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Veterinarian Technician March 2013 (Vol 34, No 3)

Clinical Pathology Close-up: Developing a Standard Operating Procedures Manual

by Margi Sirois, EdD, MS, RVT

    While there may be multiple correct ways to perform a laboratory procedure, consistency in method of performance is vital to achieving accurate, reproducible results. Therefore, all personnel in a practice who perform laboratory procedures should use the same method each time. An excellent way to ensure this is to develop standard operating procedures (SOPs) for each task.

    Box 1. Minimum Components of a Standard Operating Procedures Manual

    • Title—the name of the procedure
    • Purpose—the reason for the procedure
    • List of the required supplies and equipment
    • Detailed steps for performing the procedure
    • Implementation and review dates for the procedure

    SOPs are step-by-step procedures for performing specific tasks. While some tasks may seem less vulnerable to variation in how they can be performed, the potential still exists for variations to affect laboratory results. For example, while the procedure for running a blood sample through a clinical chemistry analyzer does not vary, differences in how samples are collected and prepared can affect the results. In addition, well-written SOPs can simplify training of new personnel and might provide some legal protection for practices if a staff member is injured while not following an SOP. An SOP should include all the information on why a procedure is performed, who performs it, and how it is performed. The specific components of an SOP can vary but should at least include the name of the procedure, its purpose, the steps for performing it, a list of the required supplies and equipment, and the dates that the SOP was written and reviewed (BOX 1).

    Preparing an SOP for a specific procedure starts with getting input from anyone who performs the procedure. If a piece of equipment must be prepared for a procedure, a separate SOP would likely be needed for the preparatory steps. SOPs that have more than 10 to 12 steps should be broken into smaller SOPs, if possible. Prepare a draft of the SOP by describing, in detail, each step of the procedure in the order in which it should be performed. Include critical timing sequences and safety warnings. Have several employees use the draft of the SOP to perform the procedure to ensure that no steps have been missed and that the SOP is sufficiently detailed.

    An SOP can be formatted in multiple ways, including simple lists, graphical presentations, and flowcharts. Determine which method works best for each procedure. Complex procedures may be best presented in a graphical format, using pictures to illustrate each step. Once an SOP has been prepared, test it for accuracy. It may help to send the SOP to someone who performs the same procedure in a different practice. Refine the SOP based on feedback from internal and external reviewers. Then implement the SOP by training all personnel to use it, ensuring that each individual follows the SOP exactly.

    Box 2. Steps for Creating a Standard Operating Procedure

    1. Observe the procedure being performed.
    2. Write a draft of the required steps.
    3. Determine the format for presenting the SOP.
    4. Obtain external and internal reviews of the SOP.
    5. Revise the SOP based on reviewer comments.
    6. Train the staff.
    7. Audit the SOP.

    SOPs must be regularly reviewed and updated. Audit an SOP by periodically observing personnel as they perform the procedure. A new SOP should be reviewed within a few months and then at least annually. Incorporate the review date within the document. BOX 2 summarizes the basic steps for preparing an SOP.

    All of your SOPs should be contained in a manual that is organized to allow easy retrieval of the information. A three-ring binder works well and should contain a table of contents. SOPs can be sorted into tabbed sections according to the type of procedure (FIGURE 1).

    The process of writing SOPs can help improve how procedures are performed and can be used for staff development in combination with SOP training and employee performance reviews. An SOP manual can be used as a component for documenting quality-assurance systems. The article “Quality Documentation Challenges for Veterinary Clinical Pathology Laboratories” reviews documentation requirements and how to incorporate SOPs into laboratory quality assurance.

    SOP manual

    Figure 1. SOPs can be sorted into tabbed sections according to the type of procedure.

    Your SOP writing does not have to stop at the laboratory door. SOP manuals can help ensure consistent performance in all areas of a practice, from nursing processes to inventory control procedures. Numerous resources provide templates and detailed instructions for developing SOPs. Many of these resources are available for free on the Internet. Click here for an article that features examples of SOPs.

    Your SOP manual can become a valuable tool for training employees and reviewing their performance. Review your SOPs regularly to ensure that they are accurate and reflect current standard practices.

    Dr. Sirois is section editor of Veterinary Technician's Clinical Pathology Close-up series.

    NEXT: Crash Carts: Preparation and Maintenance

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