Spreekuurassistent op poli Traumachirurgie

Objective

To measure the effects of a medical scribe in an orthopaedic trauma surgery outpatient clinic on consultation time, patient satisfaction, doctor satisfaction and costs.

Design

Cross-sectional study.

Method

At a level-1 trauma centre in the Netherlands, all standard outpatient trauma consultations were performed either with or without a medical scribe, for a period of 10 weeks. Length of consultation time was defined as the time from commencement of the consultation until the moment the electronic health record had been completely filled out and checked by the surgeon. Patient satisfaction was assessed using a validated questionnaire (PSQ-NL-18). Doctor satisfaction was assessed through a non-structured interview when the study ended in which doctors voiced their opinion on the cooperation with the medical scribe and the feasibility of employing medical scribes. Staffing costs of consultations were calculated by multiplying the gross salaries of surgeons and scribes (in €/min) and the consultation time (in minutes).

Results

A total of 151 patients were seen with the scribe, and 304 without the scribe. The mean consultation time was 3.2 minutes shorter in the study group compared with the control group (95% CI: 2.2-4.2). Patient satisfaction did not differ between the groups (mean PSQ-NL-18 total score: 4.4 (SD: 0.5) in the group with scribe and 4.3 (SD: 0.5) in the group without scribe (p = 0.45). The physicians felt they had more patient interaction and found working with the medical scribe satisfying. Mean staffing costs with the medical scribe (€19.35 per consultation, SD 10.4) were significantly lower than without (€21.82 per consultation, SD 11.3; p = 0.03). Annually, a cost reduction of €10,500 could be achieved in this outpatient clinic by the introduction of a medical scribe.

Conclusion

The use of a medical scribe for the documentation during a consultation in an outpatient clinic with a high patient turnover seems to increase doctor productivity and doctor satisfaction.

Conflict of interest and financial support: none declared.