The association of workflow interruptions and hospital doctors' workload: a prospective observational study
The association of workflow interruptions and hospital doctors' workload: a prospective observational study
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DOI：
10.1136/bmjqs-2011-000188
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发表时间：
2012-05-01
影响因子：
5.4
通讯作者：
Sevdalis, N.
中科院分区：
文献类型：
--
作者：
Weigl, M.;Mueller, A.;Sevdalis, N.
背景：医护人员的主观工作量被认为对医疗服务的性能和安全性很重要。本研究调查工作流程中断和医院医生的能力，以管理他们的感知工作量在一个安全和有效的martens.Aim：要检查观察到的工作流程中断与医院医生的感知工作量的关系在白天clinical shifts.Methods：一项前瞻性研究，43个完整的轮班观察29名医生在内科和外科专科。通过使用先前验证的观察仪器进行观察，评估工作流程中断。医生评估他们的工作量两次在他们的白班使用三个项目的验证美国宇航局任务负荷指数（NASA-TLX;精神需求，努力，挫折感）。最常见的是护理人员、电话/传呼机中断和医生同事的中断。高级医生报告的工作量高于初级同事。总体工作流程中断与医生的工作量显著相关（beta=0.22; p=0.03）。进一步的分析表明，医生的工作量与特别是中断护理人员（β =0.23; p=0.03）。结论：频繁的工作流程中断可能与医生的工作量增加。医疗保健环境需要更好地设计，以减少不必要的中断和分心，使医院医生可以有效和安全地管理临床工作。
Background: Subjective workload in healthcare employees is suspected to be important for the performance and safety of healthcare delivery. This study investigates associations between workflow interruptions and hospital doctors' capability to manage their perceived workload in a safe and efficient manner.Aim: To examine the relationship of observed workflow interruptions with hospital doctors' perceived workload during day clinical shifts.Methods: A prospective study of 43 full shift observations with 29 doctors working in internal medicine and surgical specialties. Workflow interruptions were assessed via observation using a previously validated observation instrument. Doctors assessed their workload twice throughout their day shift using three items of the validated NASA-Task Load Index (NASA-TLX; mental demands, effort, frustration).Results: Hospital doctors were on average disrupted 3.66 times per hour. Most frequent were interruptions by nursing staff, telephone/beeper interruptions and by fellow doctors. Senior doctors reported higher workload than their junior colleagues. Overall workflow interruptions were significantly related to doctors' workload (beta=0.22; p=0.03). Further analyses revealed that doctors' workload was associated particularly with interruptions by nursing personnel (beta=0.23; p=0.03).Conclusions: Frequent workflow interruptions may be linked with increased workload in doctors. Healthcare environments need to be better designed to reduce unnecessary interruptions and distractions so that hospital doctors can manage clinical work efficiently and safely.