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Trial registered on ANZCTR
Registration number
ACTRN12616000308493
Ethics application status
Approved
Date submitted
3/03/2016
Date registered
9/03/2016
Date last updated
9/06/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Patient experiences of and attitudes regarding medical scribes in an Australian Emergency Department
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Scientific title
Patient experiences of and attitudes regarding medical scribes in an Australian Emergency Department
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Secondary ID [1]
288382
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None
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Universal Trial Number (UTN)
U1111-1178-7798
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Trial acronym
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Linked study record
ACTRN12616000223437
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Health condition
Health condition(s) or problem(s) studied:
medical scribes - patient responses to their presence during emergency medicine consultations
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Condition category
Condition code
Public Health
297814
297814
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0
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Health service research
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Medical scribes are being used during consultations in emergency departments at Cabrini Emergency Department during a study on the economics and utility of medical scribes in Australian Emergency Departments (September 2015-September 2016, ACTRN12615000607572).
A medical scribe is a personal assistant to the emergency physician who stands near the physician during consultations documenting the consultation and arranging tests, consultations and hospital beds as required. They use a computer-on-wheels connected to the hospital electronic medical record.
This study will administer a survey to patients or their representatives, seeking to determine their thoughts and attitudes towards the scribe being in the room and assisting with the consultation. It will be administered to the patient/representative on a single occasion only, whilst the patient is in the Emergency Department
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Intervention code [1]
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Not applicable
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Comparator / control treatment
The controls will be patients who attend the Emergency Department during the same time periods who don't have a medical scribe allocated to their doctor that visit.
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Control group
Active
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Outcomes
Primary outcome [1]
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Net promoter score for the ED visit/consultation as a measure of patient satisfaction - provided by the patient/representative
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Assessment method [1]
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Timepoint [1]
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April 2016 to September 2016, during the ED visit
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Secondary outcome [1]
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Patient's general satisfaction with the consultation while a scribe is present in the room during a consultation, with items taken from the Press Ganey survey, overall satisfaction with consultation questions
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Assessment method [1]
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Timepoint [1]
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April 2016 to September 2016, whilst the patient is in the Emergency Department
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Secondary outcome [2]
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Patient's self-reported ability to give the physician personal medical information with the scribe in the room, measured by survey questions, measured on a 5 point Likert scale, completed by the patient or their representative
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Assessment method [2]
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Timepoint [2]
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April 2016 to September 2016, whilst the patient is in the Emergency Department
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Secondary outcome [3]
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Patients' tolerance of the scribe being present in the room during a medical physical examination, measured by survey questions, measured on a 5 point Likert scale, completed by the patient or their representative
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Assessment method [3]
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Timepoint [3]
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April 2016 to September 2016, whilst the patient is in the Emergency Department
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Secondary outcome [4]
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Patients' ability to tolerate the increased crowding in the room during a consultation with the medical scribe in the room, measured by survey questions, measured on a 5 point Likert scale, completed by the patient or their representative
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Assessment method [4]
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Timepoint [4]
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April 2016 to September 2016, whilst the patient is in the Emergency Department
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Secondary outcome [5]
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Patients' views on the perceived professionalism of the physician whilst the scribe is present for the consultation, measured by survey questions, measured on a 5 point Likert scale, completed by the patient or their representative
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Assessment method [5]
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Timepoint [5]
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April 2016 to September 2016, whilst the patient is in the Emergency Department
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Eligibility
Key inclusion criteria
Patient attending Cabrini Emergency Department between April 2016 and September 2016
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who decline to participate/give consent to the study
Patients who are unable to communicate in written English who do not have an advocate/friend/family member attending who can fill in the survey and give consent on their behalf
Patients who are at risk of spreading infection to research staff
Patients who are immunocompromised and for whom contact with research staff poses a risk
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Study design
Purpose
Psychosocial
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Prospective
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Statistical methods / analysis
Press Ganey patient net-promoter scores relating to Cabrini ED became available mid study to us from 2015.
We used a non-inferiority calculation with a clinically important drop in net promotor score being thought to be 10% - a small informal survey of our hospital administrators indicated that a scribe program would be at risk even if scribes provided strong economic gains if there was a more than 10% drop in net-promotor score.
