AIM: To find out the number and nature of the interruptions which occur in general medical consultations. DESIGN: Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre). PATIENTS AND OTHER PARTICIPANTS: All the interruptions which occurred on the days chosen within the period of study were analysed. MEASUREMENTS AND MAIN RESULTS: The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption. CONCLUSIONS: There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.
AIM: To find out the number and nature of the interruptions which occur in general medical consultations. DESIGN: Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre). PATIENTS AND OTHER PARTICIPANTS: All the interruptions which occurred on the days chosen within the period of study were analysed. MEASUREMENTS AND MAIN RESULTS: The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption. CONCLUSIONS: There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.