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Emergency consultants value medical scribes and most prefer to work with them, a few would rather not: a qualitative Australian study
  1. Timothy Luke Cowan1,
  2. William A Dunlop1,
  3. Michael Ben-Meir1,
  4. Margaret Staples2,3,
  5. Ainsley Treadwell1,
  6. Eliza Gardner-Brunton1,
  7. Katherine Justice Walker1,2
  1. 1Department of Emergency Medicine, Cabrini Hospital, Melbourne, Victoria, Australia
  2. 2Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
  3. 3Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
  1. Correspondence to Timothy Luke Cowan, Department of Emergency, Cabrini Hospital, Melbourne, Victoria, 3144, Australia; timcowan{at}hotmail.com.au

Abstract

Objective The utilisation of medical scribes in the USA has enabled productivity gains for emergency consultants, though their personal experiences have not been widely documented. We aimed to evaluate the consultant experience of working with scribes in an Australian ED.

Methods Emergency consultants working with scribes and those who declined to work with scribes were invited to participate in individual interviews (structured and semistructured questions) about scribes, scribe work and the scribe program in October 2016.

Results Of 16 consultants, 13 participated in interviews, that is, 11 worked with scribes and 2 did not and 3 left Cabrini prior to the interviews. Consultants working with scribes found them most useful for capturing initial patient encounters, for finding information and completing discharge tasks. Scribes captured more details than consultants usually did. Editing was required for omissions, misunderstandings and rearranging information order, but this improved with increasing scribe experience. Consultants described changing their style to give more information to the patient in the room. Consultants felt more productive and able to meet demands. They also described enjoyment, less stress, less cognitive loading, improved ability to multitask, see complex patients and less fatigue.

In interviews with the two consultants declining scribes, theme saturation was not achieved. Consultants declining scribes preferred to work independently. They did not like templated notes and felt that consultation nuances were lost. They valued their notes write-up time as time for cognitive processing of the presentation. They thought the scribe and computer impacted negatively on communication with the patient.

Conclusion Medical scribes were seen to improve physician productivity, enjoyment at work, ability to multitask and to lower stress levels. Those who declined scribes were concerned about losing important nuances and cognitive processing time for the case.

  • emergency care systems
  • emergency departments
  • extended roles
  • interpersonal
  • practitioners
  • qualitative research
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Footnotes

  • Contributors TLC, EG-B and WAD are Cabrini scribes. KJW is the scribe program director. AT has no relationship with the scribe program. KJW and MB-M secured funding. TLC, KJW, WAD and MS designed the methods. TLC and AT collected the data. TLC, KJW, WAD and AT analysed the data. TLC, KJW, EG-B and WAD wrote the manuscript. All authors revised the manuscript. TLC is the guarantor for the manuscript.

  • Funding The equity trustees and Cabrini Foundation/Institute funded this study.

  • Competing interests KJW reports grants from Cabrini Foundation, Equity Trustees and the Phyllis Connor Memorial Fund and non-financial support from Cabrini Institute and Cabrini Health during the conduct of the study.

  • Ethics approval Cabrini Human Research Ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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