It's estimated that presently in Australia, nearly 50% of the time a doctor spends in the emergency ward of a hospital is taken up with typing up patient notes and performing other clerical tasks. This time, many argue, would be better spent examining and tending to patients and communicating with them and their health team.
This is where scribes come in. Scribes are professionals trained in completing the clerical data entry associated with an emergency visit, freeing up the treating doctor to focus on medical tasks instead. Scribes are already used in hospitals throughout the US and have been trialled in other countries, with the first Australian trial taking place recently across five Victorian hospital emergency departments – Austin Hospital, Bendigo Hospital, Cabrini Malvern, Dandenong Hospital and Monash Children’s Hospital.
The data showed that by taking over the administrative workload, scribes allowed doctors to treat 25% more patients per shift and decreased the total time a patient needed to spend in the emergency department by an average of 19 minutes. In cost terms – through increased revenue generated by additional patients or time-based performance improvements – the research found that scribes could save hospitals up to AU$43.48 per hour.
Nor did this come at the cost of patient or doctor comfort. The research showed that the majority of patients were unperturbed by the presence of scribes in their consultations; 85% of doctors said they actually preferred to work with scribes; while other medical staff in the emergency department were unaffected.
Associate Professor Katie Walker from Cabrini said she hoped the research would persuade Australian hospitals to employ scribes, thus enabling emergency physicians to focus on their core work and safely attend to more patients. Down the track, scribes could even be introduced beyond the emergency ward to other medical disciplines, as well as to health systems in other countries – “Ideally,” she says, “I would like to see scribes as a fundamental part of medicine worldwide.”
The trial was supported by senior researchers from the Cabrini Institute, Monash University and the Emergency Medicine Events Registry (EMER) (Australasian College for Emergency Medicine, Australian Patient Safety Foundation). It was funded by the Cabrini Foundation; as well as the following trusts that Equity Trustees is responsible for; the Phyllis Connor Memorial Trust, Ella and Michael Brazier Fund, the Charles Lamond Forrest Estate, the Louisa Henty Estate, the Charles and Jessie Strong Trust, the Theodotus John Summer Charitable Trust and the Charles Frederick William Taylor Estate.
Photo: Medical scribe Lachlan Hegarty and A/Prof Katie Walker, Director of Emergency Medicine Research at Cabrini Malvern, with a patient.