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Emergency department workplace interruptions: are emergency physicians "interrupt-driven" and "multitasking"?
C D Chisholm1, E K Collison, D R Nelson
1Department of Emergency Medicine, Indiana University School of Medicine and Emergency Medicine and Trauma Center, Methodist Hospital, Clarian Health Partners, Indianapolis, IN 46202, USA. cchisholm@clarian.com
Summary
Emergency physicians experience frequent interruptions and task disruptions in the emergency department (ED). Higher patient volume correlates with more interruptions and breaks-in-tasks, impacting physician workflow.
Area of Science:
- Medical research
- Human factors engineering
- Healthcare management
Background:
- Interruptions in high-stakes professions like aviation can lead to critical errors.
- The impact of interruptions on emergency department (ED) workflow and physician performance is not well understood.
Purpose of the Study:
- To quantify the frequency and types of interruptions encountered by emergency physicians.
- To analyze the relationship between interruptions, breaks-in-task, and patient volume in the ED.
Main Methods:
- An observational, time-motion task-analysis study was conducted in three diverse ED settings.
- Emergency physicians were observed for 180-minute periods, recording tasks, interruptions, and breaks-in-task.
- Interruptions were defined as brief attention shifts, while breaks-in-task involved attention shifts >10 seconds leading to task changes.
Main Results:
- Physicians performed an average of 67.6 tasks per 180-minute period.
- A mean of 30.9 interruptions and 20.7 breaks-in-task occurred per observation period.
- Both interruptions and breaks-in-task significantly correlated with the number of patients being managed concurrently.
Conclusions:
- Emergency physicians operate in an "interrupt-driven" environment.
- Frequent interruptions and subsequent breaks-in-task are characteristic of ED physician work.
- Patient load is a key factor influencing interruption frequency and workflow disruption.