The use of medical scribes increased emergency doctors’ productivity and reduced patients’ length of stay, according to a new study.
The study, led by a group of Fellows of the Australasian College for Emergency Medicine (ACEM), found that scribes allowed emergency doctors to see 16% more patients per shift and 26% more primary patients per shift (where the main consultation, investigations, results, treatment and referrals occurred).
The study, published in the British Medical Journal (BMJ), also found that patients were in and out of the emergency department 19 minutes faster when a scribe was present, allowing other patients to come in from the waiting room to be treated instead.
Conducted across five Victorian emergency departments, the study is the first large, multi-centre, randomised, independent (not sponsored by a scribe company) economic evaluation of the scribe role anywhere in the world.
A trained scribe, often a university student wanting a career as a healthcare professional, enters electronic documentation (notes) into the computer, including patient history, physician examination findings, test results, and other information.
“Emergency departments across the world struggle to get doctors to patients in a timely fashion, with emergency doctors spending lots of time at computer terminals, rather than at patient bedsides,” lead author and ACEM Fellow, Associate Professor Katie Walker said.
“Scribes can free up a doctor’s time and allow them to focus on the patient.”
A/Prof Walker said scribes are gaining in popularity.
“Doctors like using scribes, they feel less stressed and tired despite their heavy workload, and patients don’t mind if scribes are helping the doctor,” A/Prof Walker said.
“Scribes, being paid to work alongside a specialist, have a wonderful exposure to the healthcare system, which assists with training the next generation of healthcare workers.”
“Emergency physicians and patients both want to see more of each other. Clerical support is needed to enable our doctors to leave their computers and return to patient bedsides.”
A/Prof Walker’s co-authors included the following Fellows of the Australasian College for Emergency Medicine:
- Dr Michael Ben-Meir
- Dr Rachel Rosler
- Dr Adam West
- Professor David Taylor
- Dr Gabby O'Connor
- Associate Professor Thomas Chan
- Dr Diana Badcock
- Dr Mark Putland
- Dr Kim Hansen
- Dr Carmel Crock
ACEM President Dr Simon Judkins said: “I congratulate A/Prof Walker, Dr Ben-Meir and all the team involved in this study. It’s an example of how we should support new ideas and innovations to improve the impact emergency physicians can have in care delivery in the most acute and critical area of health.”
Dr Judkins added: “Research, one of the pillars of ACEM, helps improve the speciality of emergency medicine and the care we deliver to our patients.”
A/Prof Walker and Dr Ben-Meir said: “We believe private emergency medicine can stimulate innovation and conduct high quality research and we would encourage all private emergency departments to do the same.”
About the study
The study evaluated the effect of scribes at five emergency departments. Eighty-eight emergency doctors worked with 12 scribes. Measurements included physicians’ productivity (total patients, primary patients per hour), patient throughput (door-to-doctor time, length of stay), patient safety and an economic analysis of the costs and benefits of a scribe program.
Data were collected from 589 scribed shifts (5098 patients) and 3296 non-scribed shifts (23,838 patients) from November 2015 to January 2018 at Cabrini, Dandenong, Austin, Clayton (paediatrics) and Bendigo emergency departments.
Read A/Prof Walker and Dr Ben-Meir’s thoughts on how clinicians work in a digital age
Background
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
Contact
Andre Khoury
ACEM Public Affairs Manager
03 8679 8813
0498 068 023
[email protected]