Thursday, January 8, 2015

Patient Care, Interruptions and Breaks in Task- A Day in the LIfe

I spent much of the last 2 weeks covering the ID services in the hospital. The pace was fast and the patient load was heavy. These last few weeks had me reflecting on how my time is actually spent in the hospital and how often I am distracted by phone calls, pages etc.

I dug up this article, on how hospitalists spend their time. Much of it is on indirect patient care activities, such as charting and making phone calls, coordinating care. Per this publication, only 18% of the time in the hospital is spent on actual patient care. I believe it.

Next, I found this article on interruptions and breaks-in- task in an emergency department. An "interruption" was defined as event that briefly required the attention of the doctor but did not result in switching to a new task. A "break-in-task" was defined as an event that resulted in changing tasks. Not surprisingly, per each 180-minute review period, there were on average 40 interruptions and 21 breaks-in-task. Are airline pilots distracted as often when flying a plane?

We are driven to distraction and this certainly cannot be good for either efficiency or patient outcomes. The challenge lies in quantifying the impact of distractions on patient safety, and, in response, designing systems where patient care is both the primary focus and is insulated from unnecessary distractions. This would be huge. 

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