Risk of Medical Errors by ED Doctors Linked to Interruptions
Chisholm noted that while some interruptions are unavoidable, some of them are unnecessary. Part of the problem centers with how inefficiencies are built into the system "to create unnecessary interruptions," he says.
He gave a common example: an ED doctor determines that he needs to admit a patient to the orthopedic service. "I call and leave a message, and now I have to sit by the phone for 2 to 30 minutes. And I may be in the middle of performing a physical on another patient when the service calls back, calling me away from the bedside. And that interrupts."
He suggests that EMR systems create electronic "virtual patient records accessible to multiple nurses and consultants for review and data entry simultaneously, allowing asynchronous information transmission and interaction without interruptions." Also, use of electronic message boards "could allow communication with consultants without the currently built-in telephone call interruptions."
In this way, Chisholm says, the ED doc could post information in the virtual medical record that would explain the patient's needs to the orthopedic surgeons on the service, "and they could reply in electronic format, rather than place a call back," avoiding a good number of these interruptions.
The researchers observed 203 two-hour periods and four hospitals, two of them community hospitals and two academic.
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