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Qual Saf Health Care. 2010 Aug;19(4):284-9. doi: 10.1136/qshc.2009.039255. Epub 2010 May 12.

The impact of interruptions on clinical task completion.

Author information

1
The University of Sydney, PO Box 170, Lidcombe, Sydney 1825, Australia. Johanna.westbrook@sydney.edu.au

Abstract

BACKGROUND:

Interruptions and multitasking are implicated as a major cause of clinical inefficiency and error.

OBJECTIVE:

The aim was to measure the association between emergency doctors' rates of interruption and task completion times and rates.

METHODS:

The authors conducted a prospective observational time and motion study in the emergency department of a 400-bed teaching hospital. Forty doctors (91% of medical staff) were observed for 210.45 h on weekdays. The authors calculated the time on task (TOT); the relationship between TOT and interruptions; and the proportion of time in work task categories. Length-biased sampling was controlled for.

RESULTS:

Doctors were interrupted 6.6 times/h. 11% of all tasks were interrupted, 3.3% more than once. Doctors multitasked for 12.8% of time. The mean TOT was 1:26 min. Interruptions were associated with a significant increase in TOT. However, when length-biased sampling was accounted for, interrupted tasks were unexpectedly completed in a shorter time than uninterrupted tasks. Doctors failed to return to 18.5% (95% CI 15.9% to 21.1%) of interrupted tasks.

CONCLUSIONS:

It appears that in busy interrupt-driven clinical environments, clinicians reduce the time they spend on clinical tasks if they experience interruptions, and may delay or fail to return to a significant portion of interrupted tasks. Task shortening may occur because interrupted tasks are truncated to 'catch up' for lost time, which may have significant implications for patient safety.

PMID:
20463369
DOI:
10.1136/qshc.2009.039255
[Indexed for MEDLINE]

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