TF11 Emergency Department Scribes: A Two-Step Training Program

Heaton, Heather A.; Samuel, Robert; Farrell, Kyle; Colletti, James E.

doi:10.1016/j.annemergmed.2015.07.480

Cited by 9 publications

(3 citation statements)

References 0 publications

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“…19,22,38,44,45,[53][54][55][56][57][58][59][60][61] Most of the training programs described in the literature are divided into 2 phases: an initial didactic phase and an applied, "hands-on" phase. In the didactic phase, written or online tutorials, 45,53,62,63 quizzes, 56 and clinical simulations 20,25,40,42,44,46,47,54,57,58,62 are used to teach the trainee on clinical procedures, Healthcare Insurance Portability and Accountability Act compliance, medical terminologies, documentation structure, billing and coding processes, and use of clinical information systems such as EHRs. In the applied, "hands-on" phase, the trainee would shadow or practice scribing on real clinical shifts, sometimes with a senior scribe trainer who provides supervision and feedback.…”

Section: Training Certification and Managementmentioning

confidence: 99%

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How does medical scribes’ work inform development of speech-based clinical documentation technologies? A systematic review

Tran

Chen

Liu

et al. 2020

Journal of the American Medical Informatics Association

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Objective Use of medical scribes reduces clinician burnout by sharing the burden of clinical documentation. However, medical scribes are cost-prohibitive for most settings, prompting a growing interest in developing ambient, speech-based technologies capable of automatically generating clinical documentation based on patient–provider conversation. Through a systematic review, we aimed to develop a thorough understanding of the work performed by medical scribes in order to inform the design of such technologies. Materials and Methods Relevant articles retrieved by searching in multiple literature databases. We conducted the screening process following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) in guidelines, and then analyzed the data using qualitative methods to identify recurring themes. Results The literature search returned 854 results, 65 of which met the inclusion criteria. We found that there is significant variation in scribe expectations and responsibilities across healthcare organizations; scribes also frequently adapt their work based on the provider’s style and preferences. Further, scribes’ job extends far beyond capturing conversation in the exam room; they also actively interact with patients and the care team and integrate data from other sources such as prior charts and lab test results. Discussion The results of this study provide several implications for designing technologies that can generate clinical documentation based on naturalistic conversations taking place in the exam room. First, a one-size-fits-all solution will be unlikely to work because of the significant variation in scribe work. Second, technology designers need to be aware of the limited role that their solution can fulfill. Third, to produce comprehensive clinical documentation, such technologies will likely have to incorporate information beyond the exam room conversation. Finally, issues of patient consent and privacy have yet to be adequately addressed, which could become paramount barriers to implementing such technologies in realistic clinical settings. Conclusions Medical scribes perform complex and delicate work. Further research is needed to better understand their roles in a clinical setting in order to inform the development of speech-based clinical documentation technologies.

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Section: Training Certification and Managementmentioning

confidence: 99%

“…At times, scribes will be asked to leave the room (eg, while a sensitive clinical exam is being performed). 46,62 As mentioned previously, the provider may also interact with the scribe outside the exam room to add more information that was not specifically discussed during the encounter.…”

Section: Interactions With the Providermentioning

confidence: 99%

How does medical scribes’ work inform development of speech-based clinical documentation technologies? A systematic review

Tran

Chen

Liu

et al. 2020

Journal of the American Medical Informatics Association

View full text Add to dashboard Cite

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“…Their aim has been to reduce the time a physician spends documenting consultations into electronic medical records (EMRs). We know that scribes are well tolerated by patients [11,14,17,18] and physicians [14,17,19] and how to train scribes [2,20,21]. We don't have a good understanding of the quality of the scribed documentation.…”

Section: Background and Significancementioning

confidence: 99%

The 9-Item Physician Documentation Quality Instrument (PDQI-9) score is not useful in evaluating EMR (scribe) note quality in Emergency Medicine

Walker¹,

Wang²,

Dunlop³

et al. 2017

Appl Clin Inform

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SummaryBackground: Scribes are assisting Emergency Physicians by writing their electronic clinical notes at the bedside during consultations. They increase physician productivity and improve their working conditions. The quality of Emergency scribe notes is unevaluated and important to determine. Objective: The primary objective of the study was to determine if the quality of Emergency Department scribe notes was equivalent to physician only notes, using the Physician Documentation Quality Instrument, Nine-item tool (PDQI-9). Methods: This was a retrospective, observational study comparing 110 scribed to 110 non-scribed Emergency Physician notes written at Cabrini Emergency Department, Australia. Consultations during a randomised controlled trial of scribe/doctor productivity in 2016 were used. Emergency physicians and nurses rated randomly selected, blinded and de-identified notes, 2 raters per note. Comparisons were made between paired scribed and unscribed notes and between raters of each note. Characteristics of individual raters were examined. The ability of the tool to discriminate between good and poor notes was tested. Results: The PDQI-9 tool has significant issues. Individual items had good internal consistency (Cronbach's alpha=0.93), but there was very poor agreement between raters (Pearson's r=0.07, p=0.270). There were substantial differences in PDQI-9 scores allocated by each rater, with some giving typically lower scores than others, F(25,206)=1.93, p=0.007. The tool was unable to distinguish good from poor notes, F(3,34)=1.15, p=0.342. There was no difference in PDQI-9 score between scribed and non-scribed notes. Conclusions: The PDQI-9 documentation quality tool did not demonstrate reliability or validity in evaluating Emergency Medicine consultation notes. We found no evidence that scribed notes were of poorer quality than non-scribed notes, however Emergency scribe note quality has not yet been determined.

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