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[An analysis of the interruptions in general medicine consultations]
F Buitrago1, G Pozuelos, A Cumplido
1Centro de Salud La Paz, Unidad Docente de Medicina Familiar y Comunitaria de Badajoz.
Aim:
To find out the number and nature of the interruptions which occur in general medical consultations.
Design:
Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre).
Patients And Other Participants:
All the interruptions which occurred on the days chosen within the period of study were analysed.
Measurements And Main Results:
The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption.
Conclusions:
There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.