Written procedures with their step-by-step breakdown are a fundamental tool for ensuring quality through consistent execution of the work. As a standardized guideline for tasks, procedures serve many additional purposes: basis of training, ensuring regulatory requirements are met, ensuring documentation is prepared and handled correctly.
As written prescriptions of how work is to be performed, they can be based on abstract and often decontextualized expectations of work. The writers of the procedures are translating Work-as-Imagined. As a result, it is easy to write from a perspective of ideal and stable conditions for work and end up ignoring the nuances introduced by the users of procedures and the work environment.
The day-to-day activities where the procedures are implemented is Work-as-Done. Work-is-Done is filled with all the factors that influence the way tasks are carried out – spatial and physical conditions; human factors such as attention, memory, and fatigue; knowledge and skills.
Ensuring that our procedures translate from the abstraction of Work-as-Imagined to the realities of Work-as-Done as closely as possible is why we should engage in step-by-step real-world challenge as part of procedure review.
Steven Shorrock calls this procedural level “Work-as-Prescribed.”
Work-as-Prescribed gives us the structure to take a more dynamic view of workers, the documents they follow, and the procedural and organizational systems in which they work. Deviations from Work-as-Prescribed point-of-view are not exclusively negative and are an ability to close the gap. This is a reason to closely monitor causes such as “inadequate procedure” and “failure to follow procedure” – they are indicators of a drift between Work-as-Prescribed and Work-as-Done. Management review will often highlight a disharmony with Work-As-Imagined.
The place where actions are performed in real-world operations is called, in safety thinking, the sharp-end. The blunt-end is management and those who imagine work, such as engineers, removed from doing the work.
Our goal is to shrink the gap between Work-as-Imagined and Work-as-Done through refining the best possible Work-as-Prescribed and reduce the differences between the sharp and the blunt ends. This is why we stress leadership behaviors like Gemba walks and ensure a good document change process that strives to give those who use procedure a greater voice and agency.

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