Applying speech-to-text systems in documentation

摘要

White R Scott E (2015) Applying speech-to-text systems in documentation. The intensive care unit at Alder Hey Children's Hospital decided to use a speech-to-text software program to release nurses from the increasing burden of complex, free-text documentation. Nurses were trained using a cascade technique at the bedside. Background noise and staff accents were the main difficulties encountered during implementation. Our experience of this process has led us to develop a new appreciation of the human factors that affect documentation. Speech-to-text software can bring improvements to the quality of nursing documentation but, if benefits to patients are to be maximised, accompanying changes need to be made to how nurses think about, and produce, their documentation. Documentation consumes a large proportion of nurses' clinical time and has been estimated to take up about 20% of a shift (Yee et al, 2012). The intensive care unit at Alder Hey Children's Hospital is upgrading its electronic patient record (EPR) system and applied for funding from the Nursing Technology Fund to introduce speech-to-text software and hardware so nurse documentation could be improved. This article describes the introduction of speech-to-text technology in a large, busy ICU. Quantity versus quality The amount of documentation required of nurses in Alder Hey's ICU has increased significantly in the last 20 years, for a number of reasons (Box 1). Our patient population includes sicker, often clinically unstable children who require advanced therapies. Achieving a good standard of nursing documentation in a highly changeable clinical environment is a challenge. We switched our nursing notes from paper to an EPR system a decade ago and staff have grown used to documenting their notes on a computer. However, our staff are not touch-typists and we felt this change in the method of recording patient notes has had a negative impact on the accuracy and quality of nursing records.