title: Effects of the no interruption zone on distraction levels, withdrawal times, and adenoma detection rates of colonoscopy.
abstract: BACKGROUND
  The creation of no interruption zones (NIZs) reduces medical errors by reducing distraction levels on hospital wards. To date, the effect of a NIZ during colonoscopy has not been evaluated.
  
  
  OBJECTIVE
  Assess the effects of a NIZ during colonoscopy, on distraction levels, withdrawal times, and adenoma detection rates (ADRs).
  
  
  METHODS
  This was a non-randomized prospective study of screening colonoscopies at a teaching hospital. The intervention, a NIZ, was created by limiting conversations to the care of the patient undergoing the procedure and posting a "do not disturb" sign during the withdrawal phase of colonoscopy. Distraction levels, withdrawal times, and ADRs were analyzed at baseline and after the NIZ.
  
  
  RESULTS
  The implementation of the NIZ leads to a significant reduction of high-distraction-level environments (13.1 vs. 5.1 %; p < 0.0001). There was a significant decrease in withdrawal time with NIZs; (10.6 vs. 9.9 min, p = 0.0038). There was no significant difference in ADRs (38 % baseline vs. 36 % NIZs, respectively; p = 0.33).
  
  
  CONCLUSIONS
  Creation of a NIZ was associated with a significant decrease in high-distraction environments and shorter withdrawal times with no significant change in ADRs. Further studies are needed to evaluate whether lower distraction levels in an endoscopy suite translate to improved quality measures.
authors.affiliation: Baylor Scott and White Healthcare, 2401 South 31st Street, Temple, TX, 76502, USA.
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Behazin
authors.forename: Michelle
authors.initials: M
authors.lastname: Thompson
authors.forename: Mena
authors.initials: M
authors.lastname: Milad
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hart
authors.forename: Juhee
authors.initials: J
authors.lastname: Song
authors.forename: Mark
authors.initials: M
authors.lastname: Jeffries
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Sears
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000368:Aged; D001288:Attention; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy / Q000523:psychology / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D005762:Gastroenterology / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies