Time Motion Analysis: Impact of Scribes on Provider Time Management

J Emerg Med. 2018 Jul;55(1):135-140. doi: 10.1016/j.jemermed.2018.04.018. Epub 2018 May 26.


Background: Scribes are unlicensed professionals trained in medical data entry. Limited data exist on the impact of scribes on provider time management in the emergency department (ED). Time-motion analysis is a tool utilized in business to capture detailed movements and durations to task completion. It offers a means to categorize how providers allocate their time during a clinical shift.

Objective: Evaluate the impact of scribes on how ED providers spend their time.

Methods: A prospective observational study was conducted to assess scribe impact on provider time utilization. Four research assistants (RAs) observed attending providers on 24 8-h control shifts (without a scribe), and 24 scribed shifts. RAs observed and categorized provider activity. Providers self-reported after-hours documentation times. Two-sample t-tests were used for normally distributed data, and Wilcoxon rank-sum tests were used for skewed data. All tests were two-sided, and p-values < 0.05 were considered statistically significant.

Results: Scribes decreased total documentation time both on shift (mean 55.3 vs. 36.4 min, p < 0.001) and post shift (mean 42.5 vs. 23.3 min, p = 0.038). They did not significantly decrease the amount of time spent reviewing the medical records or placing orders, nor did they have an impact on provider time spent at patients' bedside or time spent discussing patient care with team members.

Conclusion: The presence of scribes decreased provider documentation time but did not change the amount of time spent at the bedside or communicating with other team members. Scribes may be a potential strategy to decrease the clerical burden.

Keywords: clerical burden; electronic medical records; provider burnout; scribes.

Publication types

  • Observational Study

MeSH terms

  • Administrative Personnel / standards*
  • Administrative Personnel / statistics & numerical data*
  • Documentation / methods
  • Electronic Health Records / instrumentation
  • Electronic Health Records / statistics & numerical data
  • Emergency Service, Hospital / organization & administration
  • Emergency Service, Hospital / statistics & numerical data
  • Health Personnel / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data
  • Patient Satisfaction
  • Prospective Studies
  • Time Management / methods*
  • Time and Motion Studies