• Katherine Walker, Michael Ben-Meir, Phebe O'Mullane, David Phillips, and Margaret Staples.
• Emergency Department, Cabrini Hospital, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2014 Dec 1;26(6):543-8.

ObjectiveThe study aims to determine if trained scribes in an Australian ED can assist emergency physicians (EPs) to work with increased productivity.MethodsThis 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. Additional analyses included total patient time in ED; individual doctor productivity; time to see a doctor; time on ambulance bypass; and complaints/issues identified with scribes.ResultsThere was an overall increase in doctor consultations per hour of 0.32 patients (95% confidence interval (CI) 0.17, 0.47). This varied between doctors from an increase in patients per hour of 0.16 (95% CI -0.09, 0.40) to 0.65 (95% CI 0.41, 0.89). Billings per patient were increased (AUD15.24; 95% CI -AUD18.51, AUD48.99), but the increase was not statistically significant; time to see a doctor reduced by 22 min (95% CI 11, 33); bypass episodes reduced by 66 min per shift (95% CI 11, 122), total patient ED stay remained constant.ConclusionsIn this pilot study, scribe usage was feasible, and overall improvements in consultations per hour were seen. Overall income improved by AUD104.86 (95% CI AUD38.52, AUD171.21) per scribed hour. Further study is recommended to determine if results are sustained or improved over a longer period.© 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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