09.04.11
Clarity of information
In the pursuit of hitting its targets, Trafford Healthcare NHS Trust has rolled out a digital dictation system to improve the Trust’s overall efficiency reports Richard Mackillican
Members of the IM&T team at Trafford Healthcare NHS Trust are constantly looking for ways to increase the efficiency of its services.
“Our remit is to provide technological solutions in order to bring about greater efficiencies of the administration and patient pathways within the Trust,” explained Stephen Parsons, IM&T project manager at the Trust. “By finding these efficiencies we are also helping towards hitting our government targets for things such as cancer treatment waiting times.
“With this in mind, one of our main challenges was around the dictation of documents. At the Trust we have around 200 staff who dictate patient information after episodes of care, with around 55 medical secretaries to transcribe that information. This meant that we saw a large amount of work being generated and as a result of using the old analogue system – which had been in place for about twenty years – we were experiencing delays in the process.”
These delays can be a common experience for Trusts who use analogue tapes, the reason being that the tapes required transportation, which in itself can be time consuming and costly. At Trafford this meant that the tapes then wouldn’t be ready for transcription until the following day, which meant that there was a very wide scope for efficiencies to be made in that area.
The team also identified a problem in the ability of consultants to mark their notes as being urgent whilst using the analogue system.
“The only way that a clinician could do this was by saying the word ‘urgent’ at the beginning of their recording,” said Stephen. “Given that there was no way to effectively prioritise urgent letters, we realised that we had a problem.
“So we looked out into the market place to see what was going on and then after going through a procurement process, we acquired a digital dictation system and it has generated results quite quickly, which can only get better.”
The Trust has reported other benefits from using the digital system; these include better clarity of the dictations and the fact that letters are ready to be dictated as soon as they are authored, instead of the tapes having to go through the usual laborious process of being transported from the clinicians to the secretaries.
Clinicians have been encouraged to dictate their letters in clinic to ensure the full benefits of immediacy in the digital dictation process are realised.
“There is no more waiting until the end of the day. Much like an email the recording will be sent to the secretary’s inbox and is ready for transcription immediately. That information is then typed up into an electronic patient records system,” said Stephen.
The Trust is working towards a target of a 48 hour turnaround for letters to be transcribed.
“We have got a process which used to take around two to three weeks down to around five days now, meaning that we have already halved the time it takes,” explained Margaret Irving, admin and clerical manager at the Trust.
One issue which is very sensitive in the health service is of course job losses, with much suspicion being directed at new technology; however it is not the case at Trafford.
“We have not had any job losses as a result of this system,” added Margaret. “There is now a fairer distribution of workload.”
Digital dictation technology has enabled the Trust to grow its medical secretary roles, meaning that they now manage both patient and consultant diaries, along with dealing with direct enquiries from patients and their families.
“It has allowed people to grow their role to cover more office management, taking on the role of personal assistant,” said Margaret. “Our personal assistants are using the time previously taken up by typing letters to carry out administrative duties.”
This flexibility is a big bonus for any Trust who makes use of digital dictation.
“Hospitals are always changing and so we need to be able to adapt what we are doing to meet the challenges that we face. This system allows us to do that by improving efficiencies,” said Stephen.
So would Stephen recommend that others procure a digital dictation system at their Trust?
“Definitely,” he answered. “NHS North West have recognised it now as being a key IT solution. It works well and generates huge efficiencies, both for patients and staff.”
Obviously these systems cost money, but given the huge amount of success and the efficiencies being enjoyed by the Trusts who do use them, it is hard to reject them on financial grounds, given the long term benefits which they offer.
The experience of Trafford Healthcare NHS Trust has also shown that far from being a harbinger of unemployment for Trust administrative staff, it can enhance their careers and enable managers to distribute work more evenly.
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