Do Telephone Call Interruptions Have an ImPact on Radiology Resident Diagnostic Accuracy?

被引:95
作者
Balint, Brad J. [1 ]
Steenburg, Scott D. [1 ]
Lin, Hongbu [2 ,3 ]
Shen, Changyu [2 ,3 ]
Steele, Jennifer L. [1 ,4 ]
Gunderman, Richard B. [1 ,4 ]
机构
[1] Indiana Univ, Hlth Methodist Hosp, Sch Med, Dept Radiol & Imaging Sci, Indianapolis, IN 46202 USA
[2] Indiana Univ, Sch Med, Dept Biostat, Indianapolis, IN 46202 USA
[3] Indiana Univ, Fairbanks Sch Publ Hlth, Indianapolis, IN 46202 USA
[4] Indiana Univ, Sch Med, Dept Radiol & Imaging Sci, Div Radiol Educ, Indianapolis, IN 46202 USA
关键词
Interruptions; diagnostic accuracy; patient safety; ELECTRONIC HEALTH RECORDS; PATIENT-SAFETY; INTERPRETATION DISCREPANCIES; BURNOUT; WORK;
D O I
10.1016/j.acra.2014.08.001
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Rationale and Objectives: The purpose of this study was to measure the effect of distractions, in the form of telephone call interruptions, on radiology resident diagnostic accuracy. Materials and Methods: Radiology resident discrepancy reports and reading room telephone logs at an academic tertiary care pediatric hospital were collected over a 13-month period. Phone call times and durations were recorded. Major discrepancy shifts (defined as a call shift where at least one major discrepancy was discovered the following morning by the attending radiologist between the resident preliminary and attending final reports), and dictation time stamps for each discrepant preliminary dictation were also recorded. Telephone call volume and preliminary report time stamps were compared between "discrepancy shifts" and "no discrepancy shifts." Results: Each call shift spanned 14 hours, during which one radiology resident was responsible for the generation of preliminary interpretations. Review of the discrepancy log data revealed 51 major discrepancies in 41 shifts, of which 39 discrepancies had documented error details and resident preliminary report time stamps. The average number of telephone calls for the "discrepancy shifts" was slightly greater than the "no discrepancy shifts" (48.59 vs. 44.02) but was not statistically significant (P = .0575). However, there was a statistically significant increase in the average number of phone calls in the 1 hour preceding the generation of a discrepant preliminary report versus the "no discrepancy shifts" (4.23 vs. 3.24 calls, P = .027). One additional phone call during the hour preceding the generation of a discrepant preliminary report resulted in a 12% increased likelihood of a resident error (P = .017). Conclusions: Distractions in the form of telephone call interruptions may negatively impact on-call radiology resident diagnostic accuracy. Efforts should be made to limit distractions in the reading room.
引用
收藏
页码:1623 / 1628
页数:6
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