Physician, Interrupted: Workflow Interruptions and Patient Care in the Emergency Department

Renaldo C. Blocker, Heather A. Heaton, Katherine L. Forsyth, Hunter J. Hawthorne, Nibras El-Sherif, M. Fernanda Bellolio, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy, M. Susan Hallbeck

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background It is unclear how workflow interruptions impact emergency physicians at the point of care. Objectives Our study aimed to evaluate interruption characteristics experienced by academic emergency physicians. Methods This prospective, observational study collected interruptions during attending physician shifts. An interruption is defined as any break in performance of a human activity that briefly requires attention. One observer captured interruptions using a validated tablet PC-based tool that time stamped and categorized the data. Data collected included: 1) type, 2) priority of interruption to original task, and 3) physical location of the interruption. A Kruskal-Wallis H test compared interruption priority and duration. A chi-squared analysis examined the priority of interruptions in and outside of the patient rooms. Results A total of 2355 interruptions were identified across 210 clinical hours and 28 shifts (means = 84.1 interruptions per shift, standard deviation = 14.5; means = 11.21 interruptions per hour, standard deviation = 4.45). Physicians experienced face-to-face physician interruptions most frequently (26.0%), followed by face-to-face nurse communication (21.7%), and environment (20.8%). There was a statistically significant difference in interruption duration based on the interruption priority, χ2(2) = 643.98, p < 0.001, where durations increased as priority increased. Whereas medium/normal interruptions accounted for 53.6% of the total interruptions, 53% of the interruptions that occurred in the patient room (n = 162/308) were considered low priority (χ2 [2, n = 2355] = 78.43, p < 0.001). Conclusions Our study examined interruptions over entire provider shifts and identified patient rooms as high risk for low-priority interruptions. Targeting provider-centered interventions to patient rooms may aid in mitigating the impacts of interruptions on patient safety and enhancing clinical care.

Original languageEnglish (US)
Pages (from-to)798-804
Number of pages7
JournalJournal of Emergency Medicine
Issue number6
StatePublished - Dec 2017


  • human factors
  • interruptions
  • patient safety
  • workflow

ASJC Scopus subject areas

  • Emergency Medicine


Dive into the research topics of 'Physician, Interrupted: Workflow Interruptions and Patient Care in the Emergency Department'. Together they form a unique fingerprint.

Cite this