The nature of emergency department interruptions and their impact on patient satisfaction.
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.


CONCLUSIONS
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.
Jeanmonod
Rebecca
R
Department of Emergency Medicine, St Luke's Hospital and Health Network, Bethlehem, PA 18015, USA. rebeccajeanmonod@yahoo.com
Boyd
Molly
M
Loewenthal
Melanie
M
Triner
Wayne
W
D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D004635:Emergency Medicine / Q000193:education / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D007400:Interprofessional Relations; D008499:Medical Records; D015279:Organizational Culture; D017060:Patient Satisfaction; D018709:Statistics, Nonparametric; D013689:Telephone / Q000706:statistics & numerical data