentence.

In the ASD-STE100 specification, Issue 6, January 2013, rule 1.12, writers are advised not to use different technical names for the same thing. In Standard English, ‘members of the cluster’ was presented synonymously alongside ‘cluster nodes’. This is a clear violation of the rule 1.12 that can cause potential readability issues.

In this case, a good technical writing professional must already decide at the outset which technical term to use and then consistently apply the same term when describing the same thing.

3a) Standard English: If the cluster node hosting the active database copy or the active database copy itself fails, the other node hosting the passive copy automatically takes over the operations of the failed node and provides access to Exchange services with minimal downtime.

3b) STE: If there is a problem with the active database copy or its cluster node, a different node with a passive copy automatically replaces the unavailable node and gives access to Exchange services after a short time.

Analysis: ‘Host’ qualifies as an approved technical verb based on the nature of this text. However, in STE, only a limited group of verb tenses is allowed. The –ing form or present participle verb form is not used in STE unless it is part of a technical name. For instance: lighting, missing, servicing. From the STE example, notice that the verb ‘hosting’ is not necessary since we used the possessive determiner ‘its’ to indicate the association between the active database and the cluster node.

It is also not common to use phrasal verbs in STE as each individual verb could hold a different meaning from the phrasal verb itself. We substituted ‘takes over’ with ‘replaces’ and that adds to one less word count – a win-win. ‘Provides’ as an unapproved STE verb is replaced with ‘gives’, a verb with a more direct and clear definition.

4a) Standard English: Thus, the clusters are already serving as a disaster recovery solution themselves.

4b) STE:

Analysis: The last sentence is a summary of all that has been described and is considered repetitive in STE.

 

The case for STE – concluding points

From the brief analysis provided, it is clear by now that STE when implemented properly lets you have:

  • Higher documentation quality due to increased comprehensibility and readability
  • Standardised, concise and meaningful content
  • Reduced translation costs thanks to better source texts.

STE allows technical writers to achieve their professional goals in a timely manner with mastery of this specification in less than three training days. When correctly applied, STE writing rules help the technical author present complex information in a well-thought-out and developed style.

 

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.

Using ASD-STE100 to apply Lean Six Sigma concepts to your documentation processes

Using ASD-STE100 to apply Lean Six Sigma concepts to your documentation processes

By Ms. Shumin Chen and Dr. Frans Wijma

ASD-STE100 Simplified Technical English and Six Sigma

Below, we will outline the basic synergy between Six Sigma and Simplified Technical English.

An important Six Sigma method is known as DMAIC:

  • Define the project goals
  • Measure key aspects of the current process and collect relevant data
  • Analyse the data to identify root defects
  • Improve or optimise the current process based on the data collected
  • Control the new process to ensure that any deviations from target are corrected before they result in defects

In the domain of ASD-STE100 Simplified Technical English in relation to content creation and content management (authoring, editing, change management, version management), the basic parallel is:

  • Define the writing rules
  • Mine legacy data
  • Analyse the data to identify the common violations
  • Improve the documentation by applying the relevant rules
  • Check the documentation to ensure correct and consistent use of the rules, thus reducing the number of violations and improving output quality

 

Our ASD-STE100 working model

Shufrans-six-sigma-ste-small

ASD-STE100 Simplified Technical English provides the baseline set of writing rules that can be used as objective parameters to measure content quality. Shufrans TechDocs can extract relevant error information from your legacy publications, helping to identify the main problem areas. We then train your staff in effectively applying the rules that remedy these problems.The delivered content aims to provide key decision support for further STE implementation across departments and future technical writing projects.

Finally, we help you to implement and form of Simplified Technical English checker software to monitor and control the content creation and output. The exact implementation will be based on your existing or planned documentation process and entails many variables.

 

Your bottom line impact

ASD-STE100 Simplified Technical English involves all aspects of the documentation life cycle. It looks to make significant improvements in your content creation and content management workflow. Typically, text written in Simplified Technical English will show a 20 to 30% reduction in text volume without any information loss and at least a 60% increase in readability and user-friendliness. As the text volume is reduced by at least 20% and the remaining text becomes more repetitive, the use of Simplified Technical English typically results in 30 to 40% less translation cost.

After all, the best product is only as good as its documentation and technical data allow the customer to make optimum use of it without stretching the budget too far.

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.

Streamlining your documentation processes with a practical content strategy

Streamlining your documentation processes with a practical content strategy

Safety starts with quality. The best product is only as good as its documentation and technical data made available to the customer.

Case study

Our customer, the Finn-Power Group, established in 1969, is a multinational group of companies specialising in sheet metal working technology with 2 manufacturing sites in Italy, 1 in the US and 1 in Finland.

 

Industry concerns

Customer documentation is a vital and integral part of Finn-Power’s comprehensive range of machinery. Most crucially, the documentation needs to do its part to ensure the safe and correct use of the product by providing complete, accurate and effective information.

