The Effect of Distraction on the Quality of Patient Hand-Off [39G

Abstract

INTRODUCTION: To evaluate whether distraction affects the quality of sign-out among obstetrical providers. If distractions affect the accuracy of information shared at “sign-out,” it could lead to errors in patient management. METHODS: A randomized, prospective study among obstetrical providers who received a recorded sign-out vignette. Provider groups either received a distraction or did not during the vignette. All providers had been told that they would be participating in a trial of two methods of sign out, although in actuality they were all signed out using a single method. In the distraction arm, the participants were exposed to a “distracting event” (a phone ring, followed by a short response) that occurred midway through the vignette. Providers answered a 14-question survey based on the vignette. The results of each group were analyzed using Fisher exact and Student t tests. RESULTS: Eighty-eight providers were randomized, 44 in the distraction group and 44 in the non-distracted group. The score averages on the survey were similar between groups (11.0 and 10.8, P=.57). In addition, the average scores for questions that occurred after the distraction were similar between the distracted and non-distracted groups (6.4 vs 6.2, P=.42). Proximity to the distraction did not affect scores. CONCLUSION: While cell phones often ring in hospital settings, we did not find that a single phone ring and a brief answer to the call affected obstetrical providers’ recall of details of a standardized sign-out. More studies are warranted to determine if more frequent distractions or longer distractions would change results.