Understanding Work-as-Imagined and Work-as-Done in Biomedical Laboratories.

Abstract

Introduction: Gaps between work-as-imagined (WAI) and work-as-done (WAD) have not been studied in biomedical laboratories. WAI takes the form of standard operating procedures (SOPs), and WAD is the way in which work is really done. The workers are often unable to follow the written procedures exactly. They will realise that they have degrees of freedom to perform tasks, and as they get more experienced, they will have more choices based on practice and know-how.

Methods: Fifteen workers were interviewed to explore gaps between WAI and WAD. Participants were also asked how they assessed if the deviations they made were able to ensure safety and productivity and the best way to learn safe work in the laboratory.

Results: Participants did not always follow the SOPs exactly, which resulted in gaps between WAI and WAD. All participants did a "on the spot" mental risk assessment and deviated from SOP based on that. They were able to discern the high-risk steps that they strictly followed. The most common reason for the gaps were work pressure and time constraint, especially in time-sensitive procedures with precious samples and reagents.

Conclusion: Concepts like WAI and WAD and the inevitable gaps between them are new in the biomedical laboratories. Such gaps need to be identified, assessed, and addressed to ensure safe work. Organizations need to make safety SOPs relevant and ensure that the workers are consulted when developing SOPs. Some local variability is inevitable, and these skills can be strengthened by open communication and interactive safety training methods.