Dissertation/Thesis Abstract

Increasing efficacy of emergency department through system analysis of enterprise architecture: Utilization of medical scribes
by Al-Adwan, Omar Yousef, D.Sc., The George Washington University, 2008, 168; 3320945
Abstract (Summary)

Crowding and patient wait time has been steadily increasing in Emergency Departments (ED’s) throughout the United States. A number of causes for these challenges have been identified including triage-MD time and dwell time (wait time after disposition). This research work done in analyzing one solution to this challenge, i.e. utilizing medical scribes to alleviate the time physicians spend transcribing their notes into patient electronic health records (EHR’s).

Although the role of medical scribes varies from physician to physician, the main duty of a scribe is to transcribe the physician’s notes into the patients EHR. To perform this duty the scribe often follows the physician into the treatment room gathering the physician’s notes and prescribed medical tests for the patient. The Scribe, one sort of technology component of an Information System or simply as technology themselves, has been employed in hospital emergency department since 1995. Scribes training covers medical experience within ED and the use of the Information System before they are hired. No previous studies have investigated the effects of adding scribes within ED.

The evaluation of the impact of scribes contained in this research takes advantage of a mixed methods approach including analysis of archival data, interviews with and observations of staff, scribes and physicians in an Emergency Department. The archival data used covered one full year of the Emergency Department’s operation.

Several important issues emerged from this evaluation. First, there is no simple measure of the impact of scribes on Emergency Departments. For example, one factor that increases the complexity of measuring the impact of scribes is the depth of and variety of their utilization by different physicians. This can be seen in the variance from vi i physician to physician in the increased number of patients seen when scribes are available. Second, this research reveals significant impact of scribes on the number of patients seen, 10.3% increase in the number of patients seen per hour. Physicians, nurses, and supporting staff indicated that Scribes have had a positive impact on the ED not only in entering patients’ documentation into the system, but also in helping and performing job functions and responsibilities in the ED.

Indexing (document details)
Advisor: Hamner, Marvine P.
Commitee: Eisner, Howard, Harrald, Jack, Shaw, Greg, Sikka, Neal
School: The George Washington University
Department: Engineering Mgt and Systems Engineering
School Location: United States -- District of Columbia
Source: DAI-B 69/08, Dissertation Abstracts International
Subjects: Systems science
Keywords: Emergency department, Enterprise architecture, Medical scribes
Publication Number: 3320945
ISBN: 978-0-549-74982-0
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