Additionally, with the EU machinery directive in place and the EU now comprising of 28 countries, there is a regulatory need for clear and accurate translation into many different languages as well as specific, safety-related content.

 

Using Simplified Technical English ASD-STE100 to create user content 

To make content easier to understand as well as faster and cheaper to translate, Dr Frans Wijma gave training to Finn-Power’s team of technical translators, writers and documentation manager in the rules and practical application of this international standard. Course participants did a complete rewrite of selected sample documents in Simplified Technical English.

Finn-Power has successfully implemented ASD-STE100 since 2010 with the continuous support from the team at Shufra.

ASD-STE100 standardises vocabulary, grammar and style, while letting companies control their specific terminology (Technical Names). The ASD-STE100 standard is widely used in industries ranging from aerospace to IT, consumer electronicsautomotive and machinery.

 

The next step – formulating/designing a useful information structure

Taking on the other important aspect of documentation is the structural reuse of content and optimizing technical means for reuse. With all their business requirements in mind, Finn-Power was looking for a highly intuitive, low-threshold content management solution (CMS).

We tapped into our partner network and found Author-it to be the perfect fit with the customer’s requirements as it includes a translation management module that allows users to efficiently and effectively manage multilingual content. Author-it allows you to reuse content with a high level of granularity. While most CMS systems just let you reuse whole blocks of text, Author-it allows for text reuse on the sentence level, doing away with the need to define portions of text intended for reuse.

Said Ms Hanna Korpinen, Manager of R&D and Documentation:

Now that we have also taken on this other important aspect of documentation, we are better positioned to provide quality documentation to our customers on-time and within budget!

 


Copyright © 2013 Shufra Consultancy. 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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Turkish Aerospace Industries ensures ASD-STE100 compliance

Turkish Aerospace Industries ensures ASD-STE100 compliance

Turkish Aerospace Industries (TAI/TUSAŞ) is Turkey’s centre of technology in design, development, modernisation, manufacturing, integration and lifecycle support of integrated aerospace systems, including fixed-wing and rotary-wing aircraft, UAVs and satellites.

TAI asked Shufra to assess the level of compliance of its documentation with the ASD-STE100 specification. Based on the findings, Shufra delivered an advanced training course for the technical writers and other people in the ILS department, providing them with new insights to take compliance to the next level. Writers especially liked the workshop that allowed participants to review and rewrite their own document samples under the guidance of the experienced Dr Frans Wijma who is widely regarded as the leading expert in Simplified Technical English, aviation documentation and multilingual documentation.

 

He gave ASD-STE100 training to over 130 companies worldwide. Customers include Black & Decker, Boeing, Microsoft, Rolls-Royce and Samsung. Said ILS specialist Mr Halil Kan: “TAI hired Frans to work with our experienced team and help them to improve their ASD-STE100 Simplified Technical English skills. Frans helped us to identify areas for improvement both in our own documents and in those supplied by our customers and partners. At the end of the training, we all had learned simple yet effective methods to improve the quality, readability and compliance of our writing. Most importantly, we learned how to scrutinize text for commonly made mistakes and how to balance compliance with optimum readability. We enjoyed working with Frans, who has a pleasant personality and an open mind. I am happy to recommend him to any company that wants to improve its documentation, be it for compliance reasons or to facilitate translation.”

Hear more from our satisfied customers.

Tata Consultancy Services hired Shufra to maximise customer satisfaction in terms of compliance with ASD-STE100 Simplified Technical English.

Tata Consultancy Services hired Shufra to maximise customer satisfaction in terms of compliance with ASD-STE100 Simplified Technical English.

ASD-STE100 was originally developed to make maintenance documentation for aircraft and their components easier to understand for a global audience. Over time, use of the specification was increasingly required for other types of manuals in the electronics, automotive and IT industries. Amongst them is Tata Consultancy Services (TCS), a subsidiary of the Tata Group. By 2012 revenues, TCS is one of India’s most valuable companies, and the largest India-based IT services company.

 

Tata’s services include technical publications for major aircraft manufacturers and their suppliers, who require compliance with relevant standards such as ASD-STE100.

Airbus is widely known to have strict STE quality checks that are difficult to meet for outside suppliers. Head of Aerospace Vertical, Mr Sureshbabu says: “Amidst the financial turmoil of 2008, India continues to offer new business opportunities. At TCS, we constantly keep up with high quality standards and keep our customers happy. Learning how to optimally use a documentation standard like ASD-STE100 is a substantial boost to our technical writing team’s capabilities and significantly improved our compliance rating.”

Said Dr Frans Wijma, Shufra’s principal trainer: “To date, Shufra has trained 20 technical writers and SMEs at TCS and we expect many more companies in India to take this leap forward.”

Hear more from our satisfied customers.