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Medical Scribes Up Productivity for Emergency Medicine Doctors

THURSDAY, Jan. 31, 2019 -- Use of medical scribes in the emergency department improves physician productivity and reduces patient length of stay, according to a study published online Jan. 30 in The BMJ.

Katherine Walker, M.B.Ch.B., from Cabrini Hospital in Malvern, Australia, and colleagues conducted a randomized trial at five emergency departments in Victoria that used trained scribes during their respective trial periods. A total of 88 physicians worked their routine shifts and were randomly allocated one of 12 scribes for their shifts. Data were obtained from 589 scribed shifts (5,098 patients) and 3,296 nonscribed shifts (23,898 patients).

The researchers found a 15.9 percent increase in physician productivity with scribes, from 1.13 to 1.31 patients per hour per doctor. There was also a 25.6 percent increase in primary consultations, from 0.83 to 1.04 patients per hour per doctor. There was no change in door-to-doctor time. Median length of stay reduced from 192 to 173 minutes. Placing scribes with senior doctors at triage achieved the greatest gains, while the smallest gains were seen with scribes in subacute/fast-track regions. There were no reports of significant harms involving scribes. A favorable financial position was seen with the use of scribes in a cost-benefit analysis based on productivity and throughput gains.

"Future work should include testing scribes in other settings and countries and involve patients in the research team," the authors write. "Financial analysis based on gains in productivity and throughput supports implementation of scribes."

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Posted: January 2019

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