Impact of a scribe program on patient throughput, physician productivity, and patient satisfaction in a community-based emergency department

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 pat...

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Bibliographic Details
Published in:	Health informatics journal Vol. 27; no. 1; p. 1460458217692930
Main 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
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-01-2021 SAGE PUBLICATIONS, INC
Subjects:	Efficiency, Organizational Emergency medical care Emergency Service, Hospital Humans Patient Satisfaction Physicians Productivity Prospective Studies patient satisfaction scribes patient throughput physician productivity
Online Access:	Get full text
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Summary:	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 time-motion 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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1460-4582 1741-2811
DOI:	10.1177/1460458217692930