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UID:HFESHCS_2025 International Symposium on Human Factors and Ergonomics i
 n Health Care_sess147_POST331@linklings.com
SUMMARY:HE18 - Scoping Review on Studies That Evaluate Effect of Built Env
 ironmental Features on interruptions during clinical procedures
DESCRIPTION:Poster Presentation\n\nHoma Pesarakli (Texas A&M University); 
 Amir Hossein Javid (Vanderbilt University Medical Center, Texas A&M Univer
 sity); and sahar zandi, Farzan Sasangohar, and zhipeng Lu (Texas A&M Unive
 rsity)\n\nIntroduction. Studies have shown that interruptions are a signif
 icant cause of errors, which are a primary contributor to adverse events t
 hat can result in severe injury or even death. These interruptions play a 
 pivotal role in causing medication errors. Built environmental factors fre
 quently lead to numerous interruptions during the medication administratio
 n process. Despite this, there is a scarcity of comprehensive studies revi
 ewing how these environmental variables influence the frequency of interru
 ptions. In healthcare settings where interdisciplinary teams operate dynam
 ically and information fluctuates rapidly, even small interruptions can ha
 ve a significant impact on patient care. These interruptions can lead to t
 he loss of critical knowledge, memory lapses, and eventually, medical erro
 rs. Therefore, it is essential to consider how the physical environment ex
 acerbates or alleviates disruptions to enhance patient safety.\nStudy Purp
 ose and Research Questions. This study evaluates articles that analyze the
  influence of built environmental factors on the occurrence of interruptio
 ns during clinical procedures. The primary goal is to assess how physical 
 environmental features contribute to interruptions and how extensively thi
 s relationship has been examined in literature. Our evaluation was guided 
 by three key questions: What data collection methods are used? What is the
  level of evidence? What are the key findings?\nMethodology. A scoping rev
 iew was conducted on empirical studies that evaluated the effect of built 
 environmental factors on interruptions. Data was extracted from the articl
 es using a standard set of elements, including author affiliation, setting
  (country, hospital, unit), publication year, study design, purpose, data 
 collection methods, study participants or sample, clinical procedures, and
  key interruption findings. The measured variables included independent va
 riables related to both physical and non-physical environmental factors, a
 s well as outcome variables.\nFindings. The review synthesized findings fr
 om 34 empirical studies. This study showed that interruption, distraction,
  and disruption terminologies were defined differently across studies, aff
 ecting research design and interpretation. Of the reviewed studies, 13 use
 d "interruption," five used "disruption," and five used both "distraction"
  and "interruption." The studies were conducted in various clinical settin
 gs, including medical and surgical units, operating rooms, emergency depar
 tments, ICUs, and more specialized units such as pediatric post-anesthesia
  care units (PACUs). Study participants included nurses, physicians, pharm
 acists, patients, and various support staff. \nStudies were categorized in
 to two main types: observational and experimental. Observational studies (
 n=10) examined the natural occurrence of interruptions without any interve
 ntion. These studies aimed to understand the frequency, characteristics, a
 nd contributing factors of interruptions, both environmental and non-envir
 onmental. By observing interruptions in their natural setting, these studi
 es provided valuable insights into the underlying causes and patterns of i
 nterruption behavior. Experimental studies (n=16), which included interven
 tional and quasi-experimental designs, focused on evaluating the effective
 ness of various interventions in reducing interruptions. These studies man
 ipulated one or more variables (the intervention or factor) and measured t
 he outcome (interruptions). The goal was to identify the most effective ap
 proaches for minimizing interruptions and to understand how different inte
 rventions influenced interruption frequency. The primary data collection m
 ethods used were observation, interviews, and surveys. Some studies also r
 elied on self-reported interruptions and distractions. These methods varie
 d according to the study designs and the objectives of the research. Video
  recordings and focus groups were occasionally used to supplement the data
  collected through direct observation. \nThe study variables were categori
 zed into three groups: environmental, non-environmental, and outcome varia
 bles. Environmental features were studied to assess their impact on reduci
 ng interruptions. The concept of no-interruption zones (NIZ) was examined 
 extensively where specific areas were designated to be interruption-free t
 hrough signage and physical barriers or even the red taped on the floor, a
 nd their impact on reducing interruptions was investigated. Other variable
 s related to the physical environment include signage, quiet zones, medica
 tion room type (joined or separated/ dedicated) operating rooms (OR) wall 
 barriers (visual and physical separation), layout of workstations (open vs
 . enclosed), traffic-related factors, and ward environment characteristics
  like noise. Non-environmental Variables include factors that are not rela
 ted to the physical environment but rather to the processes, protocols, an
 d human factors involved in healthcare delivery. They include standard pro
 tocols, educational interventions, red tabard vests, staff training, check
 lists, frequently used drug handbooks, communication strategies, and staff
  positioning during handoffs.  The outcome variables measured the effectiv
 eness of the interventions in reducing interruptions and distractions. The
 se metrics included the number of distractions, flow disruptions, interrup
 tion duration, percentage of interruptions, interruption-free preparation 
 time, frequency of interruptions, and the reasons for interruptions. \nCon
 clusion. This scoping review highlights the critical role of built environ
 mental features in influencing the frequency of interruptions during the m
 edication process, which can significantly contribute to medical errors an
 d adverse events. The findings emphasize that while some environmental int
 erventions, such as the establishment of no-interruption zones (NIZ), quie
 t zones, and dedicated medication rooms, have been extensively studied, th
 ere remains a substantial gap in understanding the broader range of design
  features and their impact on interruptions. This gap is particularly pron
 ounced in areas such as the layout of clinical areas and traffic-related f
 actors which can play a pivotal role in either mitigating or exacerbating 
 interruptions. The research also reveals inconsistencies in how interrupti
 ons, distractions, and disruptions are defined and measured, which hinders
  the comparability of results across studies and suggests the need for sta
 ndardized definitions and methodologies.\nUltimately, this study underscor
 es the need for more empirical research that systematically examines the i
 nfluence of various built environment features on interruptions across dif
 ferent healthcare settings. By addressing these gaps, healthcare facilitie
 s can enhance patient safety, improve workflow efficiency, and reduce the 
 occurrence of errors. Future research should focus on integrating design s
 olutions with operational protocols to create safer and more efficient cli
 nical environments.\n\nTrack: Digital Health (DH), Simulation and Educatio
 n (SE), Hospital Environments (HE), Medical and Drug Delivery Devices (MDD
 ), Patient Safety and Research Initiatives (PS)
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