Print

Print


there are a few groups that will do the training for you.

we used one. i do not know their name but could get you in touch off  
list

don
On Jan 30, 2009, at 10:24 AM, Meta Carroll wrote:

> Hi Scott and Dave and all,
>
> I used Cerner and scribes with the excellent group Northwest Acute  
> Care Specialists who staff the EDs of  the Legacy Health System  
> (mothership: Emanuel Hospital and Emanuel Children's in Portland).
>
> Cerner was initially challenging for me, my first experience in an  
> electronic ED, but ultimately computerized physician order entry  
> (CPOE) became comfortable, and ease of data retrieval was a godsend.  
> CPOE is time intensive -- no individual order requires a great deal  
> of time -- but with each order it really adds up over entire shift.  
> This was facilitated by two things:
> 1) patient "caresets" created physicians, which is a list of orders  
> pertinent to a chief complaint or diagnosis, so that you click on  
> "abd pain" and have the list of orders ready for your check marks  
> (meds, nursing orders, labs, etc).
> 2) the use of scribes --  college-aged students with medical career  
> aspirations and solid science backgrounds, who follow you with  
> portable "computers on wheels" and hang on your every word,  
> completing 90+% of your electronic medical record (electronic T  
> chart was the one chosen for its breadth and depth and flexibility  
> within peds) while the patient is still in the ED.
>
> Downsides to scribe program:
> This is labor intensive in the recruiting and training phase. The  
> scribe has to learn medical language, then pediatric specific  
> language, as well as the electronic T chart. The latter was the  
> easiest for this millennial generation group of "kids", and many  
> became more facile with T system than the docs.
> The scribes are in transition in their education/career, so training  
> and bringing in new staff is an ongoing process.
>
> To summarize:
>
> Disadvantages to Cerner/CPOE
> 1) Time required for CPOE
> 2) When computers go down (unexpected failure or scheduled  
> "downtime") -- back to painful paper in a staff fully accustomed to  
> the efficiency of electronic, with resultant potential delays in  
> care delivery.
>
> Advantage to Cerner/CPOE
> 1) You don't have to waste time explaining to a secretary what test/ 
> film you want. Just order it.
> 2) Physician errors (particularly drug dosing) caught by computer. I  
> think this is huge.
>
> Disadvantages to Scribes:
> 1) Cost, time, effort, training investment
>
> Advantages to Scribes
> 1) Charting is done contemporaneous to care, more detailed and  
> accurate, and you're home post-shift about an hour earlier.
> 2) Having a "personal assistant" at your side telling you the CXR is  
> completed, the lab results are in, don't forget to call the primary,  
> etc is actually quite......luxurious.....especially for any brain  
> fatigued with multitasking at the end of a shift.
> 3) Well worth the investment, time, training, cost.
> 4) Gets your head out of the computer, allows you face time to talk  
> with/teach patients and family
> 5) They're young, eager-to-learn folks, enthusiastic about their  
> career path, who infuse energy in the workplace.
>
> Hope my thoughts, opinions are helpful
>
> Meta Carroll, MD
> Children's Memorial Hospital
> Northwest Community Hospital
> Chicago
>
> PS: I'm missin' my scribes, can you tell?
>
>
> On Jan 30, 2009, at 8:25 AM, David Ernst wrote:
>
>> Please leave replies online as interested in responses.  Thanks.
>>
>> Dave Ernst, MD
>>
>> -----Original Message-----
>> From: Pediatric Emergency Medicine Discussion List
>> [mailto:[log in to unmask]] On Behalf Of Scott Freedman
>> Sent: Friday, January 30, 2009 9:14 AM
>> To: [log in to unmask]
>> Subject: scribes in your ED
>>
>> We are evaluating many processes that could potentially positively  
>> impact
>> efficiency and throughput.  One I am keenly interested in is the  
>> use of
>> scribes. Is any department or group using  dedicated scribes and  
>> what has
>> been the experience?  We soon will be transitioning to Cerner EMR  
>> and I am
>> most interested to hear back from anyone who use scribes 1) with an  
>> EMR such
>> as Cerner and 2) with residents.
>> Feel free to respond directly to me so as to not cloud the listserv  
>> with
>> such a specific topic/ question.
>>
>> Thank you!!
>>
>> -- 
>> Scott H. Freedman, MD
>> Medical Director, Pediatric Emergency Medicine
>> MEP
>> (240) 826-7017
>>
>> For more information, send mail to [log in to unmask] with  
>> the
>> message: info PED-EM-L
>> The URL for the PED-EM-L Web Page is:
>>                 http://listserv.brown.edu/ped-em-l.html
>>
>> For more information, send mail to [log in to unmask] with  
>> the message: info PED-EM-L
>> The URL for the PED-EM-L Web Page is:
>>                 http://listserv.brown.edu/ped-em-l.html
>
> For more information, send mail to [log in to unmask] with  
> the message: info PED-EM-L
> The URL for the PED-EM-L Web Page is:
>                http://listserv.brown.edu/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
                 http://listserv.brown.edu/ped-em-l.html