Abstract
Introduction: The Integrated Care Programme for Chronic Disease (ICPCD) and Sláintecare recommendations (2018) describe a process of transformation in the healthcare system in Ireland. Specialised integrated services are being initiated in community network areas nationally. The Sláintecare vision is one of equal health service for all, providing “The Right Care, in the Right Place, at the Right Time”.
This poster represents a service improvement initiative within the respiratory nurse-led integrated care service.
It aim is to explore the benefits of digital dictation of letters as a method of freeing up time for the Clinical Nurse Specialist (CNSp) to see more patients.
Why is it important: Currently, there is no patient information system that links the hospital, GP and Integrated Care Services. Thus the process of communication information is very time consuming. The CNSp communicates patient outcomes by typing up letters, as soon as possible after clinic appointment, which are sent to GP’s or hospital consultants. There are however, barriers to typing up letters which slow down this process. The Nursing and Midwifery Bord of Ireland (NMBI) recommend documentation is recorded as soon as possible after seeing a patient to ensure accuracy of data collected.
Aims and Objectives:
To demonstrate the need for a digital dictation service for CNSp.
To highlight the barriers involved in typing up letters.
To compare T-Pro digital dictation with letter typing process.
Assess cost benefit.
To highlight how this service fits in to the vision of Sláintecare.
Methods:
A literature search was conducted using medline, cinahl, up to date.
Review process of letter formation versus dictation.
Calculate proposed time saving using dictation service.
Cost benefit analysis.
Survey monkey sent to CNSp colleagues integrated care service.
Business case drafted for approval.
Results:
Barriers to letter formation where reported as speed of typing ,room booking, lack of integrated system, inability to type up a letter immediately after seeing a patient.
The process of typing a letter would be quicker using a dictation service.
The average time taken to type up a letter as per monkeysurvey results varied but on average was 32.5 minutes. The proposed time to dictate a letter was 15minutes.
Cost effectiveness could be achieved also in terms of administration staff typing letters and possibility for the CNSp to see more patients.
The literature supports the use of digital dictation, saying it enhanced nursing practice, saved time, increased accuracy and job satisfaction, prevented margins for error, nurses spending less time on indirect care.
Conclusion:
The results demonstrate that a digital dictation service could save the CNSp time to see more patients.
Patient letters could be recorded as soon as possible after seeing patients in various locations.
The research showed that dictation services could be used to enhance nursing practice.
The Business case was approved and T-pro has now been introduced on a trial basis in the CHO9 Integrated care CNS'S/ANP's.
The utilisation of technology is essential to ensure the mission of Sláintecare is achievable. Right Care, right place, right time, Right technology.