• Heather A Heaton, Rona Wang, Kyle J Farrell, Octavia S Ruelas, Deepi G Goyal, Christine M Lohse, Annie T Sadosty, and David M Nestler.
• Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
• J Emerg Med. 2018 Jul 1; 55 (1): 135-140.

BackgroundScribes are unlicensed professionals trained in medical data entry. Limited data exist on the impact of scribes on provider time management in the emergency department (ED). Time-motion analysis is a tool utilized in business to capture detailed movements and durations to task completion. It offers a means to categorize how providers allocate their time during a clinical shift.ObjectiveEvaluate the impact of scribes on how ED providers spend their time.MethodsA prospective observational study was conducted to assess scribe impact on provider time utilization. Four research assistants (RAs) observed attending providers on 24 8-h control shifts (without a scribe), and 24 scribed shifts. RAs observed and categorized provider activity. Providers self-reported after-hours documentation times. Two-sample t-tests were used for normally distributed data, and Wilcoxon rank-sum tests were used for skewed data. All tests were two-sided, and p-values < 0.05 were considered statistically significant.ResultsScribes decreased total documentation time both on shift (mean 55.3 vs. 36.4 min, p < 0.001) and post shift (mean 42.5 vs. 23.3 min, p = 0.038). They did not significantly decrease the amount of time spent reviewing the medical records or placing orders, nor did they have an impact on provider time spent at patients' bedside or time spent discussing patient care with team members.ConclusionThe presence of scribes decreased provider documentation time but did not change the amount of time spent at the bedside or communicating with other team members. Scribes may be a potential strategy to decrease the clerical burden.Copyright © 2018 Elsevier Inc. All rights reserved.

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