Medical scribes improve workflow in outpatient surgical setting

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The use of medical scribes had a positive impact on workflow in an outpatient surgical setting, increasing the number of patients seen and the level of resident involvement.

That’s among the findings from a pilot study presented this week at the 2019 American College of Surgeons Clinical Congress.

The study involved two attending surgeons at an outpatient surgical oncology practice at Loma Linda University Medical Center in California.

"While often employed by physicians in nonsurgical specialties, scribes are rarely seen in surgical outpatient clinics," observes lead author Sirivan Seng, MD, who is currently a resident physician at Crozer-Chester Medical Center in Upland, Pa.

"Our main finding was that medical scribes increased the number of patients seen per day and resident contact with patients in the clinic," says Seng, who—along with colleagues—reviewed outpatient clinic records and compared various metrics before and after medical scribes were introduced into the surgical practice.

Specifically, the average number of patients seen per day increased from 10 to 16. In addition, the study’s results showed that resident involvement in patient visits increased from 34 percent to 45 percent when assisted by a scribe.

"I think it's really important, from a resident perspective, that medical scribes become incorporated into the surgical practice,” adds Seng. “Not only does it benefit the attending physician, but it also benefits the resident and the patient.”

She concludes that the use of medical scribes “could be one of the great tools that enhances physician-patient encounters and improves surgeon workflow.”

While scribes in the study improved workflow, the average patient wait times for clinical encounters were similar without scribes—about 30 minutes. And although times to completion and closure of charts were shorter with scribes, it was not significant. In addition, there were no significant differences in medications prescribed, orders placed, cases scheduled or length of office visits.

Seng surmises that the reason the scribes did not lead to significant improvements in productivity may be because of the relatively small sample size—a total of 335 clinical encounters occurred in the study, 183 without scribes and 202 with scribes.

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