Workflow interruptions in an era of instant messaging: A detailed analysis

Abstract

Introduction: The complex practice environment and responsibilities incumbent on diagnostic radiologists creates a workflow susceptible to disruption. While interruptions have been shown to contribute to medical errors in the healthcare delivery environment, the exact impact on highly subspecialized services such as diagnostic radiology is less certain. One potential source of workflow disruption is the use of a departmental instant messaging system (Webex), to facilitate communications between radiology faculty, residents, fellows, and technologists. A retrospective review was conducted to quantify the frequency of interruption experienced by our neuroradiology fellows.

Materials and methods: Data logs were gathered comprising all instant messages sent and received within the designated group chats from July 5-December 31, 2021, during weekday shifts staffed by neuroradiology fellows. Interruptions per shift were calculated based on month, week, and day of the week.

Results: 14,424 messages were sent across 289 total shifts. The 6 fellows assigned to the main neuroradiology reading room sent 3258 messages and received 10,260 messages from technologists and other staff. There was an average of 50 interruptions per shift when examined by month (range 48-53), and 52 interruptions per shift when examined by day of the week (range 40-60).

Conclusion: Neuroradiology fellows experience frequent interruptions from the departmental instant messaging system. These disruptions, when considered in conjunction with other non-interpretative tasks, may have negative implications for workflow efficiency, requiring iterative process improvements when incorporating new technology into the practice environment of diagnostic radiology.

Keywords: Diagnostic radiology; Instant messaging; Interruptions; Workflow.

Fig 1.

Interruptions per Shift by Month. Pictorial depiction of the total number of messages sent categorized by month, with corresponding average number of interruptions per shift.

Fig 2.

Interruptions per Shift by Day of the Week. Pictorial depiction of the total number of messages sent categorized by day of the week, with corresponding average number of interruptions per shift.

Fig 3.

Instant messages per hour averaged over the work week (Monday-Friday). Pictorial depiction of the average number of messages (sent and received) per hour averaged over the work week (Monday-Friday).