Scribes can benefit both doctors and hospitals, according to a new study.
The study, which included 88 physicians, was conducted in five emergency departments in Australia. The doctors worked shifts in which they were randomly assigned trained scribes to help them with a multitude of administrative tasks, including documenting medical care while a doctor evaluates a patient.
Doctors who had a scribe to help them increased their productivity by the number of patients per hour by 15.9% overall and the stay in the emergency department decreased by 19 minutes per patient, the researchers found. The study also looked at whether there was any adverse effect from using scribes and found no significant risk to patient safety.
Scribes give doctors time to see more patients by documenting medical consultations, printing paperwork and arranging tests and appointments. The scribes in the study were all medical or premedical students.
The use of scribes was particularly helpful in primary consultations when the doctor was the main physician for a patient without further care from another physician. In those cases, scribes increased physician productivity by 25.6%.
There was no change in the door-to-doctor time for patients, but their stay in the emergency department was shorter when the doctor used a scribe.
Using scribes did not have a significant impact on patient safety. One in 300 consultations reported a patient safety incident, which involved incorrect patient identification and ordering of tests. And the presence of scribes worked at times to reduce medical errors. For instance, a scribe made sure a room where a patient with a multiresistant organism infection was cleaned before a new patient occupied the cubicle.
The researchers did a cost-benefit analysis that showed, based on doctor productivity and the reduction in time patients spent in the emergency department, using scribes could save hospitals $26 per scribe hour if the hospital covered the cost of training and $35 per scribe hour if the scribe paid for the training.
Patients and doctors would both like more access to each other and scribes can enable this, say the authors of a new BMJ research paper https://t.co/xo0vU1KBaB— The BMJ (@bmj_latest) January 31, 2019
“Given the strong preference of physicians for working with a scribe, no effect on the patient experience, minimal risk, and the productivity and throughput gains outlined, emergency department and hospital administrators should strongly consider the potential local utility of scribes in their workforce and financial planning,” the researchers concluded.