UMEM Educational Pearls

Title: How does our workspace effect our work?

Keywords: design, workspace, handoff, interruptions, collaboration (PubMed Search)

Posted: 9/21/2024 by Mercedes Torres, MD (Updated: 9/25/2024)
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Did you know that emergency physicians spend nearly 1/3 of their handoff time responding to interruptions?
EPs are interrupted around 7-11 times during handoffs, accounting for 11% of the total adverse events, a third of which are considered preventable.
This study examined the number of interruptions and perception of collaboration in three different physical spaces in the same ED: an open workstation, an enclosed workstation, and a semi-open workstation (see photos and blueprints below).
Most EDs have open workstations as they are thought to optimize visibility and opportunities for collaboration among team members of all levels.
EPs conducting handoffs in open workstations experienced more interruptions (patient care-related or not) as compared to those in the enclosed workstations.
Investigators found that enclosure of the physicians’ workstation can decrease the number of times physicians are interrupted during critical tasks like handoffs, therefore decreasing the risk of errors and adverse events.
EPs perceived a high degree of collaboration with colleagues in the enclosed workstation during handoff and felt less interrupted.
While the number of documented handoff interruptions in the semi-open plan were lower than the open workstation, EPs still perceived interruptions as frequent.
While there are clear benefits of the open workstation in the ED, it may be worth considering a different venue, specifically for handoffs, such as a “No Interruptions Zone” (NIZ) to decrease the perceived and actual frequency of interruptions, while also improving the sense of collaboration between team members during the handoff process.

References

Joshi R, Joseph A, Ossmann M, et al. Emergency Physicians’ Workstation Design: An Observational Study of Interruptions and Perception of Collaboration During Shift-End Handoffs. HERD: Health Environments Research & Design Journal. 2021;14(4):174-193. doi:10.1177/19375867211001379