|
|
#100098 - 06/11/08 11:27 PM
Tips to improve accuracy/QA and "the ear."
|
VMT
New Member
Registered: 06/11/08
Posts: 3
Loc: Lisle, IL
|
Help please!
I have had one bad day! Everything that could go wrong certainly did and since the day went so terribly, I am stewing in a funk.
Here is the deal. I need advice and tips on how to improve my accuracy/QA. I was recently hired, eight months ago, by an orthopedic group consisting of 22 physicians. I am in-house and transcribe a variety of reports. Prior to being hired, I had absolutely zero experience and fresh out of the local community college where I received my MT degree. As part of being a new hire was job training, which was about three months maximum. I trained on all 22 physicians and was approved to be on my own.
Approximately 1-1/2 months later I had my first QA and it was disaster. I received a score of 96.5% with my biggest problem being omitted words (let me clarify, not terminology). I was so upset that I wanted to quit. I felt like I had severely disappointed the transcription manager since I personally believe I was only hired because my instructor at the community college put in a word for me and said I was so good. I felt like I had let not only myself down, but my manager and trainer. The manager was very understanding and asked me to slow down my production to work on the QA. At the time, I was between 800-1200 lines per day. I also know that this is on the low side.
For two more months I was trying my best to improve my QA by relistening to the dictation. Yes, I am aware that this is a big “no-no.” My production dropped to between 800-900 lines. I had yet another QA review and the good news is that it went up to 99.3%. I was riding pretty high for a little while since my goal was not to be where I was from the last QA, but here is the problem—I am still making errors! Stupid errors at that!
I will sometimes catch myself omitting words such as “that” or mistaking “this” for “it” and vice versa. Today all of this compounded together in one big ball of S&%T! My group of doctors which I primarily type (also know as the crap group which none of the other groups want to touch because we have the worse dictators in the practice) had a rash of priorities. When we finish a report it is downloaded into chartcare/citrix and our physicians can view the report via computer. Well the system was not loading the reports, so our manager had to manually fax the priorities over to the clinics. Of course, we all printed out and handed her our reports and that is when my day went from bad to worse. Yes, I felt like I started and went through the day lobotomized. I was extremely tired today and I knew that when the day began, but I had not expected to make such mistakes.
The manager had to call me three times to let me know of the mistakes on the reports I had submitted. The first was to let me know I had a floating letter “a” in the sentence. Where I got this I have no idea! The second was a medical term, hyperextension. Throughout the bulk of the document I had hyperextension; however, in one sentence it was hypertension. Well, I know I did not type that. I probably missed the “e” or the “x” and the word autocorrected, but what was I to say? Then not paying attention to what I was doing, the doctor dictated “airstrip splint.” He always says this and we all know it is Air-Stirrup, but what do I type? Oh yes, airstrip and yes the manager caught it. So my day went all to hell. I just feel like I am giving her reports with errors on them all the time (not horrid amounts all the time in truth) and it does not seem to me that anyone else has these problems. I know that everyone makes mistakes and I have caught more than my share on other reports transcribed by my co-workers, but I just feel like I am a worthless transcriptionist. I am doing everything that I can to be accurate, but I am failing. I am relistening to the reports. I would hate to resort to rereading as well, but I do not know what else to do.
Does anyone have any tips to improve accuracy? Is there any one particular thing that I need to focus on?
Also, does anyone have any tips for “the ear?” My trainer has a fantastic ear. She has only worked professionally as a transcriptionist for three years and she can hear things that I can only catch a fraction of. She also never relistens and never rereads and I assume her QA is around 100%. Are there tips for helping decipher mumbled works, etc.?
Any help is greatly appreciated. I may actually be relocating and in search of a new job. The thing is that I am not sure I have what it takes to be hired anywhere else. I need to sharpen my skills and fast.
Thank you all for your help!
|
|
Top
|
|
|
|
|
#100104 - 06/12/08 02:29 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: VMT]
|
Stroker
New Member
Registered: 12/17/05
Posts: 16
|
I've been transcribing 35 years. I still relisten to difficult reports or new-to-me dictators to make sure everything is correct. There is no crime in relistening for accuracy.
