Task interruption, an everyday life banality ?

23 November 2020

Charly PATRY , Léa ATME, Anne-Marie VIDAL, Delphine BOLLE, Lobna JEMOUR, Damien BRUEL Pharmacy, Hospital Center of Le Mans, 194 Avenue Rubillard, 72037 Le Mans

Objective :
According to the Haute Autorité de Santé (HAS), a task interruption (TI) is the cessation of anactivity causing a break in the course of the activity and a disruption of the operator’s concentration.
This work consisted to identify the causes of TI in our unit of chemotherapy reconstitution throughout the manufacturing process and to find solutions to limit them.

Method :

1-Identification of critical steps during the manufacturing process
2-Development of a grid for collecting observations according to HAS criteria (2016 manual)
3-Observation of 3 critical tasks of the process (pharmaceutical validation, room management, manufacturing)
4- Observation of 7 pharmacy technicians (PT) and 3 phamacists over 4 half-days,
5-Analysis of the results and feedback to the team with suggestions for improvements

Results :
In the pharmaceutical validation post : 43% of TIs are unjustified (surrounding noise or discussions with a pharmacist colleague) versus 57% that are justified (an input of information by a nurse or an information request by a PT/pharmacist).
In the chemotherapy production area : 85% of TIs of room managers are justified and concern almost exclusively manufacturing controls. Those of the manipulators are not justified in 65% of cases (distractions, whether voluntary or not).
Results have been submitted to the team with suggestions for actions in order to limit TIs based on 4 areas for improvement : action on sources, improving teamwork, management of secondary tasks, implementation of physical actions.

Discussion & conclusion :
The feedback to the team allowed two essential things : to make the team aware of the possible consequences of TIs (major risk of medication error, loss of time on the whole chemotherapy circuit), and the implementation of actions to limit them. Overall, the team accepted all the points for improvement, which did not require a major reorganisation of the manufacturing process but could have a positive impact, particularly in terms of workstation ergonomics. It is looking forward to the arrival of a manufacturing control camera that will probably reduce TIs of the room manager. It would be interesting to carry out a second observational study to assess the effectiveness of theactions implemented.
This evaluation could also be extended to other pharmacy activities with a high risk of medication errors (picking, hospital retrocession, etc.).

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