چکیده (انگلیسی):

Background:In the primary health care setting, patients interact directly with their healthcare workers (HCW),
which include their primary physicians, nurses and pharmacists. Studies have shown that such interactions, when
interrupted by phone calls received by either party, can lead to adverse outcomes and negative experiences. There
is insufficient data however on the factors affecting the reaction and responses of both patients and HCWs when
phone calls occur amidst their interaction. Understanding these factors will allow for the introduction of targeted
measures to mitigate the negative impact of such interruptions and improve patient-HCW relationships. This study
therefore aims to understand the impact of unplanned phone calls during primary health care consultations on
patient–HCW interactions and the factors affecting the patient and the HCW responses.
Method:This study used focus group discussions (FGD) to gather qualitative data from patients and HCWs who
had visited or worked in a major public primary healthcare institution in Singapore. The FGDs were audio-recorded,
transcribed, audited and analyzed using standard content analysis to identify emergent themes.
Results:15 patients and 16 HCWs participated in 5 FGDs. The key themes that emerged from these FGDs were
patients’ and HCWs’ attitudes toward professionalism and respect, task and thought interruption, call characteristics,
the impact on patient safety and stakeholders’ experiences. Phone calls during consultations answered by either
party often resulted in the answering party feeling apologetic and would usually keep the phone conversations
short as a sign of respect to the other party. Both stakeholders valued the consultation time and similarly reported
negative experiences if the phone-call interruptions became prolonged. Calls from the desk phone answered by
HCWs were perceived by most patients to be relevant to healthcare services, with the assumption that HCWs
exercised professionalism and would not attend to personal calls during their clinical duties.HCWs expressed their
concerns and distress about potential medical errors due to phone-calls interrupting their clinical tasks and thinking
processes. However, they acknowledged that these same phone-calls were important to allow clarifications of
instructions and improved the safety of other patients.
Conclusion:Phone interruptions affected patient and HCW interaction during consultations and factors leading to
their adverse reactions need to be recognized and addressed.