My best advice is to take your time, focus on what you are doing and proofread. Don't rely on spellcheck. It won't pick up on grammar and syntax errors. Proofreading (or "rereading" as you say) is an absolute NECESSITY and is part of MT. Every job I've had stipulates so in the job description. Not sure why you say "resort to rereading." You may have been given some bum advice.
If you are worried about your "ear," consider getting a hearing test. Rule out a hearing deficit first. Mostly, though, I think your problem is lack of focus and trying to go too fast.
MT takes time to perfect. I had the same feelings of self doubt and insecurities. How long do you think it takes a person to become fluent in another language? Years! MT is no different.
Hope this helps.
|
|
Top
|
|
|
|
|
#100112 - 06/12/08 09:37 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Stroker]
|
DaisyDuke
Junior Member
Registered: 06/11/08
Posts: 43
|
You are fine. These are common mistakes made when you are rushing to get a higher line count. I sometimes think that they are too strict with omissions of no great consequence. Sometimes they make a bigger deal out of that than comprehension which is really more important. You are new, you are getting an excellent line count for someone new and 96.5% is not the end of the world. Just pay closer attention to every word and slow down a bit and concentrate on comprehension. It's real important to be comfortable and relax. It you are too tense, you wear yourself out and then you will not concentrate enough. It's a difficult job and the high-standards of this industry are really close to impossible to achieve 100% of the time. Give yourself some credit for doing as well as you do. Due to the competitive nature of this industry these days, you have to be your own best friend and take care of you.
|
|
Top
|
|
|
|
|
#100115 - 06/12/08 10:04 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: DaisyDuke]
|
MicheleA
Member
Registered: 02/18/05
Posts: 1007
|
I wouldn't dream of not proofreading. The longer you do these docs, the faster you will get at proofreading, especially if they repeat things. My doc has huge chunks that I can actually skip because I know I added nothing to the template in that paragraph. I've been doing him for 2-1/2 years, though.
Are you required to do absolute verbatim? If not, I don't see why substituting "this" for "it" would be a problem if it doesn't change the meaning of the sentence. Sometimes it is impossible to tell exactly what they said anyway.
Chalk it up to a bad day and move on. You have the makings of a good transcriptionist. 
|
|
Top
|
|
|
|
|
#100121 - 06/12/08 11:09 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: VMT]
|
Softail
Member
Registered: 08/30/06
Posts: 357
|
VMT, one thing I've learned is to proofread as I go. I think a lot of MTs get into the habit of just typing what they "think" they hear and then proofread the entire report after the dictation is over. You're right, this is time-consuming. Try to get into the habit of going a bit slower and proofing as you go. It's easy to type a couple sentences or even a short paragraph, then take your foot off the pedal for a couple seconds to quickly scan what you've just typed. Often dictators take short breathers in their dictations. I take that time to look back over what I've already typed to see if I can catch any errors. Doing this has saved me from making those silly little errors many times. Maybe it will help you. Good luck!
_________________________
The difference between genius and stupidity is that genius has its limits -- Albert Einstein
|
|
Top
|
|
|
|
|
#100141 - 06/12/08 02:50 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Softail]
|
VMT
New Member
Registered: 06/11/08
Posts: 3
Loc: Lisle, IL
|
Thank you all for your suggestions. I do find that my mind has a tendency to fly through the sentence and complete it before the dictator has finished speaking. I have also noticed that even though I scan my document, I will still miss things with grammer that if I print and proof, I do not.
I will slow down and take my time. I will also try proofing as I go along. It is reassuring to know that other people have similar issues.
Thank you again for your help!
|
|
Top
|
|
|
|
|
#100143 - 06/12/08 03:00 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Softail]
|
Glory1863
Member
Registered: 03/27/08
Posts: 186
Loc: Beyond Antares
|
Another thing I find helpful when proofing or editing VR is to increase the size of the screen font. Word and some other programs allow you to change the size of the screen font to over 100% of the printer font size. This does not change the printer font size or how the document will print out.
Work at a comfortable pace. The more you think about pushing to go faster, the more you will screw up, plus the stress is hard on your body. That's hard to do, I know. I seem to forget this rule every time I'm trying to finish a 25 minute report before the tornado siren goes off.
