Cobe/Gambro BCT Spectra Apheresis System manual
In 1999, the operator’s manual for the Cobe BCT Spectra Apheresis System was a single 628-page manual. Most of the content was written by engineers and medical professionals, which, although accurate, was often difficult for operators—nurses and technicians in hospitals and clinics—to understand and effectively use. A high volume of calls from operators needing help with the system and the procedures, sometimes while in the middle of a procedure, concerned Cobe’s Spectra team. I was asked to help the team redesign and then rewrite the manual so it was easier to use and less confusing for operators.
The original manual had been written using Information Mapping, a structured documentation method popular in engineering environments of the era. Well-intentioned and logical to its authors, it worked reasonably well for an engineer or technician at a workbench with time to methodically work through it. It was considerably less suited to a nurse or technician in a critical care unit (the Spectra was used in hospitals and clinics around the world, where English was often a second or third language) trying to complete a life-critical procedure quickly, correctly, and without confusion.
The rewrite reorganized everything into clear, numbered procedures, written with ESL users in mind, that an operator could follow confidently under pressure, even in the middle of a procedure. Labeled photographs, illustrations, and icons were used throughout, making procedures easier to follow regardless of the operator’s English proficiency. The challenge was less about technical complexity than sheer scale: making sense of over 600 pages of engineer-written content, sometimes puzzling out what the original authors had intended, and then clearly and unambiguously expressing it.
First, the manual was redesigned and reformatted. It was changed to a “landscape” layout so that it would lie nicely on the centrifuge chamber cover. The fonts, styles, and page layouts were changed to make the manual easier to read and more professional looking.
Second, the manual was divided into four manuals. Each manual contained the information necessary for a specific type of procedure:
- The Essentials, which covered the basic setup, operation, and maintenance of the Spectra system hardware and software, the theory of operation, general troubleshooting, and use of additional equipment. (Table of Contents [PDF, 172 KB])
- The Therapeutic Apheresis Guide, which covered plasma, red blood cell, and lymphoplasma exchange procedures and platelet and white blood cell depletion procedures. (Table of Contents [PDF, 100 KB])
- The Platelet Collection Guide, which covered platelet collection procedures. (Table of Contents [PDF, 78 KB])
- The Cell Therapy Guide, which covered mononuclear, polymorphonuclear, and peripheral blood stem cell collection and bone marrow processing procedures. (Table of Contents [PDF, 81 KB])
Each manual was also completely reindexed.
Third, all the text and each procedure was updated and rewritten and new procedures were written and added. Each procedure contained the information specific to that procedure, including potential alarms and troubleshooting, minimizing the chance that the operator would have to look elsewhere for any information they might need to successfully complete a procedure.
Warning: The content of these documents is not only copyrighted by COBE BCT, Gambro BCT, and CaridianBCT but is likely outdated and incorrect. These documents must not be used for operation of the Spectra Apheresis System!
Compare the Introduction from the original Spectra manual (PDF, 630 KB) with the redesigned and rewritten Introduction from the new Spectra Essentials manual (PDF, 512 KB).
Compare the Bone Marrow Processing procedure from the original Spectra manual (PDF, 105 KB) with the redesigned and rewritten Bone Marrow Processing procedure from the new Spectra Cell Therapy manual (PDF, 816 KB).
Although I did the bulk of the work on the actual manual, I had the extensive and invaluable assistance and support of Gambro BCT managers and experts Steve Valdeck, Lori Liepold, and Sarah White.
The response was immediate. Gambro brought preliminary copies of the redesigned manual to a major medical trade show—printed and bound exactly as the final version would be—to display as exhibit copies, not to distribute. Every one of them disappeared before the end of the first day. The project manager called me after the show, delighted; he took it as the most direct possible evidence of how desperately operators around the world wanted a manual they could actually use.
Of all the many wonderful projects on which I’ve worked, this remains my favorite.