Paediatric resident workflow observations in a community-based hospital

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Workflow Analysis

Background:

• Physician training requires demonstrating competence in managing competing tasks and workflow interruptions for safe patient care.
• Understanding the nature and impact of interruptions is vital for optimizing resident performance and patient outcomes.

Purpose of the Study:

• To characterize and correlate interruptions in the workflow of paediatric residents at a community-based hospital.
• To identify factors influencing residents' ability to resume primary tasks after interruptions.

Main Methods:

• A pilot study involving direct observation of 18 paediatric residents using time-motion methodology.
• Data collection included recording activities, interruptions, and using the Multi-Tasking Ability Test (MTAT) and surveys.

Main Results:

• Residents experienced an average of 5.9 interruptions per hour, with 11% of primary tasks not resumed.
• Personal/social interruptions significantly decreased the likelihood of returning to a primary task within 5 minutes (OR 0.29).
• Interns showed lower efficiency on the MTAT compared to postgraduate year 2 residents, but MTAT scores did not correlate with task resumption time.

Conclusions:

• Frequent workflow interruptions are a common aspect of paediatric residency.
• Personal/social interruptions pose a greater risk for task abandonment than patient-related interruptions.
• Standardized curricula for interruption management and mitigation strategies are recommended for residency programs.