He Made an (Almost) Interruption-Free ED

Interruptions are, in a way, the currency of emergency medicine. But many of them may be making patient care worse rather than safer. EKGs are a perfect example: physicians may be interrupted thousands of times each year so that every tracing receives immediate attention, even when the overwhelming majority do not represent an emergency. Protecting physician attention doesn’t have to come at the expense of quickly identifying patients who need immediate intervention. In this episode, we explore how one emergency department dramatically reduced unnecessary EKG interruptions, why a 10-minute interpretation window may be safer than reflexively interrupting physicians, and how local data helped turn a counterintuitive idea into departmental practice. We also examine how asynchronous communication, protected workspaces, nursing partnerships, and a different way of thinking about attention can create a safer and more intentional emergency department. **Guest Bio:** Dr. Jake Zadra is a board-certified Emergency Physician and the current Chair of the Department of Emergency Medicine and Diagnostics at St. Mary's Hospital in Janesville, WI, where he also serves as Vice Chief of Staff. He completed medical school (’18) and EM residency (’21) at the University of Wisconsin, where he served as chief resident. Outside of medicine, he’s a live music enthusiast, enjoys slipping Lord of the Rings references into everyday conversation, and spends as much time outdoors as possible. He remains one of the few Emergency Physicians with no interest in ultramarathons or BASE jumping. **We Discuss:** - Why Every EKG Doesn’t Need to Be an Emergency - The Cost of 7,000 Interruptions to Find Two Unflagged STEMIs - What Happens When the EKG Machine Misses a STEMI - Why Fewer Interruptions May Lead to Better EKG Interpretation - How the Workflow Handles Gray-Zone EKGs - Rethinking the 10-Minute EKG Rule - Using Local Data to Build a Safer Workflow - How an EKG Drop Zone Keeps Deferred Reviews From Getting Lost - How a Quieter Workspace Reduces Drive-By Interruptions - Why Not Every Interruption Deserves the Same Response - How Secure Chat Can Become an Asynchronous Inbox - Why Nurses Need Protection From Interruptions Too - How Making Interruptions Visible Creates Buy-In Mentioned in this episode: **Rob’s Book: Supranormal** Supranormal: A Field Guide for the Impossible Job, tackles the parts of being a doctor that medical training leaves out, with practical tools for navigating conflict, overwhelm, burnout, and the sustained complexity of medicine, so you can build a career that is both sustainable and fulfilling. Get Supranormal **Get Out On Time** The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME. Learn More About The Out-On-Time Course **Six Sessions to Recalibrate Your Career** Still like the doctoring, but all the stuff around it is taking a toll? Career Longevity Coaching is six one-on-one sessions over five months to identify what’s making your work harder than it needs to be and start making changes. If you’re wondering, "How long can I keep doing it like this?" Don’t wait until the answer is "I can’t." Career Longevity and Burnout Coaching