Implementation of Scribes in an Academic Emergency Department: The Resident Perspective

在学术型急诊科实施医疗记录员制度:住院医师的视角

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Abstract

BACKGROUND: Medical scribes have been shown to improve emergency department (ED) throughput, physician productivity metrics, and patient satisfaction by fulfilling primary documentation and nonclinical functions. Little research has been done to date to study the effect of implementing a scribe program in a residency setting. OBJECTIVE: Our goal was to investigate emergency medicine residents' perception of their educational experience, including interactions with faculty, before and after the implementation of an ED scribe program. METHODS: We used a pre-post design to assess residents' perceptions of their educational experience before and after implementation of the scribe program. Residents at a large, urban academic medical center with an Accreditation Council for Graduate Medical Education-accredited, 4-year emergency medicine residency program were surveyed during August 2015 (prior to the implementation of the scribe program) and April 2016 (6 months after implementation). RESULTS: Residents reported improved educational experiences with statistically significant changes in the following areas: increased interaction with faculty due to fewer documentation requirements (P = .012); more face-to-face teaching with faculty (P < .001); increased faculty supervision for procedures (P = .016); and a decrease of delays in patient disposition due to incomplete documentation (P = .029). CONCLUSIONS: Implementation of an ED scribe program in an urban 4-year emergency medicine residency program led to improvements in residents' perceptions of their education.

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