Redefining Interruptions: Events, Causes, and Impacts in Trauma Rooms.

Abstract

Objectives: Trauma rooms, as fast-paced and demanding health care environments, are highly susceptible to interruptions that can negatively impact workflow efficiency and patient safety. These interruptions often arise from human or environmental factors. This study investigates the role of the physical environment in influencing workflow interruptions by identifying key interruptive events in a trauma room, their primary sources, and outcomes using a pilot method of observational coding.

Methods: This pilot study utilized video observations of 6 trauma cases in an urban level 1 trauma center. Using Noldus Observer XT 16 software, medical staff roles, interruptive events, their causes, and associated impacts were systematically coded and analyzed.

Results: A total of 114 events were observed. The most common events included "movement restrictions" (39%), "throwing objects" (17%), and "cleaning/clearing the floor" (13%). Key causes were "clutter/untidiness" (32%) and "mobile fixture/furniture location" (21%). Frequently observed impacts included "unnecessary task additions" (21%) and "hindered task completion" (20%). The results also revealed frequent associations between causes, events, and impacts. Movement restrictions caused by clutter/untidiness often led to disentangling cables and tubing (13.2%). Similarly, movement restrictions due to mobile fixture placement required equipment repositioning in 13.2% of cases. Throwing objects, often linked to behavioral habits, contributed to clutter (16%), whereas floor clearing/cleaning due to clutter added unnecessary tasks (13%).

Conclusion: The findings underscored the significant role of physical-environmental factors in workflow interruptions in trauma rooms. These insights can inform evidence-based design improvements and operational strategies for future enhancements, ultimately improving staff and patient outcomes in high-pressure health care settings.