Attention, QA: Your Sats are Showing

My evening shift last Saturday was a grind. In the absence of my usual partner-in-crime, the other transcriptionist on evening duty whose shift overlaps mine by about five hours, the work pool consisting of histories and physicals with tight TATs was all mine to plow through.

"Plow" is not an exaggeration. Our hospitalists (and the staff NPs who dictate for them by proxy) have a tendency to go on (and on, and on) with H&Ps in excruciating detail. This is good news for my coding colleagues, who have a richness and depth of information for their detective work, but for us it means a good half-hour to 45 minutes or longer to complete each of these monster dictations. And that's if we're speedy and also familiar with the voices.

Audio files for H&Ps exceeding 20 minutes in length aren't unusual any more. In fact, except for a couple of physicians known to be blessedly brief by comparison with 5 to 8-minute dictations, when I see a short audio length in my queue for that work type I anticipate hearing not a full dictation but an addendum. Incredibly, the more lengthy the original dictation, the more often some small detail seems to be forgotten.

I had just such an addendum on Saturday. I searched out the original report, made the required notation about the addendum job number and such, transcribed the bit of additional information, and re-ended the report. On our transcription platform, this automatically triggers a spell-check. And there they were, up in the previously transcribed portion.

The sats, and their satting relatives. Arrrgh.

I've had a rant about these before, but not here on my blog, so I'm going to rant again.

Dear QA:
WHEREAS, it is well-known that verbal medical jargon as a clinical expedient does not always translate well to the written record; and
WHEREAS, the terms "sat" (as a noun), "satted", "satting" and other variations are not only jargon but also not found in any medical or English language dictionary; and
WHEREAS, in the interest of clarity and the integrity of an individual's medical record these terms are and should be correctly expressed as "saturation", "saturated" and "saturating", preferably with a clear reference to oxygenation as well;
NOW, THEREFORE, be it resolved that when a clinician or his/her proxy dictates such jargon, the terms should and must be changed by the transcriptionist to their proper and accurate form. Failure to do so shall be considered a major error.

I feel much better now.