John-Paul Jaewoon Yu MD, PhD, Abstract Co-Author: Nothing to Disclose

Akash Pravin Kansagra MD, Presenter: Nothing to Disclose

John Mongan MD, PhD, Abstract Co-Author: Spouse, Founder, BIOinformative

The on-call radiologist operates in a highly disruptive work environment as evidenced by the frequency of interruption by incoming and outgoing telephone calls. Further research is needed to specifically ascertain the effects of frequent interruptions on the performance of on-call radiologists at academic institutions. 

Workflow interruptions in the healthcare delivery environment are a major contributor to medical error and have been extensively studied within numerous hospital settings including the nursing environment, the operating room, and on physician workflow. Less understood, though, is the role of interruptions in other highly specialized clinical domains and subspecialty services such as diagnostic radiology. The workflow of the on-call radiologist, in particular, is especially susceptible to disruption by telephone calls and other modes of physician-to-physician communication. Herein, we describe our initial efforts to quantify the degree of interruption experienced by the on-call radiologist and examine its potential implications in patient safety and overall clinical care. 

An annotated list of all completed telephone encounters including call time stamps, duration, and call origin were analyzed. The records cover a period of 13 weeks from midnight July 14, 2012 through 11:59 PM on October 12, 2012 (90 days). Data were analyzed using the R statistical package.

A total of 10,378 calls were completed during on-call hours, 5759 (55%) of which were incoming calls. Median call duration was 57 seconds. During a typical 12-hour overnight on-call shift (8PM to 8AM), there were an average of 72 telephone calls with an average total time of 108 minutes spent on the phone. There were an average of 19.3 CT studies during an overnight shift. Average telephone call volume per hour varied from 2.82 to 10.81. Hourly average CT and telephone call volume were highly correlated, with Spearman’s rho = 0.75 (rho ≠ 0 with p < 0.001). 

Yu, J, Kansagra, A, Mongan, J, The Radiologist’s Workflow Environment: Evaluation of Disruptors and Potential Implications.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011251.html