Scribes in the ED
By nature, the Emergency Department is a fast-paced, high-volume environment. Emergency Physicians have long had to manage the cognitive burden of diagnosing and treating the ever varied cases that walk through their doors while simultaneously tracking these patients through the department, conferring with other staff-members, gathering pertinent labs and imaging results, reviewing previous medical records and all the while logging this into an EMR system. Because of the sheer volume and variety of tasks at hand, the ED is the ideal venue for medical scribe support.
Key metrics tracked in the Emergency Department are positively impacted by the implementation of scribes. Physicians will find that by offloading numerous time-consuming tasks to scribes, including charting, communicating with support staff, and tracking down ancillary medical data, their efficiency and productivity will see a significant improvement. As such, departments using MSC Medical Scribes will see a boost in patients treated per hour, an increase in provider generated RVU’s per hour, and decreases in wait-times and patients LWBS.
The dramatic improvement in job satisfaction that come as a direct result of working with a scribe bolsters physician retention by limiting burnout. Better still, in pay for performance models of care, the improvements in productivity afforded to physicians by using a scribe can more than completely offset their cost. To further the financial incentive of contracting scribe services, MSC is in the process of training our scribes to document billings according to ICD-10-CA standards. Not only will this further increase physician efficiency, but scribe managed billings have been demonstrated to result in increased revenue capture per ED document by decreasing downcodes.
To begin the implementation of an MSC Medical Scribe Program, an MSC representative will conduct a thorough needs assessment for the client in question’s practice and department. This process will identify and evaluate the site-specific needs that will be addressed as new medical scribe cohort is rolled out. EMR access and training integration, organization specific compliance measures and human resource trainings, and physician and administration information sessions will be coordinated as scribe candidate recruitment begins. At this time, a Scribe Manager will be assigned to your specific site in order to best accommodate and coordinate with the members of your group as implementation moves forward, and thereafter.
Hiring & Pre-Clinical Training
In the event that the location of the client’s emergency department is within a reasonable proximity to another established site, fully trained Medical Scribes from one location may be provided with site-specific training to suit the needs of the new site in question. This allows for an expedited implementation process, and defers the recruitment period to a time when deemed necessary. For Emergency Departments in new regions, standard MSC recruitment procedures will be used, as follows.
Through established connections with premedical departments of local postsecondary institutions and through partnerships with supporting government program, MSC will develop a deep applicant pool from which to select candidates according to it’s strict and extensive hiring procedures.
Applicants selected from this group will be invited to participate in a panel interview conducted by an MSC representative, a healthcare-site representative, and a member of the medical community. While not yet hired, those selected from the interview process will undergo preclinical training, beginning with MSC’s proprietary CAMELOT Medical Scribe Training Program, as well as mandatory training in patient confidentiality, infection prevention, patient management and workplace safety. Based on this training, prospective hires will be tested for their knowledge and competency, with those achieving the necessary passing grade on these tests will move on to the final stage of preclinical training in a classroom-based training and evaluation session. Upon completion of preclinical training, the new Medical Scribe in Training will be offered a probationary contract to last the duration of their clinical training period. Medical Scribes in Training will participate in a site orientation, as well as any other site-specific trainings and certifications mandated by the department or hospital as will have been organized following MSC’s initial site assessment.
Clinical Training & Upkeep
Ahead of scribe clinical training shifts, physicians will be offered brief and thorough resources demonstrating how best to make use of their new scribe. A senior Medical Scribe from an established MSC Emergency Department, who will go on to act as the Medical Scribe Supervisor for the duration of the department’s Scribe implementation clinical shifts, will scribe for the physicians who will first be using scribes on their shifts in order to accustom the physician. After the physician is accustomed to working with a scribe, the new Medical Scribe in Training will complete a minimum of 40 hours clinical training on shift, supervised by both a physician and the Medical Scribe Supervisor. Continuous evaluation and feedback are provided during this time. Once deemed able to work independently by both the Medical Scribe Supervisor and physician, the new hire be recognized as having completed their training and probationary period, and will be considered certified to work as an MSC Medical Scribe.
Depending on the size of the department and the number of physicians intending to trial a use of scribes, this process will be repeated concurrently with between 2 and 4 additional physicians and full-time Medical Scribes in training, allowing the department to carry on self-sufficiently. Once the first tier of full-time scribes have worked the requisite hours to be adequately experienced and adept, they themselves will undergo MSC training to become Medical Scribe Supervisors, allowing for them to supervise the clinical training of the remainder of their initial MSC cohort. As demand for scribe services within the department increases and begins to exceed MSC’s available capacity, this recruitment process begins anew, albeit with a site-trained supervisor from the outset.
Once in place, an MSC Medical Scribe program will provide coverage tailored to the specific needs of your department, 24 hours a day, 365 days a year, using only the most highly qualified scribes.