Quantifying Emergency Physician Interruptions due to Electrocardiogram Review

Ioannides, Kimon L.H.; Brownstein, Daniel James; Henreid, Andrew J; Torbati, Sam; Berdahl, Carl T.

doi:10.1016/j.jemermed.2020.11.024

Cited by 2 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Work flow quality improvement projects often require very little cost. In one example, the ubiquitous requests for electrocardiogram (ECG) review by EM physicians could be completed in batches or with a more integrated approach (Ioannides et al, 2021). Implementation of departmental/ hospital policies that limit flow thieves may enhance physician absorption, resulting in improved physician well-being and superior patient care.…”

Section: Discussionmentioning

confidence: 99%

Physician Flow at Work: Examining Work Absorption, Clinical Flow, Work Fulfillment, and Flow Thieves

Shreffler

Huecker

2022

Workplace Health Saf

View full text Add to dashboard Cite

Background: The experience of “flow” at work correlates with positive job outputs and work-related attitudes. Very little current literature describes flow at work in physicians, who experience significant barriers to optimal work outputs, also known as flow thieves (e.g., case interruptions, documenting care). This study aimed to develop a measurement for physician flow (P-Flow) at work and examine the association of P-Flow with physician burnout, job satisfaction, and well-being. Methods: A pilot instrument was tested with items measuring P-Flow at work. After the pilot administration, a 14-item physician flow (P-Flow-14) scale was administered to physicians. In addition to the P-Flow-14 scale, physician respondents completed items measuring burnout, job satisfaction, and well-being. Results: This study specifies initial psychometric evidence of P-Flow-14 and 7-item P-Flow instruments for researchers interested in studying flow at work in physicians. For each P-Flow instrument, higher levels of the flow experience correlated with superior levels of well-being ( p < .01) and job satisfaction ( p < .01), and less burnout ( p < .001). Results showed initial psychometric evidence of derived subscales (work absorption, clinical flow, flow thieves, work fulfillment) for application in future research. Results showed associations between flow experience by age group and physician specialty. Conclusions/Application to Practice: To enhance well-being and job satisfaction, physicians should aim for concentration and immersion in clinical duties while reducing unnecessary distractions. These findings can be applied by employers and can guide further research on work interruptions and patient safety. Future research can validate the P-Flow scales and subscales to assess interventions aimed to improve the physician work environment.

show abstract

Section: Discussionmentioning

confidence: 99%

Physician Flow at Work: Examining Work Absorption, Clinical Flow, Work Fulfillment, and Flow Thieves

Shreffler

Huecker

2022

Workplace Health Saf

View full text Add to dashboard Cite

show abstract

“…A prospective observational study at a large urban ED found that 48% of ECG readings were initiated as interruptions but did not evaluate or compare this to other types of ED interruptions. 6 At our institution, both automated and manually generated pages via our electronic ED dashboard are commonly used to facilitate asynchronous communication between attendings, residents, nurses, consultants, laboratory, and imaging. This use of the paging system as a means for communication among the ED care team at our institution allows us to study the potential impact of pages on task interruption.…”

Section: Importancementioning

confidence: 99%

“…For example, to our knowledge, there is no prior literature on whether ECG interpretations might carry more weight as an interruption compared to a page. A prospective observational study at a large urban ED found that 48% of ECG readings were initiated as interruptions but did not evaluate or compare this to other types of ED interruptions 6 …”

Section: Introductionmentioning

confidence: 99%

Does the number of pages received per hour affect resident productivity?

Mangino,

Stenson,

Leventhal

et al. 2023

JACEP Open

View full text Add to dashboard Cite

BackgroundWorkflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour.MethodsRetrospective data was collected on resident physician (RP) emergency department shifts from July 1st, 2021 to June 30th, 2022 at an academic medical center with an annual census of 55,000 patients. A total of 2865 RP shifts were collected among the 26 postgraduate year (PGY) 1 and PGY2 residents. For each RP shift, we identified the number of pages received per hour and the number of new patients seen per hour. Pages consist of any transmitted message that was sent to the RP's personal pager, which includes both automatic (eg, bed assignments, abnormal lab values) and personalized pages from other healthcare practicioners (eg, nursing, consultants). Data were analyzed using Poisson regression controlling for clustering at the physician level to determine if the number of patients seen per hour is significantly affected by the number of pages (divided into quartiles) received.ResultsWe found the number of pages received per hour did not decrease the number of patients seen per hour. Contrary to our hypothesis, there was a strong positive relationship between the number of pages received per hour and the number of patients seen by RPs in that hour and subsequent hours. During the middle of a shift (hours 3, 4, and 5), RPs receiving pages in the third and fourth quartile (top 50% of pages) saw significantly more patients during that same hour and the next hour (p <0.001).ConclusionThe number of pages received by RPs per hour did not decrease the number of patients seen per hour. When RPs receive a higher number of pages, there is a positive association with the number of patients they see in that hour and subsequent hours. Further studies will be needed to determine whether the content of pages affects resident productivity.

show abstract

Quantifying Emergency Physician Interruptions due to Electrocardiogram Review

Cited by 2 publications

References 25 publications

Physician Flow at Work: Examining Work Absorption, Clinical Flow, Work Fulfillment, and Flow Thieves

Physician Flow at Work: Examining Work Absorption, Clinical Flow, Work Fulfillment, and Flow Thieves

Does the number of pages received per hour affect resident productivity?

Contact Info

Product

Resources

About