Background: Internal medicine residents are frequently interrupted by phone calls, which may compromise workflow, work quality and job satisfaction.
Aim: This study investigates the number, nature and impact of calls on residents and their work during evening shifts in the emergency department and ward.
Methods: This prospective observational study compares measurements from direct observations with subjective data from questionnaires.
Results: Residents received 26 resp. 30 (median) calls per shift in the emergency department and ward, with duration of 50 resp. 80 seconds. Residents perceived high burden and impact on quality of work and job satisfaction.
Discussion & Conclusion: Frequent interruptions by phone calls were observed, which resulted in high burden. Our study raises the urgency for finding solutions and provides insights necessary for possible interventions.

References

1. Zupanc A, et al. Hospital doctors’ workflow interruptions and activities: an observation study. BMJ quality & safety. 2011;20(6):491-7.
2. Parker BT, Marco C. Emergency department length of stay: accuracy of patient estimates. The western journal of emergency medicine. 2014;15(2):170-5.
3. Garcia-Gigorro R, de la Cruz Vigo F, Andres-Esteban EM, Chacon-Alves S, Morales Varas G, Sanchez-Izquierdo JA, et al. Impact on patient outcome of emergency department length of stay prior to ICU admission. Medicina intensiva. 2017;41(4):201-8.
4. Horwitz LI, Green J, Bradley EH. United States emergency department performance on wait time and length of visit. Annals of emergency medicine. 2010;55(2):133-41.
5. Linn LS, Brook RH, Clark VA, et al. Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Medical care. 1985;23(10):1171-8.
6. Mack JL, File KM, Horwitz JE, et al. The effect of urgency on patient satisfaction and future emergency department choice. Health care management review. 1995;20(2):7-15.
7. Monsell S. Task switching. Trends in cognitive sciences. 2003;7(3):134-40.
8. Parker J, Coiera E. Improving clinical communication: a view from psychology. Journal of the American Medical Informatics Association : JAMIA. 2000;7(5):453-61.
9. Bailey BP, Konstan JA. On the need for attention-aware systems: Measuring effects of interruption on task performance, error rate, and affective state. Computers in Human Behavior. 2006;22(4):685-708.
10. Spencer R, Coiera E, Logan P. Variation in communication loads on clinical staff in the emergency department. Annals of emergency medicine. 2004;44(3):268-73.
11. Westbrook JI, Coiera E, Dunsmuir WTM, et al. The impact of interruptions on clinical task completion. Quality and Safety in Health Care. 2010;19(4):284.
12. Laxmisan A, Hakimzada F, Sayan OR, et al. The multitasking clinician: decision-making and cognitive demand during and after team handoffs in emergency care. International journal of medical informatics. 2007;76(11-12):801-11.
13. Cooper CL, Rout U, Faragher B. Mental health, job satisfaction, and job stress among general practitioners. BMJ (Clinical researched). 1989;298(6670):366-70.
14. Chisholm CD, Dornfeld AM, Nelson DR, et al. Work interrupted: a comparison of workplace interruptions in emergency departments and primary care offices. Annals of emergency medicine. 2001;38(2):146-51.
15. Berg LM, Kallberg AS, Goransson KE, et al. Interruptions in emergency department work: an observational and interview study. BMJ quality & safety. 2013;22(8):656-63.
16. Brixey JJ, Tang Z, Robinson DJ, et al. Interruptions in a level one trauma center: a case study. Int J Med Inform 2008;77:235–41.
17. Chisholm CD, Collison EK, Nelson DR, et al. Emergency department workplace interruptions: are emergency physicians ‘interrupt-driven’ and ‘multitasking’? Acad Emerg Med 2000;7:1239–43.
18. Brixey JJ, Robinson DJ, Johnson CW, et al. Towards a hybrid method to categorize interruptions and activities in healthcare. Int J Med Inform 2007;76:812–20.
19. Brixey JJ, Robinson DJ, Turley JP, et al. The roles of MDs and RNs as initiators and recipients of interruptions in workflow. Int J Med Inform 2010;79:109–15.