The impact of interruptions on clinical task completion
The impact of interruptions on clinical task completion
复制标题
DOI：
10.1136/qshc.2009.039255
复制
发表时间：
2010-08-01
影响因子：
--
通讯作者：
Tran, Cuong
中科院分区：
文献类型：
--
作者：
Westbrook, Johanna I.;Coiera, Enrico;Tran, Cuong
背景中断和多任务处理被认为是临床效率低下和错误的主要原因。目的：研究急诊医生中断率与任务完成时间和完成率之间的关系。方法：作者在一家拥有400张床位的教学医院急诊科进行了一项前瞻性观察时间和运动研究。40名医生（占医务人员的91%）在工作日观察了210.45小时。作者计算了任务时间（TOT）; TOT和中断之间的关系;以及工作任务类别中的时间比例。结果医生被打断的次数为6.6次/h。11%的任务被打断，3.3%不止一次。医生同时进行多项工作的时间占12.8%。平均TOT为1：26 min。中断与TOT显著增加相关。然而，当长度偏置抽样占，中断的任务，意外地完成在较短的时间比不间断的任务。医生未能返回到18.5%（95%CI 15.9%至21.1%）的中断tasks.Conclusions，它出现在忙碌中断驱动的临床环境中，临床医生减少他们花在临床任务上的时间，如果他们遇到中断，可能会延迟或无法返回到中断的任务的一个显着的部分。任务缩短可能是因为中断的任务被截断以“弥补”损失的时间，这可能对患者安全有重大影响。
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.