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Emergency Department Scribes

Heather A Heaton, David M Nestler, Derick D Jones, Christine M Lohse, Deepi G Goyal, Jeffrey S Kallis, Annie T Sadosty
OBJECTIVES: Assess the impact of scribes on an academic emergency department's (ED) patient-specific throughput. METHODS: Study design, setting, participants: A prospective cohort design compared throughput metrics of patients managed when scribes were and were not a part of the treatment team during pre-defined study hours in a tertiary academic ED with both an adult and pediatric ED. INTERVENTION: Eight scribes were hired and trained on-site by a physician with experience in scribe implementation...
October 2016: American Journal of Emergency Medicine
Mohamed Khalifa, Ibrahim Zabani
Emergency department (ED) crowding has become a major barrier to receiving timely care. King Faisal Specialist Hospital & Research Center, Saudi Arabia worked on identifying evidence based strategies for reducing the ED crowding by improving the intake. In addition to a review of literature, qualitative survey methods were used to identify strategies, which were classified into 10 suggested procedures categorized into three types of changes. Physical improvements include using physician cubicles, creating a team triage area and an internal waiting area for less acute patients instead of occupying beds...
2016: Studies in Health Technology and Informatics
Katie Walker, Michael Ben-Meir
No abstract text is available yet for this article.
April 2016: Emergency Medicine Australasia: EMA
Mark Reiter, Leana S Wen, Brady W Allen
BACKGROUND: The landscape of the emergency medicine workforce has changed dramatically over the last few decades. The growth in emergency medicine residency programs has significantly increased the number of emergency medicine specialists now staffing emergency departments (EDs) throughout the country. Despite this increase in available providers, rising patient volumes, an aging population, ED overcrowding and inefficiency, increased regulation, and other factors have resulted in the continued need for additional emergency physicians...
April 2016: Journal of Emergency Medicine
Jeremy J Hess, Joshua Wallenstein, Jeremy D Ackerman, Murtaza Akhter, Douglas Ander, Matthew T Keadey, James P Capes
INTRODUCTION: Physicians dedicate substantial time to documentation. Scribes are sometimes used to improve efficiency by performing documentation tasks, although their impacts have not been prospectively evaluated. Our objective was to assess a scribe program's impact on emergency department (ED) throughput, physician time utilization, and job satisfaction in a large academic emergency medicine practice. METHODS: We evaluated the intervention using pre- and post-intervention surveys and administrative data...
September 2015: Western Journal of Emergency Medicine
Cara J Cabilan, Robert M Eley
The increasing burden of documentation experienced by doctors threatens the efficiency in EDs and increases the likelihood of documentation errors. Medical scribes afford the opportunity to allay this burden by removing a large component of the doctors' documentation task. Scribes have been embedded successfully in US EDs, and the effects have been mostly advantageous. The present paper provides a brief overview of the function of scribes and their potential contribution to Australian EDs.
August 13, 2015: Emergency Medicine Australasia: EMA
Cameron G Shultz, Heather L Holmstrom
BACKGROUND: Electronic health records (EHRs) hold promise to improve productivity, quality, and outcomes; however, using EHRs can be cumbersome, disruptive to workflow, and off-putting to patients and clinicians. One proposed solution to this problem is the use of medical scribes. The purpose of this systematic review is to summarize the literature investigating the effect of medical scribes on health care productivity, quality, and outcomes. Implications for future research are discussed...
May 2015: Journal of the American Board of Family Medicine: JABFM
Katherine Walker, Michael Ben-Meir, Phebe O'Mullane, David Phillips, Margaret Staples
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 patients per hour per doctor and billings per patient...
December 2014: Emergency Medicine Australasia: EMA
Aveh Bastani, Blerina Shaqiri, Kristen Palomba, Dominic Bananno, William Anderson
INTRODUCTION: At our institution, we previously described the detrimental effect of computerized physician order entry (CPOE) on throughput time and patient satisfaction (Ann of Emer Med, Vol 56, P S83-S84). To address these quality metrics, we conducted a pilot program using scribes in the emergency department (ED). METHODS: We conducted a before-and-after study of ED throughput at our 320-bed suburban community hospital with a census of 70000 annual visits. Our primary outcome measure was the effect of scribes on ED throughput as measured by the effect on (1) door-to-room time; (2) room-to-doc time; (3) door-to-doc time; (4) doc-to-dispo time; and (5) length of stay for discharged/admitted patients, between pre-CPOE and post-CPOE cohorts...
May 2014: American Journal of Emergency Medicine
Rajiv Arya, Grant Wei, Jonathan V McCoy, Jody Crane, Pamela Ohman-Strickland, Robert M Eisenstein
OBJECTIVES: There has been a steady increase in emergency department (ED) patient volume and wait times. The desire to maintain or decrease costs while improving throughput requires novel approaches to patient flow. The break-out session "Interventions to Improve the Timeliness of Emergency Care" at the June 2011 Academic Emergency Medicine consensus conference "Interventions to Assure Quality in the Crowded Emergency Department" posed the challenge for more research of the split Emergency Severity Index (ESI) 3 patient flow model...
November 2013: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Alan J Bank, Christopher Obetz, Ann Konrardy, Akbar Khan, Kamalesh M Pillai, Benjamin J McKinley, Ryan M Gage, Mark A Turnbull, William O Kenney
OBJECTIVE: Scribes have been used in the emergency department to improve physician productivity and patient interaction. There are no controlled, prospective studies of scribe use in the clinic setting. METHODS: A prospective controlled study compared standard visits (20 minute follow-up and 40 minute new patient) to a scribe system (15 minute follow-up and 30 minute new patient) in a cardiology clinic. Physician productivity, patient satisfaction, physician-patient interaction, and revenue were measured...
2013: ClinicoEconomics and Outcomes Research: CEOR
Emily L Molan
BACKGROUND: Scribe nurses within metropolitan emergency departments are traditionally Registered Nurses who document the resuscitation event to provide a true and timely representation of what occurred. Enrolled Nurses undertake the scribe role in some Australian emergency department resuscitations, particularly in rural and remote health services. There is no Australian research evidence pertaining to the role of the scribe nurse within a resuscitation team. This study explored the scribe role and the nursing work involved within it to appraise whether it is appropriate to delegate the responsibility away from Registered Nurses...
May 2013: Australasian Emergency Nursing Journal: AENJ
Hamed-Basir Ghafouri, Barzin Bagheri-Behzad, Mohammad-Reza Yasinzadeh, Ehsan Modirian, Dorsa Divsalar, Shervin Farahmand
INTRODUCTION: Emergency department manages several kinds of wounds including simple, non-bite traumatic wounds and lacerations. Prophylactic antibiotic therapy is one of pre-scribed treatment in these conditions. We aimed to compare the clinical efficacy of the two day regimen of prophylactic antimicrobial agents with the five day regimen in simple traumatic but highly contaminated wounds. METHODS: Between January 2010 and May 2010, patients presenting with simple traumatic wounds or lacerations in different parts of the body, highly contaminated with soil, debris or feces in emergency department of a referral educational hospital in Tehran (Rasul-Akram hospital), Iran, went for primary closure...
2012: BioImpacts: BI
Brian E Grunau, Matthew O Wiens, Marc Greidanus
MDMA (3,4-methylenedioxymethamphetamine), popularly known as “Ecstasy,” was first introduced and patented by Merck & Co., Inc., in 1914 as an appetite suppressant. Currently, its primary role is as an illegal stimulant used to produce a euphoric effect during parties. This case report de scribes a 31-year-old man who, after taking 3 tablets of Ecstasy, presented to an emergency department with a decreased level of consciousness and became progressively hyperthermic and rigid. During the course of his acute illness, his temperature reached 42...
September 2010: CJEM
Rajiv Arya, Danielle M Salovich, Pamela Ohman-Strickland, Mark A Merlin
OBJECTIVES: The objective was to quantify the effect of scribes on three measures of emergency physician (EP) productivity in an adult emergency department (ED). METHODS: For this retrospective study, 243 clinical shifts (of either 10 or 12 hours) worked by 13 EPs during an 18-month period were selected for evaluation. Payroll data sheets were examined to determine whether these shifts were covered, uncovered, or partially covered (for less than 4 hours) by a scribe; partially covered shifts were grouped with uncovered shifts for analysis...
May 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
D A Bluemke, J Eng
SCRIBE is an automated radiology reporting system that uses the HyperCard environment on Macintosh computers. Radiologic findings and anatomic terms are presented in graphic form, and the appropriate terms are selected by using a trackball or touch-sensitive video screen. Additional lists of more specific terms and differential diagnoses can be requested by the user for abnormal findings. The system is suited to the reporting of plain films and is being used in the emergency room of a large academic radiology department...
January 1993: AJR. American Journal of Roentgenology
S Burns, J G Wiegenstein
A simple, inexpensive system for keeping track of charts, orders, and patients in a busy emergency department is described. All orders, except the most urgent, are communicated in writing. A secretary relieves the nurses of secretarial duties, and functions as coordinator of laboratory work and communications. A traffic board, using magnetic markers, allows instant visualization of the state of the department. Swift movement of patients from room to room can occur without losing track of the patient or his chart...
February 1980: Annals of Emergency Medicine
R J Allred, S Ewer
Alternative methods for rapidly producing accurate medical records, usually dictation-transcription systems or nurse-scribe methods, have been used in emergency departments. We now have more than five years of experience with a non-nurse scribe system. This system has proven effective in generating accurate and complete medical records while enhancing patient flow. We describe the system and its implementation.
March 1983: Annals of Emergency Medicine
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