Measuring Workflow Interruptions in Endoscopy: Development and Interrater Reliability of a Structured Observation...

Area of Science:

• Medical procedure observation
• Healthcare workflow analysis
• Patient safety research

Background:

• Workflow interruptions are frequent in procedural medicine, potentially increasing cognitive load, stress, and errors.
• While studied in surgery, workflow interruptions in endoscopy are less understood.
• Objective evaluation necessitates a reliable measurement tool.

Purpose of the Study:

• To develop a structured observation tool for recording workflow interruptions during endoscopic procedures.
• To evaluate the interrater reliability of this novel measurement tool.

Main Methods:

• A tally-based observation tool was iteratively developed, categorizing interruptions into predefined domains.
• Three trained observers calibrated and simultaneously observed a subset of endoscopic procedures.
• Interrater reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis.

Main Results:

• Excellent interrater reliability for total interruptions was found (ICC 0.995 for both observer pairs).
• Reliability across interruption domains was good to excellent.
• Bland-Altman analysis showed minimal bias and narrow limits of agreement.

Conclusions:

• A structured tally-based observation tool reliably measures workflow interruptions in endoscopy.
• This instrument offers a standardized framework for future research on endoscopic workflow processes.
• The tool supports the development of targeted interventions to improve endoscopic procedures.