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

Balint, Brad J.; Steenburg, Scott D.; Lin, Hongbu; Shen, Changyu; Steele, Jennifer; Gunderman, Richard B.

doi:10.1016/j.acra.2014.08.001

Cited by 114 publications

(59 citation statements)

References 27 publications

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“…An increase in phone calls before resident generation of a preliminary report has shown significant association with discrepancies (41). Interruptions have been shown to disrupt cognitive processes, and the memory of the original task begins to fade to address the interruption (38).…”

Section: Systemic Sources and Solutionsmentioning

confidence: 99%

Bias in Radiology: The How and Why of Misses and Misinterpretations

2018

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Medical errors are a leading cause of morbidity and mortality in the medical field and are substantial contributors to medical costs. Radiologists play an integral role in the diagnosis and care of patients and, given that those in this field interpret millions of examinations annually, may therefore contribute to diagnostic errors. Errors can be categorized as a "miss" when a primary or critical finding is not observed or as a "misinterpretation" when errors in interpretation lead to an incorrect diagnosis. In this article, the authors describe the cognitive causes of such errors in diagnostic medicine, specifically in radiology. Recognizing the cognitive processes that radiologists use while interpreting images should improve one's awareness of the inherent biases that can impact decision making. The authors review the common biases that impact clinical decisions, as well as strategies to counteract or minimize the potential for misdiagnosis. System-level processes that can be implemented to minimize cognitive errors are reviewed, as well as ways to implement personal changes to minimize cognitive errors in daily practice. RSNA, 2017.

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Section: Systemic Sources and Solutionsmentioning

confidence: 99%

Bias in Radiology: The How and Why of Misses and Misinterpretations

2018

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“…Literature relating to interruptions and distractions and their impact on clinical diagnostic imaging services is limited. To date, published studies have focussed on diagnostic error in radiologists’ reports due to interruptions. To the best of our knowledge, the only published peer‐reviewed article on impacts of distractions in obstetrics ultrasound has found that active disruptive children decrease overall scanning time with sonographers ‘rushing’ their tasks.…”

Section: Introductionmentioning

confidence: 99%

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

Najafzadeh

Woodrow

Thoirs

2019

Australas J Ultrason Med

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Introduction: Obstetric sonography is a highly skilled diagnostic medical examination. Pregnant women like to socialise their ultrasound experience with family, introducing distractions for the sonographer. Our objective was to survey ultrasound practitioners to identify concerns regarding interruptions and their opinions about socialisation during the examination. Methods: An online questionnaire was disseminated to study the views of Australian and New Zealand obstetric sonographers/ sonologists. It was informed by a pilot study of possible distractors with quality and safety concerns and operator opinions regarding family bonding. Results: The opinions of 393 obstetric sonographers/sonologists informed our results. Distractors with the most negative aspects included disruptive children (93.3%) and mobile phone conversations (84.3%). Most respondents (62%) believed that a distractor only had to be present for 5 min or less to have an impact. Small children were identified by 87.5% of respondents as safety risks to themselves, to the patient and to sonographers. Sonographers were concerned that distractors caused a loss of concentration, interruption to a systematic scanning approach and increased false negatives in screening, missing important diagnoses. Sonographers strongly agreed that obstetric sonography facilitated maternal-fetal bonding, but only 15% thought that siblings bond with the fetus during the scan. Conclusion: Obstetric sonographers in our study are concerned that distractors pose a negative impact on the quality and safety of ultrasound. They also recognise the importance of family bonding. Strategies to bridge the medical and social components of obstetric sonography should be developed to reduce quality and safety threats.

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“…Analysis of Smartphone Interruptions ciplines [9,10,17,30,31]. For example, in a study of diagnostic radiology residents, increased interruptions were associated with subsequently increased discrepant reports in the following hour [32]. Secondly, medical education is impacted due to the interruption of both formal and informal teaching sessions scheduled throughout the workday [26,33,34].…”

Section: Research Articlementioning

confidence: 99%

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2017

Appl Clin Inform

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Introduction:Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. Methods: We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014. We also calculated the number of times these interruptions exceeded a pre-specified threshold per hour, termed 'crisis mode', defined as at least five interruptions in 30 minutes. We analyzed the correlation between interruptions and date, site, and patient volumes. Results: A total of 187,049 interruptions were collected over an 18-month period. Daily weekday interruptions rose sharply in the morning, peaking between 11 AM to 12 PM and measuring 4.8 and 3.7 mean interruptions/hour at each site, respectively. Mean daily interruptions per team totaled 46.2 ± 3.6 at Site 1 and 39.2 ± 4.2 at Site 2. The 'crisis mode' threshold was exceeded, on average, 2.3 times/day per GIM team during weekdays. In a multivariable linear regression analysis, site (β6.43 CI95% 5.44 -7.42, p<0.001), day of the week (with Friday having the most interruptions) (β0.481 CI95% 0.236 -0.730, p<0.05) and patient census (β1.55 CI95% 1.42 -1.67, p<0.05) were all predictive of daily interruption volume although there was a significant interaction effect between site and patient census (β-0.941 CI95% -1.18 --0.703, p<0.05). Conclusion: Interruptions were related to site-specific features, including volume, suggesting that future interventions should target the culture of individual hospitals. Excessive interruptions may have implications for patient safety especially when exceeding a maximal threshold over short periods of time.

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

Cited by 114 publications

References 27 publications

Bias in Radiology: The How and Why of Misses and Misinterpretations

Bias in Radiology: The How and Why of Misses and Misinterpretations

Distractors in obstetric ultrasound: Do sonographers have safety concerns?

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