• Peter S Graves, Stephen R Graves, Tanvir Minhas, Rebecca E Lewinson, Isabelle A Vallerand, and Ryan T Lewinson.
• Department of Emergency Medicine (P. Graves), Queensway- Carleton Hospital; Faculty of Medicine (P. Graves, Minhas), University of Ottawa; Medical Scribes of Canada (P. Graves, S. Graves, Minhas, R.E. Lewinson), Ottawa, Ont.; Faculty of Health (R.E. Lewinson), York University, Toronto, Ont.; Cumming School of Medicine (Vallerand, R.T. Lewinson), University of Calgary, Calgary, Alta. pgraves@mediscribecanada.ca.
• CMAJ Open. 2018 Jul 1; 6 (3): E360-E364.

BackgroundEmergency department efficiency is a priority across Canada. In the United States, scribes may increase the number of patients seen per hour per physician; however, Canadian data are lacking. We sought to implement scribes in a Canadian emergency department with the hypothesis that scribes would increase the number of patients seen per hour per physician.MethodsWe conducted a 4-month quality improvement pilot study in a community emergency department in Ottawa, Ontario. Data collection began January 2015 after scribe training. Physicians received shifts with and without a scribe for a period of 4 months. Across the study, the mean number of patients seen per hour was determined for each physician during shifts with and without a scribe. We compared mean (± standard deviation [SD]) number of patients seen per hour based on presence or absence of a scribe by 2-tailed paired-samples t test.ResultsEleven scribes participated and ranged in age from 18 to 23 years. Twenty-two full- or part-time emergency physicians were followed. We documented 463 physician-hours without use of a scribe and 693.75 physician-hours with use of a scribe. Across all 22 physicians, 18 (81.8%) saw more patients per hour with use of a scribe. Overall, the number of patients seen per hour per physician was significantly greater (+12.9%) during shifts with a scribe (mean [± SD] 2.81 [± 0.78]) than during shifts without a scribe (mean [± SD] 2.49 [± 0.60]; p = 0.006).InterpretationIn this pilot study, the use of scribes resulted in an increased number of patients seen per hour per physician. Because this was a small study at a single centre, further research on the effects of scribes in Canada is warranted.Copyright 2018, Joule Inc. or its licensors.

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