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医学抄写员对皮肤科医生及患者满意度的影响。

Impact of medical scribes on physician and patient satisfaction in dermatology.

作者信息

Lam Charlene, Shumaker Kassidy, Butt Melissa, Leiphart Paul, Miller Jeffery J, Anderson Bryan E

机构信息

Department of Dermatology, The Milton S. Hershey Medical Center, 500 University Drive, HU 14, Hershey, PA, 17033, USA.

出版信息

Arch Dermatol Res. 2022 Jan;314(1):71-76. doi: 10.1007/s00403-021-02206-1. Epub 2021 Mar 8.

Abstract

Physician burnout and its association with the use of electronic health records (EHRs) is well known. The impact of scribes for academic dermatologists and their patients needs to be explored. As physician burnout increases, system-based solutions are needed. To assess the impact of a scribe on physician and patient satisfaction at an academic dermatology clinic. Prospective, pre-post-pilot intervention study. During the pilot intervention, clinicians had clinic sessions with and without a scribe. We assessed changes in (1) clinician satisfaction and burnout, (2) time spent on EHR, and (3) patient satisfaction. An electronic 7-item baseline survey, 23-item mid-study survey, and a 22-item end-of-study survey to assess clinician burnout and feedback on satisfaction with medical scribes. A 19-item post visit satisfaction survey was given to patients. EHR was queried to compare amount of time spent on EHR, closure of charts, and number of patients seen during scribe coverage and at baseline. Of the six clinicians, 100% felt that there was value to scribe support. Physician burnout was low at baseline and did not change post-pilot. Active documentation time, on average, decreased by 67% per patient with a 28% increase in patients seen per clinic. Over 88% of patients disagreed with the statement, "I was uncomfortable disclosing personal information when a scribe was present" (p < 0.001). In an academic dermatology and Mohs surgery setting, medical scribes increased clinician satisfaction without compromising patient satisfaction.

摘要

医生职业倦怠及其与电子健康记录(EHR)使用的关联是众所周知的。需要探讨速记员对学术皮肤科医生及其患者的影响。随着医生职业倦怠的增加,需要基于系统的解决方案。为了评估速记员对学术皮肤科诊所医生和患者满意度的影响。前瞻性、试点前-后干预研究。在试点干预期间,临床医生在有和没有速记员的情况下进行门诊。我们评估了以下方面的变化:(1)临床医生的满意度和职业倦怠;(2)在电子健康记录上花费的时间;(3)患者满意度。通过一项7项内容的电子基线调查、一项23项内容的研究中期调查和一项22项内容的研究结束调查来评估临床医生的职业倦怠以及对医疗速记员满意度的反馈。向患者发放了一份19项内容的就诊后满意度调查问卷。查询电子健康记录以比较在有速记员参与期间和基线时在电子健康记录上花费的时间、病历的完成情况以及看过的患者数量。在六位临床医生中,100%的人认为速记员的支持有价值。基线时医生职业倦怠较低,试点后没有变化。平均而言,每位患者的主动记录时间减少了67%,每个门诊看过的患者数量增加了28%。超过88%的患者不同意“当有速记员在场时,我对披露个人信息感到不舒服”这一说法(p < 0.001)。在学术皮肤科和莫氏手术环境中,医疗速记员提高了临床医生的满意度,同时不影响患者满意度。

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