PT - JOURNAL ARTICLE AU - Johanna I Westbrook AU - Enrico Coiera AU - William T M Dunsmuir AU - Bruce M Brown AU - Norm Kelk AU - Richard Paoloni AU - Cuong Tran TI - The impact of interruptions on clinical task completion AID - 10.1136/qshc.2009.039255 DP - 2010 Aug 01 TA - Quality and Safety in Health Care PG - 284--289 VI - 19 IP - 4 4099 - http://qualitysafety.bmj.com/content/19/4/284.short 4100 - http://qualitysafety.bmj.com/content/19/4/284.full SO - Qual Saf Health Care2010 Aug 01; 19 AB - Background Interruptions and multitasking are implicated as a major cause of clinical inefficiency and error.Objective The aim was to measure the association between emergency doctors' rates of interruption and task completion times and rates.Methods The authors conducted a prospective observational time and motion study in the emergency department of a 400-bed teaching hospital. Forty doctors (91% of medical staff) were observed for 210.45 h on weekdays. The authors calculated the time on task (TOT); the relationship between TOT and interruptions; and the proportion of time in work task categories. Length-biased sampling was controlled for.Results Doctors were interrupted 6.6 times/h. 11% of all tasks were interrupted, 3.3% more than once. Doctors multitasked for 12.8% of time. The mean TOT was 1:26 min. Interruptions were associated with a significant increase in TOT. However, when length-biased sampling was accounted for, interrupted tasks were unexpectedly completed in a shorter time than uninterrupted tasks. Doctors failed to return to 18.5% (95% CI 15.9% to 21.1%) of interrupted tasks.Conclusions It appears that in busy interrupt-driven clinical environments, clinicians reduce the time they spend on clinical tasks if they experience interruptions, and may delay or fail to return to a significant portion of interrupted tasks. Task shortening may occur because interrupted tasks are truncated to ‘catch up’ for lost time, which may have significant implications for patient safety.