title: An ED scribe program is able to improve throughput time and patient satisfaction.
abstract: BACKGROUND
  At our institution, we previously described the detrimental effect of computerized physician order entry (CPOE) on throughput time and patient satisfaction (Ann of Emer Med, Vol 56, P S83-S84). To address these quality metrics, we conducted a pilot program using scribes in the emergency department (ED).
  
  
  METHODS
  We conducted a before-and-after study of ED throughput at our 320-bed suburban community hospital with a census of 70000 annual visits. Our primary outcome measure was the effect of scribes on ED throughput as measured by the effect on (1) door-to-room time; (2) room-to-doc time; (3) door-to-doc time; (4) doc-to-dispo time; and (5) length of stay for discharged/admitted patients, between pre-CPOE and post-CPOE cohorts. Our secondary outcome measure was patient satisfaction as provided by Press Ganey surveys. Data were analyzed using descriptive statistics, and means were compared using a standard t test.
  
  
  RESULTS
  Patient data from a total of 11729 patients in the before cohort were compared with data from 12609 patients in the after cohort. Despite a 7.5 % increase in volume between the post-CPOE and post-scribe cohorts, all throughput metrics improved in the post-scribe cohort. This process improved the overall door-to-doc time to 61 minutes in the after cohort from 74 minutes in the before cohort. Furthermore, patient and physician satisfaction was improved from the 58th and 62nd percentile to 75th and 92nd percentile, respectively.
authors.affiliation: Department of Emergency Medicine, Beaumont Heath Systems-Troy, Troy, MI, USA. Electronic address: abastani@beaumont.edu.
authors.forename: Aveh
authors.initials: A
authors.lastname: Bastani
authors.affiliation: Department of Emergency Medicine, Beaumont Heath Systems-Troy, Troy, MI, USA.
authors.forename: Blerina
authors.initials: B
authors.lastname: Shaqiri
authors.affiliation: Department of Emergency Medicine, Beaumont Heath Systems-Troy, Troy, MI, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Palomba
authors.affiliation: Department of Management Engineering, Beaumont Heath Systems-Troy, Troy, MI, USA.
authors.forename: Dominic
authors.initials: D
authors.lastname: Bananno
authors.affiliation: Department of Emergency Medicine, Beaumont Heath Systems-Troy, Troy, MI, USA.
authors.forename: William
authors.initials: W
authors.lastname: Anderson
mesh_terms: D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D050316:Medical Order Entry Systems; D008502:Medical Secretaries; D017060:Patient Satisfaction; D010865:Pilot Projects; D013997:Time Factors