A battle for attention: how do emergency physicians respond to interruptions? A scoping review.

Abstract

Objectives: Managing constant interruptions is an intrinsic aspect of emergency medicine practice; however, effective physician responses to mitigate their impact remain unclear. Although interruptions are exceedingly common and closely linked to adverse patient outcomes, the approaches for managing such disruptions have yet to be established. In this study, we aimed to identify how emergency physicians and residents respond to interruptions and the factors influencing their responses.

Methods: We conducted a scoping review to identify how emergency physicians and residents manage interruptions in the emergency department, searching the following databases using controlled vocabulary: Medline, APA PsycInfo, SCOPUS, and PubMed. Data extraction was conducted using the Covidence platform through a standardized and structured process.

Results: The scoping review identified 18 relevant articles, the majority of which (12/18) employed observational methods, involving a total of 417 emergency physicians. These observations, amounting to 778.6 h, were conducted across 25 emergency departments in 4 countries. Physicians responded to interruptions through task switching, multitasking, deferral, acknowledgment, and rejection. Their responses were influenced by the nature of the interrupted activity, cognitive load management, use of telecommunications, physicians' perceptions, and the work environment.

Conclusion: Emergency departments are inherently fast-paced and prone to interruptions; therefore, it is important to better understand how emergency physicians and residents navigate these disruptions. This study explores how physicians respond to interruptions and provides insights to support clinicians in identifying and developing effective management strategies.