Chest radiograph interruptions add 2 seconds to readings—and may increase burnout, reduce accuracy

Radiologists are subject to myriad interruptions. These frequent disturbances increase reading times and reduce accuracy  with potentially negative consequences for both patients and providers, according to a recent Academic Radiology study.

“Frequent interruptions reduce the efficiency of radiologists and add burden to their practice, potentially increasing the rate of burnout,” wrote corresponding author Rachel M. Wynn, PhD, with MedStar Health’s National Center for Human Factors in Healthcare in Washington, and colleagues.

The March 28 study included a total of 11 resident and 12 attending radiologists analyzing 30 chest radiographs. The individuals rated their confidence on the presence or absence of a pneumothorax.

Of all the cases, 10 were normal, 10 had an unsubtle pneumothorax and 10 had a subtle pneumothorax. During three reads of each case type, the radiologists were interrupted for 30 seconds by a separate task.

On average, the interrupted cases took two seconds longer. While this may seem small, Wynn et al. argued this extra time can be compounded, especially when radiologists are making many reads per shift. If more than one interruption occurs, the effect on image reading may increase.

When it came to accuracy, results were mixed. Accuracy decreased by 17 percent in cases with a subtle pneumothorax and increased by 6 percent for normal cases without a pneumothorax.

“This work demonstrates that these interruptions both reduce efficiency and introduce errors in image interpretation, causing patient safety concerns,” wrote Wynn et al. “Effort should be made to reduce the number of interruptions faced by radiologists that are reading cases to improve efficiency, prevent errors during image interpretation, and reduce burnout."

The researchers suggested introducing reading room assistants to implement health information technology solutions for easier communication as one possible remedy for interruptions. They noted future work is needed to examine which solutions are best for minimizing the effects of interruptions.