Identify patterns of failure and be particularly careful/watchful with those words, phrases or dictators.
Be careful with the codes you use for your expander. You really do not, for example, want to mix up "black male" and "bowel movement."
_________________________
The dogmas of the quiet past are inadequate to the stormy present. Abraham Lincoln
|
|
Top
|
|
|
|
|
#100310 - 06/14/08 10:32 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Glory1863]
|
elisha23
New Member
Registered: 05/27/08
Posts: 15
|
VMT, I am also a new MT. I always proof a report before I send it in. The thing is, I have not even once had a report for which I did not fix an error when I went back and relistened to the document. Sometimes it is a typo, and sometimes it requires listening to the audio to pick it up. Also of note is that I was able to go to blanks only status after 1 week on the job, and when I was on full audio, many of my reports came back with no changes needed by QA. A few things that have helped me is to speed up the dictation slightly the first time through - unless the dictator is a complete motormouth. That way if I need to slow someting down, the first relisten is not at all distorted. When I do relisten for my final proofing I speed it up to 150%, and only slow it down if a potential error catches my attention.
It doesn't sound as though you have an issue with big words, so this may not apply to you, but I NEVER guess at a word, even a little one. If I am not 100% certain, it gets a blank. I do often find, however, that after transcribing the entire document, I can go back and fill in at least half of the blanks once I have been through the entire report.
You may want to speak with your manager about this, if that is something that you feel comfortable doing. She may have some tips for you, or perhaps could give you some reassurance as far as enocuraging you to slow down and take your time. At the very least, she will know that you care about both the quality of your work as well as your production and are motivated to do well. Again, this depends on your manager.
Try to resist the tempation to compare yourself to other, more experienced MTs. Nobody comes into this profession knowing it all. Your trainer had to go through a learning curve, too. The best way for you to get to her level of expertise is to understand that you are still learning. Research terms, slow down dictations, etc., when you need to, and don't be afraid to ask for help when you need it. I guarantee that your managers/coworkers are going to be a lot more understanding of asking questions and lower production when you are new, than they would be when you have been on the job 3 years and never bothered to slow down and learn things.
Try not to be too hard on yourself. Just like you had to go to school to learn the fundamentals, this is a new phase of the learning process. Embrace your feedback - everyone makes mistakes, the important part is that you learn from them! You will get there. 
Edited to fix mistakes after proofing....
|
|
Top
|
|
|
|
|
#100393 - 06/15/08 09:49 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: elisha23]
|
Redpen
Member
Registered: 12/31/69
Posts: 914
Loc: Virtual Oklahoma!
|
I have a few suggestions. If they don't seem to fit your situation, I apologize. I'm only going by what you wrote in your post above, and you know how difficult it is to get the whole picture from one post!
The first thing I notice is that the degree of upset seems out of proportion to the crime. Sure, everyone wants to be perfect, but nobody is. Today, your manager found three errors. I'd be thrilled to make ONLY three errors! I'm sure I make lots more than that!
The second thing I notice is that you say your manager is understanding about this. I also notice you might think your trainer is perfect--you think she must have 100% accuracy. Is there a possibility that your manager is on track with HER expectations, but the trainer is subtly discouraging you?
This could happen if she presented unreasonable expectations for your work or if you, yourself, set the expectation that you had to be as good as she is right away.
Think about that and see if you can't get a better perspective on the "crime." In my opinion, the errors you describe are trivial. Yes, you don't want them there, but it happens. If you are transcribing letters of consultation, you'd definitely not want them there, but someone should have shown you how to find and eliminate them. It's not enough to just tell you to "try harder!" They need to give you some concrete method for dealing with them, and if nobody (like your trainer) has done that, then THAT is part of the problem.
I will sometimes catch myself omitting words such as “that” or mistaking “this” for “it” and vice versa.
This tells me that you may be transcribing using the "hear-a-word--type-a-word" method. That is, you listen for one word, then type it. You listen for the next word and type it. Listen for the next and type it. You might listen for a couple of words or even a short phrase, but you're still hearing-typing.
