DMWM Standard Operating Procedure

1. Open Dragon, and navigate to your personal job queue. Typing jobs will have been allocated to you by the Team Leader.
2. In MAXIMS, select ‘Outpatient List’. In the options at the top of the screen, pick the consultant shown in the ‘Clinic Code’ column for that job on Winscribe, and the clinic date. Press the magnifying glass button to search.
3. Right click the blue arrow next to the NHS Number of the patient for whom you wish to add a letter. When the dialog box appears, click ‘View Demographics’.
4. Back in Dragon, open the job to be added by double clicking the entry in your personal queue. Confirm that the patient’s details from the document to be added from Winscribe match those of the patient’s details you have loaded in MAXIMS.
5. Check the job in Winscribe to see if any elements of previous letters need to be copied into the new letter, for example ‘diagnostic box’. If copying the diagnostic box then paste over the one that already exists in the template.
6. If any elements are to be copied, then click ‘Patient Documents’ in MAXIMS and open the previous letter that the new job refers to in MAXIMS by right clicking on the blue arrow next to that document and clicking ’View Document’. Copy the relevant section by highlighting it, right clicking and copying. Close the document.
7. Return to the ‘Patient Documents’ screen in MAXIMS. Right click in the documents list, and click ‘New Document’
8. In the dialog box that appears, select the following options:
   1. Document Type:
      ‘ RCHT Outpatient Correspondence’ for letters addressed to GPs, C N S ’s etc.
      ‘ RCHT Consultant Correspondence’ for letters going to other Consultants or Nurse Consultants.
      ‘ RCHT Patient Correspondence’ for letters addressed directly to patients.
   2. Specialty: Select Speciality
9. Click the magnifying glass icon to search. When the ‘Name’ section shows a result, click the blue arrow next to ‘Outpatient Correspondence’
10. In the ‘Details’ box, the ‘Episode of Care’ and Care Context’ should already be completed. Change the ‘Authoring H C P ’ box to the name of the clinician who has dictated the letter you are adding. The ‘Event Date’ should be the date of the clinic appointment. Click ‘Generate’
11. A letter template will open in Word. Paste the section you copied from the previous letter and reformat appropriately.
12. Highlight the letter text in Winscribe. Right click and copy the letter text only (for example, not any instructions), and then paste it into your new letter template.
13. Amend the ‘Reference’ in the top right hand corner of the letter. The format of the reference should be ‘<Consultant Initials>/<Typist Initials>/<Hospital Number>, e.g. M P C /J L /123456. For letters added via PreScribe the typist initials must be changed to “PreScribe”, e.g. ‘J M M /PreScribe/123456’
14. Type or copy/paste the appropriate clinician sign off to the bottom of the letter, replacing the one that is already there. Next to ‘F U :’, add the date of the patient’s next appointment, or next step of treatment if no appointment date yet given. If the patient has not been discharged please type ‘Open’. If the patient has been discharged please type ‘Discharged’. Underneath the clinician sign off, add the following as a new line:
    “This letter has been typed by an outsourced resource and not reviewed.”
    
    Below this, add any CC recipients as indicated in the original dictation.
15. When your new letter is complete, press the red ‘X’ in Word to close the new document, saving if prompted to do so.
16. MAXIMS will display the edit document window. Change the number of copies to the number of copies being sent out, and then click ‘Save document changes and return.
17. If the author of the letter checks their letters, leave the document in draft. If the author of the letter does not check their letters, right click the blue arrow next to the patient’s name and click ‘Mark Ready to Send’. Then, right click again and click ‘Email to Patient GP’. All documents need a copy to be sent to the GP. Then right click one more time and click ‘Mark Completed’. You can use the checkboxes to the right of the screen to mark and batch send multiple documents.
18. If CCs of the letter need to be sent, then ascertain if these are to be sent by post or email. Reopen the letter from either the Document Worklist screen or the patient’s Documents list. Move the mouse to the bottom of the letter, and a toolbar will appear. Click the rightmost button marked ‘Show Adobe Reader Toolbar’. A new menu will appear at the top of the screen. Using the new top menu, for emailing click the envelope icon and press ‘Send Copy’. A new mail window will appear for you to compose your email, with the letter already attached. To print, use the printer icon.
19. Back in Dragon, click ‘Done’ to mark the job as complete.