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I have come to this conclusion after working at Nuance. - Which are you?

Posted: Feb 09, 2015

Since they constantly bounce us back and forth, forcing us to choose between production and quality, which have you chosen? Or aren't you there yet? I have chosen quality. At least for the moment. I think I'm getting just as whacko as they are. Signed, Present MUP Collector

production - sm

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Had to give up on quality and go for speed. No matter how much you try to be perfect, they will ALWAYS find something to fault you with. I don't have time for their stupid games. I have kids to feed.

Me, too. It's all about production. Has to be. - Will

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No matter who you are, you're going to make mistakes--which can be found if one looks hard enough. And, believe me, they're trying. For instance, When I checked Fiesa last recently, I found a place where the Indian editor made a mistake. I challenged it and got it reversed--only to have him/her (I couldn't tell by the name.) try to find another "mistake." I know this because he/she ended up auditing more than the normal number of reports. He/she did not find one but it was not for lack of trying. We will see what happens if and when the editors are able to go through even more reports.

So, yeah, this compensation program is comprised of a lot of game-playing. Why else would Nuance have ESL speakers criticizing native speakers? The fact that they do tells me that they are not serious about quality, patient safety or anything like that but, rather, saving money for Nuance.

Getting back to the issue of speed versus quality, what pays for me and everyone else at the end of the day is speed. All I can say is use your expanders to their fullest advantage. Once you get an abbreviation, phrase, etc., in there correctly, it will stay that way--in addition to saving tons of keystrokes.

I wonder if you're more likely to get fired for - quality-minded

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not meeting line counts as opposed to having lower quality?

That would depend on the type of errors found - Will

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x

But don't they knock down your cpl too far? - Just asking. nm

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x

No so far - Will

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No so far but I use my expander as much as I can. Once you get enough entries, you're pulling stuff in with the expander just as much if not more than actually typing letter by letter. I can't stress enough how much this helps. Also, be sure and back up your expander entries if your software allows for it. I have stupidly not done so in the past and really regretted it.

Somewhere in between.... - I find that I can go

[ In Reply To ..]
pretty fast and at least keep the errors to minor ones so that is what I'm doing. I do speed up in certain areas where a critical is not likely to happen, but then slow down a tad around meds/labs. The problem though is that even minor errors can add up and sink your quality, as far as THEY are concerned anyway, right off that stupid grid.

Quality transitioning to Production. - Not my choice. sm

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I also am a present MUP collector. Have been warned that the next step is performance management. Okie dokie then, speed it is. So much for my >99.8% quality. On my way out of this heckhole anyway.

Kind of have become apathetic about both but lean mostly towards - production

[ In Reply To ..]
because it doesn't matter how slow I go, how much research I do, how much relistening I do, etc., etc., SOMETHING, no matter how trivial, is ALWAYS found to knock me down the pay grid.

What a lovely atmosphere you have created Nuance!

Also a MUP collector.

I keep a list of dictators and try to keep aware - some dictate very slow

[ In Reply To ..]
And so you can bump up the speed, others talk way fast, but slowing it down may not help. I keep notes on their little peculiarities and their specialties, like "peds mushmouth" or "lab numbers warp speed" or "dictates in car or underwater" - you can't change these things but at least you are ready for them. I also keep a file for each dictator to search through when stumped.

I don't think you can really choose, because I have tried both ways (quality vs quantity) and neither on their own really works as far as I experienced. I just now try to go as fast as I can and still maintain the quality.

I find lately I am having luck with making sure I follow the text with my eyes exactly as it is being dictated. That is the biggest trap in ISR, the added words or words that sound like what is dictated but don't make sense - so you need to keep your brain working too.

I recently had "peak troponin was 4.24." I was following along with the dictation and it sounded exactly like that, slightly fast, speed of say x1-1/2. It niggled in my brain because that is a high troponin so I thought - need to see if they are being looked at for cardiac. Well no, no heart attack or any mention, I listened again normal speed, sounded the same. I slowed it way down to 0.5 and what was actually said was "peak troponin thus far 0.24."

So sometimes you have to rely on something niggling in your brain, but with that one it only sounded different when I slowed it way down, so that is why this work is so difficult to get 100%.

On the whole, following the text as it is spoken (though that sounds facile) really helps to not miss these little things, but I still do leave the odd word out or miss one they stuck in, and I get caught every time it feels like.

Another thing is ALWAYS search "year" and make sure your -year-old is correct before you send. They love to get you on that. BTW my TSM informed me that if they have a birthday you are meant to go with the demographics in the database, so if they started their stay and they were 90, but turned 91 during it, you put 91.

I also check and double check visit, date correct, right before sending. Worth the slight delay as that is a big error.

If it is one where either the dictator or the ISR has mixed up the sexes, do a search of blank-he-blank, blank-him-blank (if demographics state female that is or vice versa) and that way there are not millions of words with "he" in it that come up on the search.

Anybody else have any strategies to beat the FIESA, please spill!

That's good advice. - Thanks

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Sometimes I have an off day, but I find, like you said, the best thing is to really follow along, I actually try to keep a little behind in my reading and let the dictator be a little ahead. That way, I have the idea in my head FIRST what it should say and then if it doesn't, it's easier for me to catch I think. Can't always do that though!

nuance has started a new hobby - MUP collecting!

[ In Reply To ..]
xxoo

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