This is what it looks like: "The" type 'the'; "patient" type 'patient'; "is" type 'is'; etc.
Here is what you should be doing:
Listen to this and hold it in your mind: "The patient is a 38-year-old white female whose chief complaint today is a runny nose and sneezing. She"
Now transcribe: "The patient is a 38-year-old white female whose chief complaint today is a runny nose and sneezing."
Now listen to some more (note the overlapping "She"): "She relates that this began last week after she spent the day outdoors at the Fettucine Festival. She"
Now transcribe that sentence, up to the period. After you can do this effectively, you begin listening again while typing, right about when you type the middle of the sentence. That's another lesson, though! Right now, all you want to do is be sure you're listening to whole sentences, or at least whole phrases, instead of bits and pieces.
Why do we do this? Because nobody can catch the difference between "this" and "that" or "is" and "it." We pick up about half of what we transcribe from context alone, not from listening intently to each word.
If you are having trouble getting the "little words" right, the cause is almost always that you are not transcribing on context, but that you are listening too closely to individual words.
New students begin by hearing and typing individual words, but once they have that under control, they go on to larger chunks of text, until they are able to handle whole sentences.
There is no trick for ear training, other than to listen and transcribe a lot of dictation. It does help to look at samples of a particular doctor's dictation, remembering that your coworkers who transcribed them might not have done them correctly. If you are having trouble with the blithering insides of a physical exam, then study up on what goes in there. Do a web search until you find a medical student website that you can learn from. If you are having trouble with procedures, then find a website that talks about them. If you are having trouble with drugs, then read manufacturer literature and websites that discuss the drugs. Get appropriate references, too.
The more you know, the easier it will be to understand what you hear. No matter what you learned in school, it isn't enough!
The thing is that I am not sure I have what it takes to be hired anywhere else. I need to sharpen my skills and fast.
The first thing you need to do is assess where your skills are. The AHDI has some self-assessment modules available at a reasonable price. Try one of those. If you're successful with it, then you can confidently seek other employment. If not, then you'll know what to work on.
You might also consider taking the RMT exam. That will confirm to you and future employers that you know what you're doing.
I would also recommend that you stay with your current employer for at least one year. If you do relocate, it will be easier to get a job with a national if you have a year of experience. If you are not already transcribing to BOS standards, then that's something else that would enhance your employability.
Good luck! Remember that Rome wasn't built in a day! MTs aren't, either.
_________________________
Redpen
(The Andrews School)
|
|
Top
|
|
|
|
|
#100498 - 06/17/08 02:45 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Redpen]
|
VMT
New Member
Registered: 06/11/08
Posts: 3
Loc: Lisle, IL
|
Thank you Redpen for your helpful suggestions. You are absolutely right about typing as I listen. As fast as the dictator speaks is as fast as I type. I almost never break in typing and I can see how my mind will speed past words. I do this, yet I am still able to catch dictator errors all the time. The manager especially likes the fact that I have noticed so many errors in the dictation and reports.
I think that the other responders and you may be right about other people in the workplace having their own distinct method of typing and proofing that may work for them but on the whole is not really a method that should be suggested. I have also been told not to proof by my trainer other than as I go along. I find that unless I seem to have an ear that can hear all and a photographic memory for what I have typed, I cannot do this. I have gone to primarily proofing once I have finished the document and relistening only if it was particularly long or jumbled and this has seemed to get me to where I believe I am at 100% accuracy.
It just goes to show that each place is different, every person you will encounter at the job will have a different method and in the end you just have to try different methods and always try your best.
I thank you all again for your help!
|
|
Top
|
|
|
|
|
#100504 - 06/17/08 03:25 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: VMT]
|
Donna2
Member
Registered: 12/31/69
Posts: 6152
Loc: Sunny FL
|
One of the problems could be your foot pedal setting. At least a 3-second delay for a new ear is suggested, more if that doesn't work. I got mine down to 1 to 2 second delay eventually.
It doesn't sound like this applies to you, but the following may help others. When I first started out, I had so many blanks it wasn't even funny, and I even got a phone call about it from my boss. There were just too many, she said. After hanging up the phone (and crying for about 1/2 hour,) I sat back and analyzed it.
