A Guide to Rule Them All

The Situation

The IMSS writing and editing team was responsible for producing annual Clinical Practice Guidelines targeted at medical specialists. These comprehensive resources contained essential information for the diagnosis and treatment of specific medical conditions and served as reference materials for practicing physicians in public healthcare.

The editorial workflow was inefficient, typically requiring approximately five rounds of revisions before final approval. This lengthy process created delays in publication timelines.

The Problem

The editorial team consisted of five editors, each operating with their own distinct editorial styles and criteria. This lack of standardization created several significant problems:

1. Inconsistent terminology and spelling: Medical terminology and general language usage varied across documents based on which editor had worked on the section.
2. Ad hoc style decisions: When questions about preferred terminology arose, editors would verbally consult with available colleagues in the office, leading to informal and undocumented style decisions.
3. Format inconsistencies: Heading hierarchies, subheading treatments, and text formatting (bold, italics) changed depending on which editor handled the section.
4. List presentation variations: There was no standardized approach for when to use bulleted versus numbered lists or how to format them.
5. Multiple late-stage corrections: Stylistic inconsistencies were often only addressed in final revision rounds, creating inefficiencies and extending timelines.

My Solution

After reviewing the most common errors and corrections among editors, I created a comprehensive style guide specifically tailored to the Clinical Practice Guidelines. This resource unified editorial standards across all publications and established clear rules for:

• Standardized medical terminology: Consistent spelling and usage of frequently appearing medical terms
• Heading and subheading hierarchy: Clear guidelines for formatting and styling each heading level
• Text emphasis conventions: Specific criteria for when to apply bold, italic, or other text treatments
• List formatting standards: Clear direction on when to use bulleted versus numbered lists and how to format them
• Punctuation guidelines: Standardized approach to punctuation throughout all publications
• Voice and tone recommendations: Guidance on maintaining consistent voice and formality level

Most importantly, the style guide was implemented during the manuscript phase of editing, allowing for early standardization rather than last-minute corrections.

Results

The implementation of the comprehensive style guide delivered several measurable benefits:

1. Reduced revision cycles: The number of revision rounds decreased from five to three on average.
2. Earlier standardization: Style consistency issues were addressed in initial editing phases rather than last-minute revisions.
3. Improved editorial efficiency: Editors could reference the guide instead of consulting colleagues for style decisions.
4. Enhanced document consistency: Final publications maintained consistent styling across all sections regardless of which editor had worked on them.
5. Foundation for broader standardization: The style guide became the foundation for standardizing all content produced by the department.

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A seemingly simple document (a style guide) can significantly streamline complex editorial workflows, reduce production cycles, and improve content quality in specialized publishing environments.