Further evidence suggests interruptions to radiology reporting rooms are detrimental to patient safety

Interrupting radiologists during image interpretation—an inconvenience that can disrupt the physician’s workflow an average of five times an hour—increases reporting times and decreases accuracy, especially in complex cases, according to research published in this month’s edition of Academic Radiology.

“The primary responsibility of a radiologist is accurate and efficient image interpretation,” first author Rachel M. Wynn, PhD, and colleagues wrote. “The radiologist’s role as a consultant, however, lends itself to frequent interruptions.”

These interruptions, which can range from answering phone calls to responding to pages to in-person interactions with other clinicians, have been proven detrimental to radiology practices in the recent past, most notably in a Current Problems in Diagnostic Radiology study published earlier this month. In that trial, a team of British researchers found that phone calls directed to radiology reporting rooms were disruptive 90 percent of the time.

Wynn et al.’s work focused on a greater scope of interruptions but was smaller in scale, comprising just 11 radiology residents, 12 attending radiologists and 30 chest radiographs, according to the study. The radiographs were divided in thirds based on the presence or absence of a pneumothorax, or collapsed lung. Ten cases were considered “normal”, ten had an unsubtle pneumothorax and ten showed a subtle pneumothorax.

The team’s results were consistent with findings from earlier this March—while interruptions statistically increased accuracy during normal case readings, Wynn and co-authors found interrupted tasks had significantly longer reading times and reduced accuracy, especially when it came to a subtle pneumothorax.

This wasn’t a surprise to the researchers, they said.

“Most of the interruptions observed in this study required complete disengagement from the case read, making it more difficult to resume reading the case after the interruption than if the interruption had only required partial disengagement,” Wynn and colleagues wrote. “Some interruptions in a radiologist’s workflow are unavoidable, but previous work has suggested that interruptions cause frustration and introduce patient safety concerns in the healthcare environment.”

An on-call radiologist can be interrupted two or three times during an initial case reading, the authors wrote, especially during peak hospital hours. And though overarching stats might not be available for radiologists yet, researchers know that clinicians who are interrupted in the emergency room fail to return to their original tasks 18.5 percent of the time, and that radiologists are likely to forget key components of an image’s analysis if they step away.

“Our focus is on the influence interruptions have on patient safety, but interruptions can also have an impact on other aspects of radiology as well, such as workflow and provider burnout,” the authors wrote. “The effects of interruptions can also be mitigated by prioritizing the necessary interruptions and identifying ways to assist radiologists in their resumption of case reads after an interruption.”