Interruptions in workflow for RNs in a Level One Trauma Center

Area of Science:

• Healthcare Management
• Clinical Workflow Analysis
• Patient Safety Research

Background:

• Interruptions significantly impact healthcare delivery, influencing health information systems, clinical workflow, and medical error rates.
• Systematic study of interruption outcomes (medical errors, decreased efficiency, increased cost) in healthcare lags behind other industries.

Purpose of the Study:

• To identify and classify the types of interruptions experienced by nurses in an Emergency Department (ED) at a Level One Trauma Center.
• To lay the groundwork for developing interventions to manage interruptions and enhance healthcare quality and patient safety.

Main Methods:

• An observational field study utilizing the shadowing method with Registered Nurses in a Level One Trauma Center's ED.
• Development of an ethnographic data collection technique and a data coding method for capturing and analyzing interruptions.

Main Results:

• Nurses in the ED were observed to be both recipients and initiators of interruptions.
• The most frequent sources of interruptions included telephones, pagers, and face-to-face conversations.
• Collected interruption data confirmed that interruptions are frequent events in critical care and other healthcare settings.

Conclusions:

• Interruptions are pervasive in ED settings, necessitating systematic study to understand their causes and effects.
• The developed data collection and analysis methods provide systematic, comprehensive data for further research.
• Future research will utilize this data to analyze workflow dynamics, identify information flow bottlenecks, and develop interventions to improve emergency care efficiency and patient safety.