It’s Scribe Time

November 23, 2016

Short Attention Span Summary

It’s Scribe time (a nod to sad Cleveland Indian fans)!
In this meta-analysis of 17 studies, there was no impact of scribes on length of stay or time to disposition.  But there was a slight increase in number of patients per hour and possible increase in RVUs generated by those using scribes.  There was a qualitative assessment of improvement in patient and provider satisfaction.

Spoon Feed
Scribes may help increase the number of patients seen per hour and also may increase revenue.  They also seemed to make providers and patients more satisfied.

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Abstract

Am J Emerg Med. 2016 Oct;34(10):2018-2028. doi: 10.1016/j.ajem.2016.07.056. Epub 2016 Jul 28.

Effect of scribes on patient throughput, revenue, and patient and provider satisfaction: a systematic review and meta-analysis.

Heaton HA1, Castaneda-Guarderas A2, Trotter ER3, Erwin PJ4, Bellolio MF5.

Author information:

1Department of Emergency Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905. Electronic address: Heaton.heather@mayo.edu.

2Department of Emergency Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905; Knowledge and Evaluation Research Unit, Plummer 4, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

3Department of Emergency Medicine, Texas Health Harris Methodist Hospital, 1301 Pennsylvania Ave, Fort Worth, TX 76104.

4Mayo Clinic Libraries, 200 First St SW, Rochester, MN 55905.

5Department of Emergency Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

Abstract

BACKGROUND:

Scribes offer a potential solution to the clerical burden and time constraints felt by health care providers.

OBJECTIVES:

This is a systematic review and meta-analysis to evaluate scribe effect on patient throughput, revenue, and patient and provider satisfaction.

METHODS:

Six electronic databases were systematically searched from inception until May 2015. We included studies where clinicians used a scribe. We collected throughput metrics, billing data, and patient/provider satisfaction data. Meta-analyses were conducted using a random effects model and mean differences (MDs) with 95% confidence intervals (CIs) with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

RESULTS:

From a total of 210 titles, 17 studies were eligible and included. Qualitative analysis suggests improvement in provider/patient satisfaction. Meta-analysis on throughput data was derived from 3 to 5 studies depending on the metric; meta-analysis revealed no impact of scribes on length of stay (346 minutes for scribes, 344 minutes for nonscribed; MD -1.6 minutes, 95% CI -22.3 to 19.2 minutes) or provider-to-disposition time (235 minutes for scribes, 216 for nonscribed; MD -18.8 minutes, 95% CI -22.3 to 19.2) with an increase in patients seen per hour (0.17 more patient per hour; 95% CI 0.02-32). Two studies reported relative value units, which increased 0.21 (95% CI 0-0.42) per patient with scribe use.

CONCLUSION:

We found no difference in length of stay or time to disposition with a small increase in the number of patients per hour seen when using scribes. Potential benefits include revenue and patient/provider satisfaction.

Copyright © 2016 Elsevier Inc. All rights reserved.

PMID: 27534432 [PubMed – in process]