My problem was that I was not keeping my foot on the pedal long enough on the trouble spot to process everything that was being said. Once I realized that, my blank count improved dramatically. I tended to lift my foot too soon. Just another word or two beyond the trouble spot was all I needed. This does something very important. It allows your brain to process what was said, connecting it with a couple of other words to give a better context of what might fit
You have a high percentage, so don't worry. Also, it is very possible the other people are making errors, but your boss is doing the right thing by talking to them in private. Assume that if she is talking to you in private, that's how she's handling the other ones. Try not to put others up on a pedestal. We're all here struggling along and making errors as we go.
If you are apologizing profusely and verbally expressing how you are feeling badly, they'll just feel bad correcting you. Your better bet would be to say, "Oh, my. I need to improve that. Do you have any suggestions on how I can stop making these types of errors?" It will make her feel important and willing to help, and it will also show that you are truly wanting to improve it.
Sounds to me that you are doing fine!
_________________________
Donna
|
|
Top
|
|
|
|
|
#100509 - 06/17/08 04:04 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: VMT]
|
FarAwayDeb
Member
Registered: 03/15/02
Posts: 2772
Loc: just south of Rochester, NY
|
The more you know, the easier it will be to understand what you hear. No matter what you learned in school, it isn't enough!
I can definitely agree with this. You said you do orthopedics, so I would recommend spending as much time as you can at ortho websites and learning as much as you can. You are typing what you hear them say, but do you really UNDERSTAND what they are saying? What helps me with operative notes (my favorite) is that I usually know and understand exactly what they are doing, step by step, it's almost like I'm there watching. It's much easier to understand even a poor dictator if you really know what he's talking about.
As for those little words, you always have to watch for context, make sure it makes sense, and that it's grammatically correct. One of my biggest problems is that my fingers will drop the ending of a word or put the wrong ending "ed" instead of "ing" for example -- but in looking it over, only one of those words will be correct in the sentence.
_________________________
Good grammar ain't easy.
|
|
Top
|
|
|
|
|
#100549 - 06/17/08 06:06 PM
Re: Tips to improve accuracy/QA and "the ear."
[Re: FarAwayDeb]
|
Donna2
Member
Registered: 12/31/69
Posts: 6152
Loc: Sunny FL
|
FarAwayDeb- Oh, now that's what I should do. I'm very familiar with the flow of words and popular phrases, and I have a pretty good idea of the anatomy in orthopedics, but I can't "see" the operation. I'm relying on my experience with repetition and having knowledge of anatomy/terminology. I think the reason I never took the time is because I'm not particularly interested in transcribing surgeries, particularly orthopedics. I only learned it because I figured if I want to be well rounded, that's what I would have to do. Interestingly, I would love to physically view a surgery (not ortho), but I never particularly liked transcribing it.
I am QA, and I have a high accuracy with all my reports, but I think my life would be easier if I had a visual in my head.
_________________________
Donna
|
|
Top
|
|
|
|
|
#105839 - 08/01/08 03:27 AM
Re: Tips to improve accuracy/QA and "the ear."
[Re: Donna2]
|
csimm112
New Member
Registered: 08/01/08
Posts: 2
|
VMT,
Thank you so much for sharing your experience. Although I imagine it was hard to relive such a hard situation, you expressed a lot of the same frustration I have been having but I could not put words to it adequately!
I am a newbie as well, but I have not gone to school, only self taught, and I am truly thankful that I have had my MIL and SIL as mentors. (They are exceptional MTs.) I have had some PRN work here and there, but I have been wanting to advance to PT work. I just kept hitting a brick wall where I felt like something was wrong. I could tell that the quality of my work was not progressing as well as I would have liked but I did not know how to fix it....
Your question got some great responses-especially Redpen... I think that I need to change how I listen to the dictation as well...
So VMT- you helped me!
Keep your head up, and I know you will be fine. You really have the desire to be a great MT, and it seems as though you are willing to hard work for it... that can be half the battle by itself!
:-)
|
|
Top
|
|
|
|
Moderator: Annie
|
