A Study of Emergency Physician Work and Communication:

Objectives: A time and motion analysis of emergency physician (EP) function was conducted. The primary endpoint was to characterize emergency physician (EP) time utilization and patterns of interruption. A secondary endpoint was to identify correlates of interruptions. Methods: A physician observer shadowed 11 EPs and documented physician tasks in a standardized manner. This was a nonrandomized convenience sampling over 16 periods of approximately six hours each, including days, evenings, overnights, weekdays and weekend shifts. Statistical analysis was performed using SPSS and SAS. Correlations were identified using Spearman’s Coefficient and verified using Fisher’s exact test. Results: EPs ranged in age from 29-55, and reported 1-35 years in practice and diverse certifications. 2,889 tasks were characterized by duration and 13 activity types over 5,507 minutes (approximately 92 hours). EP time was devoted primarily to patient interaction (27.7 %), chart review and entry (16.7 %) and computerized data retrieval and entry (11.8 %). EPs were interrupted 400 times (approx every 13.8 minutes). 9.75 % of interruptions required a transit of 3 meters or more, often across the department. The most frequent sources of interruptions were nurse (53.7 %), physician (31.8%), and family member (5.8 %). The rate of interruption was correlated with shift intensity, as measured by average delay from patien