Dr. Peter Currie is a graduate of the University of Minnesota Medical School and completed his residency in emergency medicine at Hennepin County Medical Center in Minneapolis, MN. He joined the EPPA team in 2005 where he has held a number of leadership positions in addition to his ongoing medical practice including Quality Assistant and Assistant Medical Director at Unity Hospital. Dr. Currie sat down with us to discuss his most recent role is the Director of Quality for EPPA.
Q: Tell me about your role as the Director of Quality.
A: In my role as Director of Quality, I look after patient relations, quality projects, risk management, and continuing medical education for EPPA. Patient safety also falls in there; however our site medical directors are more responsible for the operational details of their sites relating to patient safety.
Q: What common issues and initiatives are you working with?
A: EPPA’s leadership team is working to standardize care around best practices to improve quality and reduce waste and harm. The Quality Department is building clinical guidelines on important and/or frequent Emergency Department presentations with this in mind.
Q: What quality variables do medical scribes effect?
Scribes have impacted the following areas: peer review (root cause analysis), patient complaints, and quality indicators. In that they play an important role in all of these areas because they produce most of our clinical documentation. Specifically, the EPPA Scribe Program has been particularly helpful when we have had to implement a particular documentation protocol to address an issue with safety or quality. Examples include documenting communication of test results to the patient as part of an action plan at one of our hospital sites.
Q: Where do medical scribes have the most significant impact with patient safety and quality of care?
A: Scribes facilitate providers by producing timely documentation that is accurate. Having notes done immediately makes hand-offs of care safer. Further, anything that allows the physician/APC to be in front of the patient rather than behind a computer is arguably beneficial to quality and productivity.
Q: Where can medical scribes create a problem with regards to safety and quality?
A: The biggest recurring issue I see related to scribes is the use of standardized phrasing/documentation. Everything in the electronic health record note has to be true and accurate and confirmed by the physician/APC who is responsible for the note. Anytime a dotphrase or other shortcut in documentation is used by a scribe but is not accurate or does not apply, it creates a problem. While we don’t expect a scribe to understand all the intricacies of medical care in the Emergency Department, common sense on the part of the scribe can eliminate many of these situations (“I discussed the plan of care with the patient” when the patient is six months old). Ultimately, the clinician is responsible for what is in the chart but whatever the scribe can do to reduce or eliminate these issues is important.