Increased administrative efficiency

The Coventry and Warwickshire Partnership NHS Trust was formed in 2006 and provides a wide range of mental health and learning disability services for people across Coventry and Warwickshire, as well as providing community services for people in Coventry since April 2011. The Trust provides inpatient, community and day clinics, as well as specialist services, to a population of about 1 million people from more than 100 locations across the region, including five hospital sites and 70 community locations. 

As a geographically diverse organisation, in 2015, the Trust recognised an opportunity to increase its administrative efficiency by creating a centralised operation that would enable a virtual team to work seamlessly across sites. It embarked upon a restructuring and re-banding of its secretarial services and in parallel sought to upgrade its analogue dictation system to a digital solution that would support a more agile and mobile workflow. 

As Dr. Bescoby-Chambers, Consultant Psychiatrist with Coventry and Warwickshire Partnership NHS Trust, explains:

Our overall aim was to improve the accuracy and timeliness of clinical correspondence, whilst also having a better distribution of skills amongst the wider administrative team. As a predominantly mental health trust, the majority of our clinics are in the field. We were struggling with the reliability of our previous system; dictaphones would break down and tapes would invariably go missing which would lead to duplication, not to mention delays in getting letters out to patients’ GPs.

Amanda Gill, Support Services Lead for the Trust, adds: “From an administrative perspective, there was the hope that creating a centralised model supported by appropriate technology would give us greater visibility of workload and enable us to cross cover when needed. Having a pool of shared resource would also mean that we would have the right person doing the right job at the right time, so make better use of the skills within the team.” 

Improved Workflows

Following a review of the available market solutions, the Trust selected BigHand’s Digital Dictation, Speech Recognition, and Mobility software along with its healthcare-specific workflow platform, BigHand Correspond.

“What appealed to us about BigHand was its capability,” says Dr. Bescoby-Chambers. “From the outset, the speech recognition has proven to be more accurate than previous software my colleagues and I had tried, and it has learned as user adoption has increased, to the point where it can now compensate for how different clinicians might speak and the language we use.”

Not only has this increased accuracy and improved the turnaround time of clinical correspondence, the BigHand platform has also provided clinicians with the ability to prioritise tasks. “Whereas previously, an analogue dictation would sit on a tape along with other dictations – and secretarial teams might receive multiple tapes at the same time – unless you said something was urgent, it would simply sit in the queue,” Dr. Bescoby-Chambers explains.

Now, as soon as I have completed an urgent or priority dictation, I can send it over with a target date on the voice file and I know that it will be dealt with by the team.

Similarly, administrative staff have benefitted from the BigHand platform. As Amanda Gill says, there is far greater visibility of workload and a newfound agility within the team. “What we have really gained is the ability to cross cover,” she comments. “If a particular team is struggling with a high volume of dictations or has staff shortages, we can pick up the dictations anywhere. This has been a real asset. 

“Another benefit of the digital dictation is that we can see how long a voice file is. It has allowed us to make the most of the 30 minutes at the end of the day, for example, so we’ve increased productivity on multiple fronts.”

She adds: “The final main benefit has been around right-skilling the team. We can make sure that our band 4 medical secretaries are able to deal with the higher-level aspects of their role in supporting the consultant and team, while band 3 admin support are responsible for the audio and typing, and our band 2 staff manage the printing and sending out of the correspondence and uploading it to our patient system. The whole system means that we have been able to create efficiencies within the team, which ultimately have a positive impact on the consistency of patient experience and care.” 

Ensuring Adoption

Implementing both the new technology platform and ensuring the success of the restructured, centralised model required a significant effort, and indeed one that is still in progress, however, BigHand’s implementation team was able to support Trust staff through the process.

Amanda Gill explains: “Both clinical and administrative staff had to learn that there were certain things within the dictation that they needed to do to get the most out of the system. From using particular shortcut keys to help ensure the right letter format, to training the speech recognition software, BigHand staff attended our monthly best practice workshops to make sure we were really optimising how the system could work for us.

“It did take a little while, but the feedback now is that staff would never want to go back to analogue,” she concludes.

Similarly, Dr. Bescoby-Chambers is enthused. “To put things into context, last Friday I dictated my week’s letters – 26 of them. It took me less than two hours, and two working days later they have already been processed and are back with me to validate and sign. On average, clinical correspondence is now turned around within 10 days, whereas prior to BigHand we would be looking at a timescale closer to a month.

“The sooner you can get correspondence to a patient’s GP, the better this works for the whole local healthcare system – and of course for the patient. In this regard, BigHand has helped us make significant improvements for the people of Coventry and Warwickshire.”