Objective To explore the nature of interruptions that occur during clinical practice in the emergency department (ED). We determined the frequency, duration and type of interruptions that occurred. We then determined the impact on patient satisfaction of those interruptions occurring at the bedside.
Methods This was a cohort study of ED physicians and physicians in training. Trained research associates were assigned to an individual provider during 4-hour blocks of time during day and evening shifts. The research associates recorded the activity that was interrupted, as well as the nature and the duration of the interruption. If the interruption occurred during the principal interaction with a patient, the patient's satisfaction score was recorded on a 10-point scale.
Results Physicians were commonly interrupted in all clinical activities, but most frequently during reviewing of data (53%) and charting (50%). Bedside interruptions occurred 26% of the time, and had a negative impact on patient satisfaction. The majority of interruptions (60%) were initiated by another healthcare provider (physician or nurse). Interruptions only rarely resulted in a physician changing tasks before completion.
Conclusion Interruptions occur commonly during all clinical activities in the ED, and are frequently generated by providers themselves. These have a negative impact on patient satisfaction. The direct impact on medical errors or on provider satisfaction has not been determined.
- patient satisfaction
- quality assurance
- anaesthesia, general
- emergency care systems, emergency departments
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Presented at ACEP Scientific Assembly, October 2008, Chicago, Illinois.
Presented at NY ACEP Scientific Assembly, July, 2007, Lake George, New York.
Competing interests None.
Ethics approval This study was conducted with the approval of the institutional review board of the site where the study occurred.
Provenance and peer review Not commissioned; externally peer reviewed.