title: Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: A qualitative study.
abstract: OBJECTIVE
  Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.
  
  
  METHODS
  Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.
  
  
  RESULTS
  Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.
  
  
  CONCLUSIONS
  Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Emergency Medicine Solna, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. Electronic address: lena.berg@karolinska.se.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Berg
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Emergency Medicine, Falun Hospital, Falun, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Ann-Sofie
authors.initials: AS
authors.lastname: Källberg
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Ehrenberg
authors.affiliation: School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Florin
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Emergency Medicine Solna, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Östergren
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Emergency Medicine Solna, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: Therese
authors.initials: T
authors.lastname: Djärv
authors.affiliation: School of Biomedical Informatics/School of Nursing, University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Juliana J
authors.initials: JJ
authors.lastname: Brixey
authors.affiliation: Department of Medicine Solna, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Department of Emergency Medicine Solna, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
authors.forename: Katarina E
authors.initials: KE
authors.lastname: Göransson
mesh_terms: D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D009726:Nurses / Q000523:psychology*; D010465:Perception; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D013548:Sweden; D013647:Task Performance and Analysis; D016526:Workload / Q000592:standards*
keywords: Clinicians; Disturbance; Emergency care; Interruption; Non-disturbance; Patient safety risk; Physician; Recipient; Registered nurse; Work environment