Task interruptions from the perspective of work functions: The development of an observational tool applied to inpatient hospital care in France The Team'IT tool.

Abstract

In France, hospital units responsible for providing inpatient care have few opportunities to address the issue of task interruptions. In Australia, the Dual Perspectives Method (DMP) has been developed to assess interruptions. The method makes it possible to link teamwork and interruptions, by considering the work functions that constitute the system. To develop a tool that can characterize interruptions from the point of view of work functions that is tailored to French hospital units providing inpatient care. The aim was to adapt the items recorded using the DPM and their response categories, and to study the acceptability of observing interruptions for participating teams. The items recorded in the DPM were translated and adapted taking into account the French definition of interruptions. This step identified 19 items that targeted the interrupted professional, and 16 that targeted the interrupting professional. The characteristics of interruptions were recorded in September 2019 among 23 volunteer teams in a region in western France. Two observers simultaneously observed the same professional. Observations lasted seven consecutive hours, and targeted all professional categories within the same team. The characteristics of 1,929 interruptions were noted. The observation period was well-received by teams. The following terminology regarding the work functions of the interrupting professional was clarified: "coordination of institutional resources", in relation to "the establishment's support processes", "patient services", and "the patient's social life". We believe that our categorization of response modes is exhaustive. We have developed an observational tool, Team'IT, which is tailored to inpatient hospital care in France. Its implementation is the first step in a system to support teams in managing interruptions, and will enable them to reflect on their working methods, and whether interruptions can be avoided. Our work is part of an approach that seeks to improve and enhance the safety of professional practices, by contributing to the longstanding, complex debate about the flow and effectiveness of patient care. ClinicalTrials.gov NCT03786874 (December 26, 2018).