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Write it Up – Lessons from My Days as a Paramedic

Being a paramedic during the formative years of my working life, I’ve been surprised at how many of the lessons that I learned on the job have translated to the business world.

Paperwork is perhaps universally a dirty word among those who have to do it. I have many a fond memory of sitting scrunched down in the passenger seat of an ambulance, racing to the next call, with the big metal clipboard on my lap and my pen flying as I tried to get my reports done from the last few calls before I blend all the details in my memory. The trip sheets were legal sized, printed in 8-point font, and crammed from top to bottom with required fields; and don’t forget to press hard to get all 3 copies!

While the hand cramps from hours of writing weren’t my favorite, I had been trained well about the necessity of good documentation. Without cameras in our mobile phones (I had been working in EMS for four years before a mobile phone was even a consideration), the only record of what happened on a scene and in the ambulance was what we wrote down. We had to make sure that we documented everything from what we found at the scene, what the patient said, and anything else that affected our call. We had to demonstrate that we had performed a head-to-toe physical assessment on every patient, and then document the care we provided, the impact it had, and our management of the call from beginning to end. This had to be done in enough detail such that if there were a legal question years later we would be able to testify accurately.

This training has continued to serve me as my career has grown over the last few decades. While I can’t remember the last time that I touched a carbonless triplicate form, I spend a lot of time ensuring that process, policy, procedure, and perspective have been documented appropriately and effectively. I have done this for my own jobs where I have been a potential single point of failure and I wanted to ensure that the company was covered. As a consultant, I have worked with clients to review and evaluate how they do what they do, document it, and refine those processes into best practices.

Documenting process, including demonstrating strong internal controls can reduce the scope of evaluation by external audit for SOX compliance, ultimately reducing costs.[1] As processes are reviewed and documented, gaps in what should be done vs. what is actually happening start being identified. When we start closing those gaps, we can substantially alleviate risks to the business.[2] And, by engaging workers to develop documentation of not just what is, but what should be the way work is done, best practices can be developed that are specific to a business while institutional knowledge is preserved.[3] This documentation of the mandatory, the recommended, and the discretionary createa a robust array of information about how and why different things are done, and what flexibility each individual has within the organization.[4]

My shift in understanding about the need for documentation from protection to proactive opportunity-finding has been an important maturation as I’ve learned about business. While it is important to provide that layer of protection that good organizational documentation provides, leaders should also leverage their employees and engage them to use the documentation process to reinforce a culture of improvement.

[1] https://hbr.org/2006/04/the-unexpected-benefits-of-sarbanes-oxley

[2] ibid

[3] https://hbr.org/2013/05/define-your-organizations-habi

[4] ibid

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