7-2 Final Project

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Southern New Hampshire University *

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BUS 210

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Medicine

Date

Jan 9, 2024

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docx

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5

Uploaded by ColonelDonkey3482

7-2 Final Project Submission: Article Analysis The purpose of the study is to assess how scribes affect how emergency department staff members use their time. The study aims to understand how the presence of scribes influences the time allocation of ED providers during their clinical shifts. The research question in this study is, "How do scribes affect the time management of ED providers, specifically in terms of time spent on tasks such as documentation, patient interaction, and communication with team members?” With less time spent on documentation tasks, the presence of scribes in the ED will help healthcare providers manage their time more effectively, potentially reducing the administrative burden. The underlying. The hypothesis of the study is that the presence of scribes will lead to a reduction in the time spent on documentation tasks during the clinical shift. The study anticipates that scribes will assist in documenting patient history and examinations, thereby allowing providers to spend less time on clerical tasks. The design of the study is a prospective observational study. It involves collecting data by directly observing attending ED providers during their clinical shifts in an ED setting. The study compares the time allocation of providers during shifts with scribes to those without scribes, aiming to quantify the impact of scribes on provider time management. The data collected is analyzed to draw conclusions about the effect of scribes on various aspects of provider time utilization. The method of data collection in the study involves direct observation by research assistants (RAs). The RAs observed attending providers during their shifts, categorizing, and recording the provider's activities. They also collected self-reported data on after-hours documentation times from the ED providers. The data collection method is appropriate for addressing the research question and objectives of the study, which involve assessing how the presence of scribes impacts the time allocation of ED providers during clinical shifts. By directly observing ED provider activities and collecting self-reported documentation times, the study can gather detailed information on
how time is spent. Using self-reported data for after-hours documentation times is a weakness of the data collection method used in this study. The possibility of recall bias or inaccurate reported times is now present. The study's sample size was small (24 shifts with scribes and 24 shifts without scribes), and it was carried out in a single academic ED. This small sample size might not accurately reflect the range of provider experiences across different ED settings. The type of data collected is quantitative data. This data includes numerical values that depict the amount of time emergency room staff spends on various activities, such as interacting with the electronic health record, spending time with patients in bed, and staff meetings. For the purposes of the study's goals and analysis, it quantifies how time is distributed during clinical shifts. The method of data analysis used in the study involves various statistical tests, including two- sample t-tests and Wilcoxon rank-sum tests, to compare the quantitative data collected from shifts with scribes and shifts without scribes. “All tests were two-sided, and p-values < 0.05 were considered statistically significant “(Heaton et al, 2018). The tests are used to see if there are statistically significant variations in how time is divided up when scribes are present. The data analysis method is appropriateness for this study because it aligns with the study's objectives, which involve comparing and quantifying the impact of scribes on provider time management. By using statistical tests, the study can determine whether the observed differences are significant or could have occurred by chance. The Advantages of the Data Analysis Method which is the use of statistical tests adds rigor to the analysis and allows for the quantification of differences. This enhances the reliability of the study's conclusions. Also, statistical tests provide an objective way to compare the data from shifts with and without scribes, reducing the potential for bias. The Disadvantages of the Data Analysis Method main one is assumptions, some statistical tests, such as t-tests, rely on assumptions about data distribution, which may not
always hold true. In such cases, the results can be less dependable and limited to Quantitative Data. Weaknesses of the Data Analysis Method, The study's sample size is relatively small, 24 shifts with scribes and 24 shifts without scribes which can limit the generalizability of the findings and the power of statistical tests and the study was conducted in a single academic ED, which may limit the generalizability of the results to other healthcare settings with different patient populations and workflows. The key demographics are the attending ED providers on a 24 8-hour control shifts both with and without scribes and the research assistants observing and organizing the providers activity. After-hours documentation times were self-reported by ED providers. Statistically significant results indicate that the observed differences in time allocation were unlikely to have occurred by random chance. In this study, the presence of scribes was found to have statistically significant impacts on provider time management in certain aspects, such as documentation time. The study has several differences in the groups with scribes and without scribes. Scribes significantly decreased total documentation time both on shift and post-shift. Scribes did not significantly decrease the time spent reviewing medical records or placing orders. Scribes did not have a significant impact on provider time spent at the patient's bedside or time spent discussing patient care with team members. These differences suggest that the presence of scribes influenced how providers allocated their time during clinical shifts, particularly regarding documentation time. Limitations of the study includes a small sample of 24 8-hour shifts with scribes and 24 8-hour shifts without scribes. This limited sample size may not fully represent the diversity of ED providers, and the findings may not be generalizable to all ED settings. The small sample size can also limit the power of statistical analyses and may not detect subtle effects or interactions.
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