Argyll and Clyde NHS covers an area of almost 3000 square miles, serving a population of just under half a million residents. It is a region of contrasts, comprising rural and urban areas, mainland and island locations and has areas of affluence and areas of considerable deprivation.
Historically the Department of Pathology and Cytopathology was housed at three of the larger hospitals in the region, including the Vale of Leven Hospital, Inverclyde Royal Hospital and the Royal Alexandra Hospital. Each covered its third of the region and was home to five or six pathology consultants, lab staff and administrators. But an increasing shortage of consultants led to a complete reorganisation of the service in early 2004 and required new technologies to streamline the operation.
“Recruiting pathology consultants has become more difficult over the past few years and we found we were reaching crisis point, unable to maintain a full compliment across the region,” commented Dr Charles Sutherland of Argyll and Clyde NHS. “We decided we would have to reorganise the department to make better use of our consultants, and that meant centralising.”
“We also realised that the admin staff would be best left in situ – they could better serve their hospitals if they remained in the building, and we also wished to avoid relocating more staff than necessary,” added Dr Sutherland.
The Pathology service completes over 20,000 reports annually. Specimens are collected in the field and transported to the laboratory where they are prepared by technicians. Each is then examined by a consultant. Prior to the centralisation, the consultants would dictate their analysis onto a cassette tape for typing by a local administrator.
The old system had its drawbacks, primarily borne out of the necessity to handle the tapes. A consultant may wish to have urgent reports prepared quickly, yet find they have a tape with a mix of jobs; admin staff were not always immediately available or may have a heavy workload from day to day; the tapes were prone to breakage if over-used; and administration of the tape system was cumbersome.
Centralisation of the consultants added another major headache – how to allocate jobs between administrators in three hospitals, and how to get the recordings around the country?
“We were aware of digital dictation technology and its benefits,” commented Dr Sutherland. “We knew that it would probably solve all our problems, so we asked local specialist, Voice Technologies, to recommend us a solution.” The company proposed Winscribe, a long-time developer of digital dictation and leader in its field.
After a successful evaluation, the department decided to go ahead with a full system as quickly as possible. Voice Technologies worked with Dr Sutherland and his team to configure the WinScribe system to work with the department – job types were created, the administrators and consultants were registered, and a workflow model set up to handle the reports as they were created.
With the system up and running, jobs are now handled efficiently and quickly. The consultant types the case number into a PC and uses a handheld microphone to dictate the report directly into WinScribe. As soon as the recording is complete the job is queued on the server, with the appropriate priority.
Administrators, meanwhile, can log into WinScribe from wherever they are working, and retrieve jobs for transcription according to the prioritised list. When they open a job the appropriate report template is brought up on screen, and once complete the document is automatically routed back for approval. The workload can be balanced between the admin teams and adjusted to accommodate holidays and sickness, and priority or confidential work is put in front of the right person at the right time.
“Voice Technologies has delivered exactly what they said they would,” said Dr Sutherland. “The WinScribe system is intuitive and easy. After a simple introduction to the technology both the administrators and the consultants have taken to it quickly. We are in a position to handle all our workload same day, and with fewer consultants than before.”
“Centralising the consultants has averted a crisis, and digital dictation is the technology that enabled us to continue working under the new arrangement,” concluded Dr Sutherland.