March 2011

Tracking Transcription— Five Tips To Better Measure Productivity
By Paula Pasquinelli
Radiology Today
Vol. 12 No. 3 P. 32

In 2011, productivity measurement within transcription departments will continue to be utilized as high-priority information. The following are five specific tactics that will serve departments well in meeting their goals:

1. Understand your objectives and the available metrics. The continued evolution of the healthcare industry and clinical documentation makes it imperative for transcription service professionals to be even more careful when it comes to managing the productivity and the overall performance of medical transcriptionists (MTs). As the number of career-minded MTs continues to decline and the cost of offshore transcription increases, supervisors must utilize existing transcription staff to their fullest capacity.

Robust reporting is essential to measuring staff productivity. Transcription service professionals should evaluate the available data and identify any gaps in information that could assist them in managing their team’s effectiveness.

Those responsible for transcriptionist productivity must first understand how their organizations measure productivity. Facilities use various metrics such as lines, minutes, and number of reports.

Unfortunately, these methods are often not straightforward. For example, what constitutes a line? Some would say 65 characters with spaces included, while others might say 55 characters without spaces but with header/footer characters included. Regardless of how productivity is measured, managers must first fully grasp what measurements they use to evaluate performance.

From an organizational perspective, productivity should be more than “meeting the numbers.” Managers should strive to increase document quality, decrease turnaround time, and boost physician satisfaction.

2. Monitor and manage transcriptionist performance. To meet productivity goals, transcription service professionals must use data to manage transcriptionist performance. One of the most critical yet often overlooked metrics is inactive time. In other words, this is the amount of time a transcriptionist is not actively engaged in working on a clinical document. Given that a large percentage of transcriptionists are working virtually, monitoring for excessive inactive time can help a manager “close the gap” between what an MT is producing vs. what he or she could be producing if fully productive.

For those transcriptionists who have transitioned into an editing role, which is common in radiology, proficiency data provide the transcription service professional with actionable information to drive training and mentoring for improved productivity and efficiency. Editing proficiency data is crucial granular feedback that supervisors can use to drive performance.

Transcription services professionals should monitor productivity on a regular basis and clearly communicate expectations to their staff. Transcriptionists working in the industry today should have an explicit understanding of their productivity and productivity expectations.

3. Determine whether your workflow is impacting your productivity. Workflow can play a significant role—positive or negative—in overall productivity in both hospitals and medical transcription service organizations. For example, if a transcriptionist is transitioning into an editing role but is given a low volume of editing, the learning curve will be greatly extended and productivity will decrease. If a transcriptionist is responsible for several highly customized accounts, all of which are set with first-in/first-out logic, this could also curtail productivity. While effective workflow is imperative for customer satisfaction, it should also be considered a tool for improving productivity. These are two basic workflow decisions that have a direct impact on transcriptionist performance.

Transcription service professionals should also consider total time to completion, or how much additional time and resources are needed to complete a clinical document. This becomes especially critical in an offshore workflow where there are often several layers of quality assurance (QA).

When measuring an offshore transcriptionist’s productivity, it is necessary to determine how much “layering” is occurring. There are different productivity expectations for an offshore worker’s delivering directly to the customer as opposed to one who is expected to reach a certain percentage of accuracy in order to move to the next QA level.

The same can be said for domestic workflows. Transcription managers should consider the amount of QA utilization per MT as a factor of overall productivity.

4. Consider the variables. Whether a transcriptionist is employed by a hospital, a clinic, or a medical transcription service organization, it is often unfair to measure his or her performance against another because of the many variables that may exist.

Transcription service professionals should consider the following:

• Level of difficulty and consistency of work: A person responsible for multiple accounts or multiple document types may be less productive than someone who transcribes a set of physicians and/or one or two document types. Similarly, an transcriptionist who is responsible for a group of poor dictators may be at a disadvantage. Both level of difficulty and consistency, or lack thereof, impact overall productivity.

• Type of work: Productivity expectations will vary depending on whether the work is done via a traditional method or speech recognition. While both scenarios require monitoring and management of productivity data, transcription supervisors should be aware that a worker moving from a traditional transcribing environment to editing require additional training and mentoring support.

• Additional nonproductive responsibilities: Transcription service professionals need to determine how much, if any, nonproductive responsibilities are impacting individual productivity. For example, someone assigned to QA or clinic-employed person responsible for clerical duties in addition to transcription can be expected to produce less. Any responsibilities outside of traditional transcription or editing must be considered when evaluating productivity metrics.

• Skill level: Experience and expertise matter.

• Employment status: Productivity expectations often vary between an employed workers and an independent contractor. Transcription service professionals should consider whether a transcriptionist is career minded or has chosen to be an independent contractor based on a skill he or she is able to utilize for economic reasons.

5. Determine, communicate, and manage your productivity standard. There is no nationally defined productivity standard. Create your own standard based on benchmarking that uses current results. Also, consider what the organization must accomplish to meet outlined objectives. Remember that a transcription service professional cannot expect transcriptionists to meet requirements without clear definition of those requirements.

Once expectations are determined, it becomes necessary to identify outliers and their needs. For example, these MTs may require additional training or reevaluation of their current work assignment or perhaps such employees require counseling related to job duties.

Identifying people who are not meeting productivity minimums and communicating these concerns can lead to improvement opportunities that boost not only performance but also trancriptionists’ satisfaction. Regardless of the size or the type of transcription operation, a lack of well-defined and communicated expectations will lead to insufficient results.

— Paula Pasquinelli is transcription services manager at M*Modal.