IMPLEMENTING AN EMERGENCY DEPARTMENT SCRIBE PROGRAM AT ALASKA REGIONAL HOSPITAL A Feasibility Study

Overview  Introduction  Criteria  Methods  Research Results  Conclusions  Recommendations

Introduction What is a medical scribe?  Individuals hired to assist medical professionals.  Document patient information into electronic medical records.  Ensure that all necessary elements of a medical chart are completed.

Introduction  Examined the feasibility of implementing medical scribes in the emergency department of the Alaska Regional Hospital in Anchorage, Alaska.  Researched the need for decreased emergency department wait times focusing on: Local Alaskans’ opinions on wait times and emergency department scribe use. Potential for decreased patient wait times. Potential cost benefits.

Introduction  The national average wait time to be seen by a provider in the Emergency Department is one hour.  This national average increased by 25% between the years of 2003 to 2009 alone.  Hospitals that have begun using scribes however have seen improvements in: Average patients seen per hour. Length of stay for patients. Door-to-doctor times.  The current average wait time at the Alaska Regional Hospital Emergency Department is 30 minutes.

Criteria for Feasibility  Is there enough of a potential cost benefit to justify spending the initial money on starting the program?  Is the potential decrease in emergency department wait times large enough to justify changing the way the Alaska Regional Hospital emergency department is currently being run?  Would physicians be willing to change their current methods in order to adapt to using scribes during their shift?

Methods  Researched the average wait times for emergency department visits nation wide as well as at Alaska Regional Hospital.  Located articles that discussed the financial benefits of using emergency department scribes.  Examined current research on the practicality of scribe programs and the potential benefits of their use.  Distributed a questionnaire to Alaskan residents and analyzed the results.  Researched the necessary steps of hiring new scribes as well as what constitutes their training.

Questionnaire Results Percentage of respondents who felt as if their emergency department wait time could have been decreased.

Questionnaire Results Local Alaskans’ opinions on emergency department scribe use.

Potential For Wait Time Decreases  Through the use of scribes, patient wait times have been decreased from as much as “6 hours and 21 minutes… to 4 hours and 44 minutes” at some hospitals according to Meyer (2010).  Scribe use is also associated with improved overall productivity as measured by patient’s treated per hour.  Scribes also: Allows doctors to see more patients Increases physician satisfaction Increases patient satisfaction due to the doctors spending more time on bedside interaction.

Financial Benefits of Scribe Use  Medical scribes have been shown to save hospital emergency departments hundreds of thousands of dollars.  Physicians can boost their revenues by $50 to $60 an hour when using scribes.  Scribes reduce down-coded charts maximizing a hospital’s billing potential.  Scribe implementation can potentially pay for itself due to the reduction in necessary physician coverage.

Conclusions  Uncertainty of patient wait times can cause patients to leave without being seen by a medical provider.  Local Alaskans’ believe that prior wait times in emergency departments could have been decreased.  There is a correlation between the use of medical scribes and decreased emergency department wait times for patients.  There is a correlation between the use of medical scribes and productivity based on the number of patients seen per hour.

Conclusions  Many individuals are unaware of what a medical scribe is, but appear to be supportive of their use after receiving a description of their job duties.  Local Alaskans would favor the use of medical scribes in an emergency department.  Emergency department scribes save hospitals money and increase physician income.

Recommendations  The use of medical scribes should be implemented within the emergency department.  An additional study be conducted in order to determine the costs associated with and the funding sources available to establish the medical scribe program.  Observe the program for the first year with a year end review to evaluate whether or not the use of medical scribes has indeed decreased patient wait times and saved the hospital money.

Recommendations Continued  Interview physicians currently working at the Alaska Regional Hospital to get their input on the use of scribes.  Create a new questionnaire after two years of using the emergency department scribes in order to receive feedback on whether or not local residents’ attitudes towards emergency department wait times have changed.