The Nature of Interruptions Among Inpatient Residents: a Time-Motion Observation-Based Mixed Methods Study.

Abstract

Interruptions are germane to inpatient medical practice but carry the consequences of reduced error prevention, psychological stress, and impaired knowledge consolidation among trainees. In this mixed methods study, we captured 172 task changes via time-motion observations of four residents on a general neurology service and completed semi-structured interviews with the same group. Twenty-five percent of task changes were due to interruptions, the majority via pager communications, and only 2% required urgent clinical attention. Residents reported frustration towards inefficient aspects of the pager system. Given the high rates of interruptions identified, we propose mitigating strategies such as triaging communications by urgency.