Audio transcription significantly optimizes the workflow and efficiency of physicians, nurses and administrative staff. When adopting the note-taking technique into your practice’s daily routine, be sure to abide by the following do’s and don’ts:
Do implement these tactics when dictating
- Record in a quiet space – Recording dictations in a quiet area is essential for good audio quality – you will thank yourself later.
- Learn how to use recording devices properly – Before jumping into dictation, adequately train yourself on how to properly use all involved equipment and follow dictation instructions closely.
- Identify yourself at the start of dictations – Clearly identify and spell your name and your role in the patient’s care.
- Spell out abnormal jargon – If you use unusual or complex medical terms in your speech, pause after pronunciation to spell out the abnormal word or words. Apply this tactic to words that sound alike, too.
- Begin each dictation with patient information – State the patient details at the beginning of a new dictation. Be sure to include the patient’s name, date of birth, MRN/ID No., date of service, type of dictation and the referring physician. When speaking the physician’s name, pause to spell the name and address, as well, if we do not have in file already.
- Speak clearly into the recording device – Moving rigidly to ensure clarity of voice in recordings can feel awkward at first, but over time, it will become natural. Keep the microphone just beyond the mouth as you move to explain concepts to patients or refer to charts.
- Verbalize punctuation – The dictation device does not always automatically pick up on pauses as implied stops between sentences. Say ‘stop’ or ‘full stop’ when you want to end a sentence.
Do not practice these tactics when dictating
- Record in a noisy area – Noisy environments muffle audio quality, so transcription notes will be compromised.
- Forget punctuation or ending note – At the end of sentences, you must verbally say ‘stop’. At the end of a dictation, you must say ‘end of dictation.’
- Chew gum, eat or drink – Any noise made by the mouth will affect the quality of the dictation. Be sure to avoid eating, drinking or chewing gum while recording.