title: The effects of interruptions on oncologists' patient assessment and medication ordering practices.
abstract: Interruptions are causal factors in medication errors. Although researchers have assessed the nature and frequency of interruptions during medication administration, there has been little focus on understanding their effects during medication ordering. The goal of this research was to examine the nature, frequency, and impact of interruptions on oncologists' ordering practices. Direct observations were conducted at a Canadian cancer treatment facility to (1) document the nature, frequency, and timing of interruptions during medication ordering, and (2) quantify the use of coping mechanisms by oncologists. On average, oncologists were interrupted 17 % of their time, and were frequently interrupted during safety-critical stages of medication ordering. When confronted with interruptions, oncologists engaged/multitasked more often than resorting to deferring/blocking. While some interruptions are necessary forms of communication, efforts must be made to reduce unnecessary interruptions during safety-critical tasks, and to develop interventions that increase oncologists' resiliency to inevitable interruptions.
authors.affiliation: HumanEra, Techna, University Health Network, Toronto, Ontario, Canada. patricia.trbovich@uhn.ca
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Trbovich
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Griffin
authors.forename: Rachel E
authors.initials: RE
authors.lastname: White
authors.forename: Venetia
authors.initials: V
authors.lastname: Bourrier
authors.forename: Dhali
authors.initials: D
authors.lastname: Dhaliwal
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Easty
mesh_terms: D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D008495:Medical Oncology / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D009864:Ontario; D010808:Physical Examination / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013996:Time and Motion Studies; D057188:Workflow; D016526:Workload / Q000706:statistics & numerical data*