Before-and-after study of interruptions in a pharmacy department

Abstract

Background: Few data exist on interruptions in the drug-use process in hospital pharmacies and their effects on patient care. Objective: The primary objective was to compare the hourly number of stimuli received and emitted (i.e., generated) by pharmacists and pharmacy technicians before and after implementation of measures intended to reduce interruptions. The secondary objective was to evaluate the impact of the corrective measures on 4 specific stimuli. Methods: This before-and-after cross-sectional observational study was conducted in the main dispensing area of the pharmacy department of a Canadian university hospital centre. Stimuli received and emitted by pharmacists and pharmacy technicians were counted before (2010) and after (2012) implementation of corrective measures designed to limit interruptions. The effect of corrective measures on targeted stimuli was measured with a t test. Results: Data were collected during a total of 93 randomly scheduled 30-min observation periods: 62 periods in 2010 (n = 2663 stimuli) and 31 periods in 2012 (n = 1217 stimuli). The average hourly stimulus rate (± standard deviation) was unchanged after implementation of corrective measures: 85.9 ± 22.2 in 2010 and 78.5 ± 20.1 in 2012 (p = 0.06). However, a significant decline was observed for many individual stimuli, including the number of face-to-face nonprofessional conversations among pharmacists (4.4 ± 4.2 in 2010 versus 1.2 ± 1.8 in 2012, p = 0.003). Conclusion: Despite the implementation of corrective measures, there was no statistically significant change in the hourly stimulus rates from 2010 to 2012. Other studies are needed to better characterize the nature and repercussions of stimuli, distractions, and interruptions.