May 20 2010 - A study from the University of Sydney published in Quality and Safety in Health Care found
that frequent interruptions experienced by hospital doctors result in less time and poorer care given to patients
and increase the potential for clinical error.
In an innovative study of the impact of such interruptions, researchers conducted a time and motion
study in the emergency department of a 400-bed teaching hospital, observing forty doctors during 210 hours of weekday
Researchers found that tasks interrupted for some reason (such as being asked a question by a colleague
while trying to write a prescription) and then completed tended to have less overall time spent on them. A single
interruption resulted in about half the time spent on a comparable uninterrupted task. The researchers speculate that
this reflects attempts to compensate for time lost dealing with the interruption.
The study found that, on average, doctors were interrupted 6.6 times an hour with 11 per cent of tasks
affected. Multi-tasking accounted for 12.8 per cent of doctors' time with an average of 1.26 minutes spent on each
task. The study found that in 18.5 per cent of cases, doctors failed to return to the original task after being
interrupted. Interruptions were most frequent during documentation (about 43 per cent) and direct and indirect
care (17 per cent and 19 per cent respectively). Doctors were least likely to be interrupted when involved in
professional communication (5 per cent) or social activities (2 per cent).
The researchers conclude:
"Our results support the hypothesis that the highly interruptive nature of busy clinical environments
may have a negative effect on patient safety. Task shortening may occur because interrupted tasks are truncated to
'catch up' for lost time, which may have significant implications for patient safety."
"The impact of interruptions on clinical task completion"
Johanna I Westbrook, Enrico Coiera, William T M Dunsmuir, Bruce M Brown, Norm Kelk, Richard Paoloni, Cuong Tran
Qual Saf Health Care qshc.2009.039255Published Online First: 12 May 2010 doi:10.1136/qshc.2009.039255