title: Describing interruptions, multi-tasking and task-switching in community pharmacy: a qualitative study in England.
abstract: BACKGROUND
  There is growing evidence around interruptions, multi-tasking and task-switching in the community pharmacy setting. There is also evidence to suggest some of these practices may be associated with dispensing errors. Up to date, qualitative research on this subject is limited.
  
  
  OBJECTIVE
  To explore interruptions, multi-tasking and task-switching in the community setting; utilising an ethnographic approach to provide a detailed description of the circumstances surrounding such practices.Setting Community pharmacies in England, July-October 2011.
  
  
  METHODS
  An ethnographic approach was taken. Non participant, unstructured observations were utilised to make records of pharmacists' every activity. Case studies were formed by combining field notes with detailed information on pharmacists and their respective pharmacy businesses. Content analysis was undertaken both manually and electronically, using NVivo 10. Main outcome measure To determine the factors influencing interruptions, multitasking and task-switching in the community pharmacy setting.
  
  
  RESULTS
  Response rate was 12 % (n = 11). Over fifteen days, a total of 123 h and 58 min of observations were recorded in 11 separate pharmacies of 11 individual pharmacists. The sample was evenly split by gender (female n = 6; male n = 5) and pharmacy ownership (independent n = 5; multiple n = 6). Employment statuses included employee pharmacists (n = 6), owners (n = 4) and a locum (n = 1). Average period of registration as a pharmacist was 19 years (range 5-39 years). Average prescription busyness of pharmacies ranged from 2600 to 24,000 items dispensed per month. All observed pharmacists' work was dominated by interruptions, task-switches, distractions and multi-tasking, often to manage a barrage of conflicting demands. These practices were observed to be part of a deep-rooted culture in the community setting. In particular, support staff regularly contributed to interruptions and distractions for pharmacists; pharmacists in turn continued to permit these. Novel directional work maps illustrated the extent and direction of task-switching and multi-tasking employed by pharmacists.
  
  
  CONCLUSIONS
  In this study pharmacists' working practices were permeated by interruptions, distractions and multi-tasking. Task-switching was also frequently employed by pharmacists. Changes to working practices by both pharmacists and support staff would help to minimise these which in turn has the potential to lead to safer and more efficient methods of working.
authors.affiliation: Medway School of Pharmacy, Chatham, Kent, ME4 4TB, UK. vl36@kent.ac.uk.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Lea
authors.affiliation: Medway School of Pharmacy, Chatham, Kent, ME4 4TB, UK.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Corlett
authors.affiliation: Medway School of Pharmacy, Chatham, Kent, ME4 4TB, UK.
authors.forename: Ruth M
authors.initials: RM
authors.lastname: Rodgers
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D019370:Observation; D010067:Ownership; D010595:Pharmacists; D010865:Pilot Projects; D011364:Professional Practice; D024382:Professional Role; D013647:Task Performance and Analysis; D014937:Work
keywords: Community pharmacy; England; Interruptions; Multi-tasking; Observations; Task-switching