Heather A Heaton1, Ana Castaneda-Guarderas2, Elliott R Trotter3, Patricia J Erwin4, M Fernanda Bellolio5. 1. Department of Emergency Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905. Electronic address: Heaton.heather@mayo.edu. 2. Department 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. 3. Department of Emergency Medicine, Texas Health Harris Methodist Hospital, 1301 Pennsylvania Ave, Fort Worth, TX 76104. 4. Mayo Clinic Libraries, 200 First St SW, Rochester, MN 55905. 5. Department 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.
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.
Authors: Peter S Graves; Stephen R Graves; Tanvir Minhas; Rebecca E Lewinson; Isabelle A Vallerand; Ryan T Lewinson Journal: CMAJ Open Date: 2018-09-04
Authors: Phichet Wutthisirisart; Gabriela Martinez; Heather A Heaton; Kalyan Pasupathy; Moriah S Thompson; Mustafa Y Sir Journal: J Med Syst Date: 2018-09-27 Impact factor: 4.460