Digital Dictation Project Pam Green Data Quality Manager

Digital Dictation
Project
Pam Green
Data Quality Manager
your hospitals, your health, our priority
Business Case
Improve the quality and efficiency of clinical correspondence to benefit
patient care
Digital dictation is a key enabler to support the Medical Secretary review
Standardise turnaround time for transcription across specialties, with the
aim to reduce this to 48 hours
Ensure clinical correspondence is accessible for the Clinician at each
patient contact
your hospitals, your health, our priority
Original Medical Secretary Structure
Division of Medicine
Consultant
Medical
Secretary
Division of Surgery
Division of Muskulskeletal
Consultant
Consultant
Consultant
Consultant
Consultant
Consultant
Consultant
Consultant
Medical
Secretary
Medical
Secretary
Medical
Secretary
Medical
Secretary
Medical
Secretary
Medical
Secretary
Medical
Secretary
Medical
Secretary
your hospitals, your health, our priority
New Medical Secretary Structure
Clinical Support Division
PA Co-Ordinator
Medicine
PA Co-Ordinator
Surgery
PA Co-Ordinator
Muskuloskeletal
Secretary PAs
(Each working for
multiple
Consultants)
Secretary PAs
(Each working for
multiple
Consultants)
Secretary PAs
(Each working for
multiple
Consultants)
Pool Typists
Medicine
your hospitals, your health, our priority
PA Co-Ordinator
Support
Secretaries
Pool Typists
Surgery
Pool Typists
Muskuloskeletal
Implementation - Pilot
Small pilot in
ENT - 8 months
System used in clinics,
wards, theatres
Portable and static
dictation devices
System used by
Consultants, Registrars,
Medical Secretaries
Pilot Area Review
Positive feedback from all
users
your hospitals, your health, our priority
Implementation – Roll Out
Users identified
Authors
300
Secretaries 140
Administrators 5
Hardware
Static devices
200
Portable devices 100
Foot pedals &
headsets
150
Roll
Out
Roll out by Speciality
(Jun/Jul 09)
MSK
Specialist Surgery
General Surgery
Anaesthetics
Medicine
Obs & Gynae
Paediatrics
Training
Training sessions planned over 8 weeks
• ½ hour for Authors
• 1 hour for typists
Training sessions delivered via
• Classroom sessions
• 1-1 sessions for Clinicians
• Training in outpatient clinics in the live system with
immediate Go Live support
your hospitals, your health, our priority
Title: Site/Type/Patient Name/ ID
Dictation is
typed in order of
•Priority
•Due by
•Clinic date
Letters are
typed directly
into the
Electronic
Patient Record
Lessons Learnt
What went well?
• Involvement of key stakeholders – Divisions, PA CoOrdinators and IM&T
• Flexible training
• Deadlines set to remove analogue dictaphones which
enforced training
• Train secretaries first so they encourage their
Consultants to undertake training
• Clear documentation of Operational Processes, Roles &
Responsibilities which were communicated to users prior
to implementation and enforced this during roll out
• Consistent approach to naming convention of the
dictation files
your hospitals, your health, our priority
Lessons Learnt
What didn’t go well?
• Roll out plan could not be adhered to due to
annual leave and some reluctance amongst
Clinicians – this extended the roll out by 8 weeks
• Clinicians ‘abused’ the use of high priority status
and avoided allocating dictation to the typing
pool – this was managed via system reports
• Issues with the technology – single sign on,
volume settings, user settings
your hospitals, your health, our priority
Where are we today?
•
•
•
•
No analogue tapes in use
466 Users
17,000+ dictations created per month
Transcription timescales reduced to within
1 week for the majority of specialties
your hospitals, your health, our priority
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Number of dictations
Digital Dictation Created last month
Total 17,243
2500
2000
1500
1000
500
0
Benefits
• Financial saving on secretarial resources –
temporary staff no longer required
• Ability to flex workload across site
boundaries
• Reduce turnaround timescales on
transcription across all specialties
• Single sign on
• High priority or due by dictations are
flagged and dealt with within timescales
your hospitals, your health, our priority
Benefits
• Improved quality of the audio playback
• Can contact a colleague to listen to
dictation at the point of query
• Quickly identify individual patient dictations
to respond to queries
• Reports readily available eg. to assess
secretarial performance, assess authors
allocation of priority and assess volume of
dictation created
your hospitals, your health, our priority
Next Steps
• Integration to WWL EPR
• Voice Recognition
your hospitals, your health, our priority
[email protected]
[email protected]
your hospitals, your health, our priority