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- Title
Impact of a scribe program on patient throughput, physician productivity, and patient satisfaction in a community-based emergency department.
- Authors
Shuaib, Waqas; Hilmi, John; Caballero, Joshua; Rashid, Ijaz; Stanazai, Hashim; Ajanovic, Alan; Moshtaghi, Alex; Amari, Ahmed; Tawfeek, Kerolos; Khurana, Anjit; Hasabo, Hesham; Baqais, Abdulrehman; Mattar, Ahmed A; Gaeta, Theodore J
- Abstract
Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods. Patient throughput metrics were (1) door-to-room time, (2) room-to-doc time, (3) door-to-doc time, (4) doc-to-disposition time, and (5) length of stay for discharged/ admitted patients. Our secondary outcome was physician productivity, which was calculated by measuring total patients seen per hour and work relative value units per hour. Additionally, we calculated the timemotion analysis in minutes to measure the emergency department physician’s efficiency by recording the following: (1) chart preparation, (2) chart review, (3) doctor–patient interaction, (4) physical examination, and (5) post-visit documentation. Finally, we measured patient satisfaction as provided by Press Ganey surveys. Data analysis was conducted in 12,721 patient encounters in the pre-scribe cohort, and 13,598 patient encounters in the post-scribe cohort. All the patient throughput metrics were statistically significant (p < 0.0001). The patients per hour increased from 2.3 ± 0.3 pre-scribe to 3.2 ± 0.6 post-scribe cohorts (p < 0.001). Total work relative value units per hour increased from 241(3.1 ± 1.5 per hour) pre-scribe cohort to 336 (5.2 ± 1.4 per hour) post-scribe cohort (p < 0.001). The pre-scribe patient satisfaction was high and remained high in the post-scribe cohort. There was a significant increase in the clinician providing satisfactory feedback from the pre-scribe (3.9 ± 0.3) to the post-scribe (4.7 ± 0.1) cohorts (p < 0.01). We describe a prospective trial of medical scribe use in the emergency department setting to improve patient throughput, physician productivity, and patient satisfaction. We illustrate that scribe use in community emergency department is feasible and results in improvement in all three metrics.
- Subjects
LENGTH of stay in hospitals; PHYSICAL diagnosis; HOSPITAL emergency services; LABOR productivity; EVALUATION of human services programs; CLINICAL trials; RESEARCH methodology; PHYSICIAN-patient relations; COMMUNITY health services; PATIENT satisfaction; PHYSICIANS' attitudes; HUMAN services programs; PRE-tests &; post-tests; DOCUMENTATION; MEDICAL care use; QUALITY assurance; DESCRIPTIVE statistics; CLINICAL competence; INTERPROFESSIONAL relations; LONGITUDINAL method
- Publication
Health Informatics Journal, 2021, Vol 27, Issue 1, p1
- ISSN
1460-4582
- Publication type
Article
- DOI
10.1177/1460458217692930