Scribes in an Australian private emergency department: A description of physician productivity

Katherine Walker, Michael Ben-Meir, Phebe O'Mullane, David Phillips, Margaret Staples

Research output: Contribution to journalArticleResearchpeer-review

30 Citations (Scopus)

Abstract

Objective: The study aims to determine if trained scribes in an Australian ED can assist emergency physicians (EPs) to work with increased productivity. Methods: This was a pilot, prospective, observational study conducted at a private ED in Melbourne. A scribe is a trained assistant who works with an EP and performs non-clinical tasks that reduce the time spent providing clinical care for patients. Shifts with and without a scribe were compared. The primary outcomes were patientsper hour per doctor and billings per patient. Additional analyses included total patient time in ED; individual doctor productivity; time to see a doctor; time on ambulance bypass; and complaints/issues identified with scribes. Results: There was an overall increase in doctor consultations per hour of 0.32 patients (95% confidence interval (CI) 0.17, 0.47). This varied between doctors from an increase in patients per hour of 0.16 (95% CI -0.09, 0.40) to 0.65 (95% CI 0.41, 0.89). Billings per patient were increased (AUD15.24; 95% CI -AUD18.51, AUD48.99), but the increase was not statistically significant; time to see a doctor reduced by 22 min (95% CI 11, 33); bypass episodes reduced by 66 min per shift (95% CI 11, 122), total patient ED stay remained constant. Conclusions: In this pilot study, scribe usage was feasible, and overall improvements in consultations per hour were seen. Overall income improved by AUD104.86 (95% CI AUD38.52, AUD171.21) per scribed hour. Further study is recommended to determine if results are sustained or improved over a longer period.

Original languageEnglish
Pages (from-to)543-548
Number of pages6
JournalEmergency Medicine Australasia
Volume26
Issue number6
DOIs
Publication statusPublished - Dec 2014
Externally publishedYes

Keywords

  • Doctor's assistant
  • Efficiency
  • Emergency medicine
  • Organisational
  • Performance indicator
  • Scribe

Cite this