We used the net promoter score and the 2015 data was as follows:
The proportion of ‘net promoters’ is 92% and non-inferiority is defined as no more than 10% less than this (i.e., 82%), the number of patient interviews is set out -
92 cases: 92 controls - balanced groups
69 cases: 104 controls - 1:2 ratio
We opted to recruit 92 patients to each group
Secondary outcomes: descriptive and qualitative analysis based on 5-point Likert scores and free-text responses.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2016
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Actual
7/05/2016
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Date of last participant enrolment
Anticipated
30/09/2016
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Actual
31/05/2016
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Date of last data collection
Anticipated
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Actual
31/05/2016
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Sample size
Target
184
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Accrual to date
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Final
213
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Cabrini Hospital - Malvern - Malvern
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Recruitment postcode(s) [1]
12732
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3144 - Malvern
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Mr Lachlan Hegarty
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Address [1]
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Emergency Department
Cabrini
184 Wattletree Rd
Malvern
3144
VIC
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Country [1]
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Australia
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Equity Trustees on behalf of donors
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Address [2]
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level 2, 575 Bourke St
Melbourne
3000
VIC
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Country [2]
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Australia
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Funding source category [3]
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Charities/Societies/Foundations
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Name [3]
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Cabrini Foundation
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Address [3]
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Cabrini
184 Wattletree Rd
Malvern
3144
VIC
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Country [3]
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Australia
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Primary sponsor type
Individual
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Name
Dr Katherine Walker
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Address
Emergency Department
Cabrini
184 Wattletree Rd
Malvern
3144
VIC
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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na
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Address [1]
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na
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Country [1]
291624
0
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Margaret Staples
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Address [1]
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Cabrini Institute
184 Wattletree Rd
Malvern
3144
VIC
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Country [1]
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Will Dunlop
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Address [2]
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Emergency Department
Cabrini
184 Wattletree Rd
Malvern
3144
VIC
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Country [2]
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Michael Ben-Meir
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Address [3]
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Emergency Department
Cabrini
184 Wattletree Rd
Malvern
3144
VIC
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Michele Levinson
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Address [4]
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Department of Medicine
Cabrini Institute
184 Wattletree Rd
Malvern
3144
VIC
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Country [4]
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Australia
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Other collaborator category [5]
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Individual
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Name [5]
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Madeline Collings
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Address [5]
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Cabrini Emergency Department
183 Wattletree Rd
Malvern
VIC
3144
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Country [5]
279083
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Cabrini HREC
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Ethics committee address [1]
294383
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Cabrini Institute 154 Wattletree Rd Malvern 3144 VIC
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Ethics committee country [1]
294383
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Australia
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Date submitted for ethics approval [1]
294383
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10/03/2016
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Approval date [1]
294383
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02/05/2016
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Ethics approval number [1]
294383
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CHREC 02-06-06-16
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Summary
Brief summary
This study is a pilot observational study, conducting a cross-sectional survey on patient attitudes and satisfaction with medical consultations whilst a medical scribe is present during an Emergency Medicine consultation. It will use a convenience sample of all patients attending Cabrini ED between the dates of April 2016 to September 2016 (the period of time there is a study being undertaken on the economics of using medical scribes at Cabrini Emergency Department). It will commence once ethics approval is obtained from Cabrini HREC. It will use a survey developed specifically for the purpose. Items will relate to patient satisfaction with the consultation and patient satisfaction with various components of the consultation. It will also include a net promoter score for the Emergency Department. It will compare consultations with scribes to consultations without scribes during the same time period using the same group of physicians and the same investigation site. Medical scribes are an emerging role in health. Their numbers are rapidly expanding. Research to date has focused on the economics of their use. There is a need for health administrators and emergency doctors to understand their potential impact on the patient during consultations and this exploratory work should assist with directing future work and guiding administrators and doctors on whether and how to utilise scribes in the future.
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Trial website
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Trial related presentations / publications
Publication: Dunlop, W., Hegarty, L., Staples, M., Levinson, M., Ben-Meir, M. and Walker, K. (2017) Medical scribes have no impact on the patient experience of an emergency department. Emergency Medicine Australasia 10.1111/1742-6723.12818 Presentation: Dunlop, W., Hegarty, L. (2016) Medical scribes have no detrimental effect on patient comfort or satisfaction during emergency consultations. ACEM Annual Scientific Meeting, Queenstown
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Public notes
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Attachments [1]
877
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/AnzctrAttachments/369972-CHREC 02-06-06-16.pdf
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Contacts
Principal investigator
Name
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Mr Lachlan James Philip Hegarty
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Address
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
3144
VIC
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Country
62946
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Australia
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Phone
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+61418188037
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Fax
62946
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Email
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[email protected]
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Contact person for public queries
Name
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Katie Walker
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Address
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
3144
VIC
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Country
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Australia
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Phone
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+61431272262
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Lachlan Heagrty
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Address
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Emergency Department
Cabrini
183 Wattletree Rd
Malvern
3144
VIC
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Country
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Australia
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Phone
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+61418188037
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Fax
62948
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF