Frequency of Emergency Department Physician Interruptions
Emergency department physicians experience approximately 10-12 interruptions per hour during their shifts, translating to 80-100 interruptions during an 8-hour shift. 1, 2, 3
Quantitative Data on Interruption Frequency
The most robust observational data demonstrates:
- 11.2 interruptions per hour (84.1 interruptions per shift) in a 2017 academic emergency department study 1
- 9.7 interruptions per hour in community hospital emergency departments 2
- 10.3 interruptions per hour (30.9 interruptions per 180-minute period) across urban teaching, suburban private teaching, and rural community hospitals 3
For an 8-hour shift, this equates to approximately 77-90 interruptions, with peaks reaching one interruption every 3 minutes during high-volume periods. 4
Sources and Types of Interruptions
The majority of interruptions originate from other healthcare providers:
- Face-to-face physician communication accounts for 26% of interruptions 1
- Face-to-face nurse communication represents 21.7% 1
- Environmental factors (alarms, phones) comprise 20.8% 1
- 60% of all interruptions are initiated by other healthcare providers (physicians or nurses) 5
Clinical Context and Risk Areas
Patient rooms represent high-risk zones for low-priority interruptions, with 53% of bedside interruptions classified as low priority despite occurring during direct patient care. 1 This is particularly concerning because interruptions during critical tasks can lead to errors, and in emergency services, 20% of interrupted tasks are not satisfactorily resumed. 4
Impact on Workflow and Task Management
Emergency physicians demonstrate distinct workflow patterns compared to other specialties:
- Emergency physicians manage 3 or more patients concurrently for 37.5 minutes per hour 2
- Physicians immediately engage interruptions 75.4% of the time, discontinuing their current task 6
- Multitasking while managing interruptions occurs 22.2% of the time 6
- Physicians reject or delay interruptions less than 2% of the time, representing a missed opportunity for interruption management 6
Clinical Significance
The number of interruptions correlates positively with the number of patients simultaneously managed (r = 0.63, p < 0.001), meaning busier shifts generate even more interruptions. 3 This creates a compounding effect where high patient volumes increase both workload and workflow disruption simultaneously.
Interruptions during medication administration and other critical tasks can compromise patient safety, as task interruption leads to diverted attention, multitasking errors, and errors of omission when resuming the original task. 4 The 2023 Anaesthesia guidelines emphasize that healthcare settings experience 5-20 interruptions per hour, with peaks of one interruption every 3 minutes, and these interruptions can generate behaviors that lead to medical errors. 4
Common Pitfalls
Bedside interruptions negatively impact patient satisfaction, yet they occur 26% of the time during clinical activities. 5 Physicians should be aware that while 63% of interruptions serve a concrete purpose in patient treatment (communication about clinical conditions, care organization, workload distribution), the remaining interruptions may be deferrable. 4
Emergency physicians rarely use interruption management strategies such as rejecting or delaying interruptions, even when performing high-risk tasks. 6 This represents an opportunity for training in interruption management techniques, including identifying critical tasks that should not be interrupted, using visual cues (vests, armbands, "Do Not Disturb" notices), and working in uninterrupted zones when possible. 4