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What are Standard Operating Procedures in healthcare?

Every field has its own set of detailed instructions which can ensure the quality of functioning. The medical field is no exception. To ensure the most appropriate and quality care for the patients in both outpatient and inpatient settings, hospitals, doctors and each of the departments follow a set of instructions called Standard Operating Procedures (SOPs). According to the National Health System Resource Centre, India the definition of Standard Operating Procedure is –

“In Healthcare, SOP is defined as a written set of instructions that a healthcare worker should follow to complete a job safely, with no adverse effect on personal health or environment and in a manner that maximizes the probability of a beneficial health outcome in an efficient manner. In simple terms, an SOP is…a written process.”

There is an SOP for all kinds of situations and emergencies present in a hospital. Physicians in an emergency room have a specific SOP for patients who come in unconscious. Laboratory Technicians have SOPs on how to handle, test and discard different bodily fluids. There are even protocols on how to discard these fluids. There is even an SOP associated with the questions to be asked when a patient comes in for a consultation. 

The Origin of the term SOPs is not clearly known. According to the Encyclopedia Britannica, the term came into existence in the mid-20th century and was already in use during the various military operations during World War II. As of today, there are SOPs available in all kinds of fields from military to business to manufacturing processes to medical practices. Not only are the SOPs different for different fields, they are also different for different aspects within the fields. The International Conference on Harmonisation in 1990 outlined the necessary SOPs for clinical practice so as to refine and streamline the regulatory requirements for various medical products. 

The SOPs are formulated mostly by the ethics committee as they decide the working of clinical trials. Clinical trials involve animal subjects and human volunteers for various products. SOPs for clinical trials involve screening the patients for any previous diseases, taking their consent, assessing the effect of the product and treating the patients during the course of the trial. A necessity has come for SOPs to be validated and enforced in routine clinical practice for every patient. 

When a patient goes to consult a doctor, the doctors ask a specific set of questions to understand and determine the cause of infection or disorder. These questions usually include the most recent occurrence of the infection, if there was any history of the disorder in the family, in some cases the kind of lifestyle and work the patient is doing, what the patient recently ate if it is food poisoning, the date of the previous menstrual infection if the patient is at a gynaecologist etc. If SOPs are in place, information regarding these answers provided by the patient will not be overlooked and ensure proper medical care

SOPs are different from guidelines in the sense that they are more rigid and detailed. SOPs help to interconnect clinical practice guidelines and the necessities at the point of care. They also ensure that the results and conclusions obtained from randomised clinical trials get incorporated into clinical practice within a short span of time. SOPs concerning outpatient consultations can inform the patient and their families about the nature of the treatment starting from diagnosis, treatment duration, possible adverse effects etc. These SOPs can be constructed during the time of consultation. 

SOPs are essential to recognise several instances such as –

  1. Possible adverse outcomes for a patient suffering from a mood disorder 
  2. Risk of unwanted side effects with medication (e.g. a family history of diabetes mellitus in a patient advised olanzapine), 
  3. Comorbid medical disorders (e.g. acid-peptic disease in a patient advised fluoxetine), 
  4. Drug interactions 
  5. The need for medical procedures like ultrasonography 
  6. Analyse the thyroid functioning in people with mental health issues
  7. Physical and metabolic assessment while providing drugs that are capable of causing side effects 
  8. For special therapies like using electroconvulsive therapy and the emergency situations that may arise due to this event

SOPs also have other advantages such as reducing miscommunication, ensuring regulatory compliance, minimizing possibilities of malpractice, improving continued medical education, and integrating quality control. The SOPs must be routinely checked and modified to stay up to date with recurring diseases and research to further improve medical care. 

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