Abstract
BACKGROUND: Medical scribes have been widely employed as documentation assistants in emergency departments (EDs) and outpatient clinics to increase productivity and clinician satisfaction. Little data exists on the utilization of scribes in the field of hospital medicine. METHODS: We attempted to address a demand-capacity mismatch by pairing a medical scribe with a hospitalist physician performing serial admissions during a 12-hour shift. Performance of the clinician was measured by total encounters, documentation completeness, and Decision to Admit to First Order time. Return on investment (ROI) was calculated by comparing incremental revenue from additional admissions seen prior to midnight, improved documentation, and removal of additional admitting hours provided by a nurse practitioner, with incremental scribe cost. Clinician satisfaction surveys were administered before and after the pilot. RESULTS: Data collected over a 6-week period demonstrated improved clinician satisfaction, increased productivity, and a ROI. The participating clinicians reported more work capacity, less time spent on documentation, and more job satisfaction. The average number of admission encounters seen per shift increased by 37%. The average number of admission encounters seen before midnight increased by 88%. The Decision to Admit to First Order time fell by 23%. The total ROI was calculated at approximately 322%. CONCLUSIONS: Pairing a medical scribe with an admitting hospitalist physician led to increased clinician satisfaction, decreased burnout symptoms, and improved productivity. The financial value was demonstrated by a generous ROI. This study suggests that the pairing of a medical scribe with an admitting hospitalist physician can add significantly more value than expense. © 2022 The authors.
