TY - JOUR
T1 - The impact of interruptions on clinical task completion
AU - Westbrook, Johanna I.
AU - Coiera, Enrico
AU - Dunsmuir, William T M
AU - Brown, Bruce M.
AU - Kelk, Norm
AU - Paoloni, Richard
AU - Tran, Cuong
PY - 2010/8
Y1 - 2010/8
N2 - 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 lengthbiased 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.
AB - 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 lengthbiased 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.
UR - http://www.scopus.com/inward/record.url?scp=77956104849&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/nhmrc/568612
U2 - 10.1136/qshc.2009.039255
DO - 10.1136/qshc.2009.039255
M3 - Article
C2 - 20463369
AN - SCOPUS:77956104849
SN - 1475-3898
VL - 19
SP - 284
EP - 289
JO - Quality and Safety in Health Care
JF - Quality and Safety in Health Care
IS - 4
ER -