Examine how interruptions in outpatient care affect clinicians, patients, and staff, and describe potential system-level approaches to improvement.
Approach:
Clinical scenario: An illustrative primary care visit shows a clinician managing prescription corrections, urgent patient messages, and staff requests while speaking with a patient.
Evidence and perspectives: The article discusses research on interruptions, task performance, patient experience, staff communication, and proposed workflow and technology changes.
Key Findings:
A study of outpatient internal medicine physicians in China reported 6.46 interruptions per hour; the article notes that no comparable investigations in US outpatient settings have been conducted during the last decade.
The article describes how multiple communication platforms can fragment attention and disrupt workflow. Research cited in the article associates physician interruptions with increased cognitive load, reduced efficiency, and clinical errors.
The article notes that patients may experience fragmented attention and cites research associating greater physician eye contact with greater patient-perceived trust.
The article describes staff making communication decisions without standardized expectations and links this lack of guidance to stress, increased error risk, job dissatisfaction, and burnout.
The article presents protected periods for asynchronous work as a promising model; the supplied text ends before detailing the cited findings about its outcomes.
Interpretation:
The article frames interruptions as a system-design problem involving clinicians, patients, and staff, rather than simply an issue of individual effort.
Limitations:
The article notes that no comparable investigations of interruptions in US outpatient settings have been conducted during the last decade.
Conclusion:
Proposed approaches include ambient AI for documentation, protected time for asynchronous work, and system-wide guidance on communication urgency, response times, and appropriate channels.
