Emergency Physician Use of Cognitive Strategies to Manage Interruptions - 01/11/17
, Allan Fong, MS a, Josh S. Puthumana, BA a, Aaron Z. Hettinger, MD, MS a, bAbstract |
Study objective |
The purpose of this study is to examine whether emergency physicians use strategies to manage interruptions during clinical work. Interruption management strategies include immediately engaging the interruption by discontinuing the current task and starting the interruption, continuing the current task while engaging the interruption, rejecting the interruption, or delaying the interruption.
Methods |
An observational time and motion study was conducted in 3 different urban, academic emergency departments with 18 attending emergency physicians. Each physician was observed for 2 hours, and the number of interruptions, source of interruptions, type of task being interrupted, and use of interruption management strategies were documented.
Results |
Participants were interrupted on average of 12.5 times per hour. The majority of interruptions were in person from other staff, including nurses, residents, and other attending physicians. When participants were interrupted, they were often working on their computer. Participants almost always immediately engaged the interruption task (75.4% of the time), followed by multitasking, in which the primary task was continued while the interrupting task was performed (22.2%). Physicians rejected or delayed interruptions less than 2% of the time.
Conclusion |
Our results suggest there is an opportunity to introduce emergency physicians to the use of interruption management strategies as a method of handling the frequent interruptions they are exposed to. Use of these strategies when high-risk primary tasks are performed may reduce the disruptiveness of some interruptions and improve patient safety.
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| Please see page 684 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Robert L. Wears, MD, PhD |
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| Author contributions: RR led the conceptual development of the study and data collection. AF, JP, and AZH participated in data analysis. AF and AZH participated in study design. All authors wrote the article. RR takes responsibility for the paper as a whole. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. This project was funded under contract/grant 1 R03 HS022362-01 from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services. |
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| The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the US Department of Health and Human Services. |
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| A podcast for this article is available at www.annemergmed.com. |
Vol 70 - N° 5
P. 683-687 - novembre 2017 Retour au numéro
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