None listed
Conditions
Brief summary
There is a rising medical cost base in emergency medicine. There is a rising seniority of medical staff required to safely perform the role of physician in an emergency department. The currently accepted productivity of a FACEM is one patient per hour. Much of this time is spent writing and printing notes, faxing documents and contacting physicians. None of this work requires the skill set of an emergency physician and there is opportunity for work substitution, performed by a well-trained medical scribe or secretary. A pilot Cabrini ED study using an American trained and experienced scribe showed emergency physician productivity improvements of around 30%. A second larger Cabrini ED study, again using an American trained and experienced scribe showed variable improvements, overall an 18% productivity improvement (submitted for publication currently). There were no major safety/quality/risk issues with the use of these scribes. This offers emergency physicians the opportunity to increase productivity without compromising quality. The next step in using scribes is to establish whether it is possible to train local Australian scribes to perform the same role with the same level of competence as their USA counterparts and what the cost of this training will be.
Interventions
A scribe or scribes will be trained on a 25-30 hour web-based, American training program in August 2015 ("The ultimate medical scribe handbook and training course - Aaron Thompson"), followed by working as a trainee medical scribe at Cabrini Emergency Department with an Emergency Physician Trainer. They will take notes as directed and will assist the physician with clerical tasks as directed. Once they achieve competency they will work with an Emergency physician or physicians at Cabrini Emergen
A scribe or scribes will be trained on a 25-30 hour web-based, American training program in August 2015 ("The ultimate medical scribe handbook and training course - Aaron Thompson"), followed by working as a trainee medical scribe at Cabrini Emergency Department with an Emergency Physician Trainer. They will take notes as directed and will assist the physician with clerical tasks as directed. Once they achieve competency they will work with an Emergency physician or physicians at Cabrini Emergency Department. They will work with the trainer from September 1st 2015 to November 30th 2015 and with the physicians from December 1st 2015 to May 31st 2016.
Sponsors
Dr Katie Walker
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
20 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Patient encounters: All patients seen during scribed shifts and scribed patient encounters during the trial period including any where the scribe was supposed to be present but wasn't. If the scribe was asked to leave an encounter by the patient or physician the encounter will be included in the analysis. Scribe: The scribe/s enrolled to participate will be all those hired to train and work as scribes at Cabrini ED during the study period. Physicians: FACEMs working on a permanent full-time or part-time contract at Cabrini Emergency Department
Exclusion criteria
FACEMs unwilling to work with a scribe or unwilling to consent to the study FACEMs working less than 1 shift per week Primary investigator of the study
Outcome results
None listed