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Medical scribes in emergency medicine produce financially significant productivity gains for some, but not all emergency physicians
Author(s) -
Walker Katherine J,
BenMeir Michael,
Phillips David,
Staples Margaret
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12562
Subject(s) - medicine , emergency department , productivity , observational study , emergency medicine , acute medicine , medical emergency , family medicine , nursing , intensive care medicine , economics , macroeconomics
Objective The present study aims to determine if a scribe in an Australian ED can assist emergency physicians to work with increased productivity and to investigate when and where to allocate a scribe and to whom. Methods This was a prospective observational single‐centre study conducted at a private ED in Melbourne. It evaluated one American scribe and five doctors over 6 months. A scribe is a trained assistant who performs non‐clinical tasks usually performed by the doctor. The primary outcomes were patients/hour/doctor and billings/patient. Additional analyses included individual doctor productivity, productivity by ED region, shift time, day of the week and physician learning curves. Door‐to‐doctor time, time spent on ambulance bypass and door‐to‐discharge time were examined, also complaints or issues with the scribe. Results There was an overall increase in doctor consultations of 0.11 (95%CI 0.07–0.15) primary consultations per hour (13%). There was variation seen between individual doctors (lowest increase 0.06 [6%] to highest increase 0.12 [15%]). Billings per patients, door‐to‐doctor, door‐to‐discharge and ambulance bypass times remained the same. There was no advantage to allocating a scribe to a specific time of day, day of week or region of the ED. There was no learning period found. Conclusions In the present study, scribe usage was associated with overall improvements in primary consultations per hour of 13% per scribed hour, and this varied depending on the physician. There is an economic argument for allocating scribes to some emergency physicians on days, evenings and weekends, not to trainees.