TalkingpointS Pivotal Role In NHS Innovation Challenge Award For Derriford Hospit al Derriford Hospitals Pathology Department, part

of the Plymouth Hospital Trust, ha s received national acknowledgement of its quest to achieve earlier cancer diagn osis, in the form of the NHS Innovation Challenge Prize. Standon, Staffordshire, September 12, 2012 -- Following an extensive overhaul of its working practices, the introduction of lean principles and investment in ke y technology, the Derriford Pathology Department has been awarded a 50,000 award to mark its significant improvement in the turnaround time for cancer results. P reviously a department that was struggling to meet the national RCPath turnaroun d times (TAT) standards, the new ways of working have transformed results, raisi ng the output to on or above the required standards for 7 and 10 days TAT and re duced the backlog of unreported cases from more than 500 to zero. Commenting on the success, Dr Dean Harmse, Head of Department Cellular Pathology at Derriford Hospital said: Previous strategies had concentrated on looking at c apacity issues and significantly staffing but in todays climate we realised we ne eded to do more with less. As a result, we looked at our ways of working, specif ically in the laboratory, and went about changing the work flow and streamlining the reporting process to significantly reduce time and delays and improve our T ATs. In the laboratory, the Pathology team set about re-structuring the work load and streamlining cases into red, yellow and green streams, (with red being most tec hnically demanding and green the least). Each stream is managed on a daily basis to ensure standards and targets were met. This allowed a first in first out appro ach to be taken. As well as this change however was the streamlining of the reporting process, an d the role both a digital template and voice recognition, in the form of Talking Point, had to play in the ability to cut reporting times. On the back off the la boratory streaming process was the introduction and creation by the Derriford Pa thology team of a digital template so that specimens could be digitally describe d macroscopically at the dissection stage and the description can be directly em bedded in the electronic database. This process eliminated the need for secretar ial transcribing of the macroscopic report. Once the case comes to the pathologi st for reporting, the pathologist can add the microscopic examination and the wh ole case is SNOMED coded and authorised live and immediately with no delays. Furthermore, the adoption of TalkingPoint, the selected voice recognition system , played a pivotal role in allowing pathologists to report in real time and offe ring a level of immediacy in authorisation that traditional forms of reporting c annot replicate. The implementation of TalkingPoint transformed the reporting process and allowed for quicker turnaround times by simply removing the time delays involved in the traditional process of dictating, typing, returning and authorisation. With Tal kingPoint the pathologist can report, SNOMED code and authorise a case in real t ime. Simply put a case is reported, coded and authorised by the pathologist with out the need for any secretarial input. Commenting on the advancements voice rec ognition has brought to the process, Dr Dean Harmse said: Previously reports were dictated by the pathologist in batches onto a tape. Once a batch of reports was complete it would be passed onto the secretary for typing and coding. The reque st forms would then be returned to the pathologist to check the report on the el ectronic database and then authorize. At any one of these stages, delays natural ly occur, be that hours or days, due to working hours, lunch breaks and holidays . As a result, the immediacy and therefore time saving capabilities of a voice r ecognition system became the obvious choice in our crusade to improve and reduce

TATs. In addition to helping improve TATs, TalkingPoint has also helped influence a ch ange in working practices in the department, as secretarial roles were redefined . Secretaries at Derriford Pathology Department are now less relied upon to type reports and instead can support pathologists in administrative duties, includin g diary management and meeting preparation, and in turn free up pathologists time to concentrate on core work. Furthermore, pathologists are also experiencing th e ability to work independently from their secretaries and can plan their workin g day according to their own patterns and demands. The department was also able to give up a secretarial post via natural wastage and help the Trust with its co st improvement strategy. A key advantage is that TalkingPoint enables the pathologists to SNOMED code cas es directly with speech recognition. This has dramatically improved the accuracy of SNOMED coding as there is no risk of secretarial transcription errors during the coding process. TalkingPoint also has a failsafe mechanism that alerts the pathologist if SNOMED codes are not entered. Continuing to discuss the important role voice recognition has had in the proces s, Dr Dean Harmse adds: Once any department has voice recognition working, it is self-propagating. When pathologists see the ability of the system it becomes a n o brainer to adopt it. It is invaluable and I would go as far as to say that I p ersonally would never take a post in any laboratory that does not have speech re cognition or a real commitment to implement it. However he adds a note of caution that voice recognition must always be carefull y integrated and never undertaken piecemeal. Voice recognition is a piece of tech nology all healthcare environments should benefit from, but it does require chan ging ways of working for a number of staff, and therefore can be met with resist ance Dr Harmse continues. To mitigate this, ensure you choose the right system. Do nt do it in steps by putting digital dictation in first and trying to convert. Ensu re it works on a small scale first before rolling out and make sure training and in-house support is implemented and available continuously. We worked very clos ely with TalkingPoint who prior to implementation, advised us how to upgrade our hardware and looked at our systems and databases prior to installation to enabl e a seamless integration. Individual scripts were created and the fact that Talk ingPoint integrates the voice recognition process with the medical database has allowed us to work on one system. This was a crucial point for us as pathologist s, as hands free working, without the need for manual keyboard work between data bases, ensures we can focus on the specimen or case and definitely helps with re porting productivity. Introducing the specimen streaming process and other lean principles transformed the working practices of Derrifords Pathology Department and as a direct result, enabled them to vastly improve their turnaround times. The 3 day TAT there went from a baseline of 15% to meeting the national standard of 50%. The 7 and 10 da y TAT improved from 38% and 48% respectively to just under 90%, exceeding the RC Path standard of 80% for both. They removed their backlog entirely, reduced thei r turnaround times of more than 10 weeks for some cases to an average of 4 days for all cases and dramatically improved the patient care by reducing the delays in the diagnosis of disease including cancer. Summing up Dr Dean Harmse said: Receiving the National Innovation award was the i cing on the cake for what we had achieved. We set out to improve our TATs and of fer a better service to clinicians and ultimately the patient. As a team, at eve ry level, we completely changed the way we work to benefit our patients. The tra nsformation has been highly rewarding. The prize money of 50,000.00 will be used for further improvement in the department, particularly to expand the role of Bi omedical Scientists in cut-up.

For further information on the Derriford Pathologys Departments NHS Innovation Cha llenge Prize log onto http://www.challengeprizes.institute.nhs.uk/innovation-inthe-nhs/ For further information on GHG Software Developments Limited or TalkingPoint ple ase log onto www.talkingpoint.uk.com or telephone: 01908 366169. Contact: Philippa Bevan Talkingpoint Accelerate Associates Standon, Staffordshire ST21 6RB 017-8279-1199 Philippa@accelerate-associates.co.uk http://www.talkingpoint.uk.com/