cassinc has nailed it! Start with a high level perusal of the CAP checklist, make notes the first time around. The next time around reference all of your procedures, if you want to get really fancy put it all on a spreasheet. If there is something missing either add it to an existing policy or procedure or create a new one and educate your staff. When you get word of when they are coming get organized. Have everything at your fingertips, manuals, QC records, etc. If your hospital is part of a group, reach out to the other BB sups. Figure out who your "stellar performers" are and get them engaged in the CAP process. This will make them less nervous the day of the inspection. When CAP comes and they are asking you questions, answer the question, be brief, don't ramble on, you might hang yourself. If you give them an answer they "don't like", ask them how they do it in their lab. Chances are good that you are doing what the reg says, it's just not in a format that is familiar to the inspector. If you get someone who is just "out to get you" be as nice as you can, take the deficiency and remember you can always contest it after the inspection if you truly feel you have fufilled the reg. It sounds like you have a lot going on. Remember, you can't/shouldn't do everything. Get your staff to help and when you leave work, don't answer e-mails, do work at home, or whatever. It's a straight path to burn out and with your abilities and skills you want to be an asset to the lab and not become a liabitliy. GOOD LUCK, keep posting!