Articles: emergency-services.
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This study's objectives were to determine the cost-effectiveness of introducing a transcription service into an emergency department (ED) and to determine the capacity of such a service to improve physician satisfaction. A prospective study of full-time emergency physicians was conducted in the ED of a community hospital in which a transcription service was introduced during peak periods of demand. Measurement was defined from a time-and-motion study consisting of direct observation by an industrial engineer who measured documentation time required for written and dictated charts. ⋯ When the records were transcribed, the mean subjective scores for satisfaction with the medical record improved from 2.1 to 3.6 (P = .0025) on a scale of 1 to 4. Surveys of nonemergency staff physicians documented that legibility score improved from 2.6 to 3.1 (P = .0056) and completeness improved from 2.6 to 3.0 (P = .0157), both on a scale of 1 to 4. It was concluded that dictating and transcribing ED medical records decreases the time required for documentation, improves record legibility and quality, allows more patients to be seen per physician-hour, and improves the satisfaction of emergency and nonemergency physicians.