Up-to-date documented procedures and clinical protocols underpin effective clinical governance, but for many radiology services, the systems for creating, maintaining and disseminating these documents, (often numbering well over one hundred) leave much to be desired.

The problem has long been recognized. Protocols and procedures are often developed by different staff and stored on different PCs, with no formal processes in place to ensure systematic review of their contents. The result is duplication and confusion as to whether documents are at draft stage, have been superseded or are the latest approved versions. The original document is often lost, necessitating a rewrite and increasing the risk of key points being missed or inappropriate changes being made. The problem gets further compounded as staff leave the service.

The first stage of solving this problem is to agree a strategy for creating a central library of procedures and protocols using the integrated document management system in CIRIS. All of the documents produced around the department can be gathered from individual PCs, uploaded into CIRIS and then linked with the standard list of processes. When assessments are done for a set of process indicators, the person responsible will assign ownership of the associated documents to individuals and ensure that the work of de-duplication and document review takes place. The benefit of this is that the work of cleaning up what documents already exists is spread across the staff in the service. The work of reviewing and updating can be made part of the systematic review of good practice across the whole service.

It is easy to underestimate the work required to create and maintain an effective document management system. Patient and staffing pressures make the delivery of the service difficult enough without having to find the time to design a document management system. There are also some very real practical issues to deal with like getting IT departments to maintain systems, making the systems work across different sites and the storage space required on servers. The document management system in CIRIS is a managed service which means you do not have be concerned with these problems. With no software to install or update, CIRIS has been designed to be used by anyone with a basic level of computing skill (if you can use a web browser, you can use CIRIS). This ensures that documentation is readily available to staff from any PC with access to the Web including PC's on different sites and at home!