Interruptive communication patterns in the intensive care unit ward round

OBJECTIVE An exploratory study to examine interruptive communication patterns of healthcare staff within an intensive care unit (ICU) during ward rounds. METHODS The study was conducted in a tertiary hospital in Sydney, Australia. Nine participants were observed individually, for a total of 24 h, using the communication observation method (COM). The amount of time spent in conversation, the number of conversation initiating and number of turn-taking interruptions were recorded. RESULTS Participants averaged 75% [95% confidence interval 72.8-77.2] of their time in communication events during ward rounds. There were 345 conversation-initiating interruptions (C.I.I.) and 492 turn-taking interruptions (T.T.I.). C.I.I. accounted for 37% [95% CI 33.9-40.1] of total communication event time (5 h: 53 min). T.T.I. accounted for 5.3% of total communication event time (56 min). CONCLUSION This is the first study to specifically examine turn-taking interruptions in a clinical setting. Staff in this intensive care unit spent the majority of their time in communication. Turn taking interruptions within conversations occurred at about the same frequency as conversation initiating interruptions, which have been the subject of earlier studies. These results suggest that the overall burden of interruptions in some settings may be significantly higher than previously suspected.