Interruptions at Work in Healthcare: How to Handle Them

Healthcare teams can reduce interruptions at work by separating urgent from nonurgent communication, protecting high-risk clinical tasks, routing patient portal messages to the right team member, setting clear patient expectations, and giving clinicians scheduled time to manage inbox work. Importantly, hospitals shouldn’t frame interruptions as an individual time-management problem. They’re a workflow, safety, and workforce well-being issue.

That distinction matters. In one inpatient observational study, healthcare professionals experienced an average of 10.5 interruptions per hour, and more than half were classified as avoidable. Meanwhile, patient portals have become a normal part of care access, with 65% of individuals nationally offered or accessing online medical records or a patient portal in 2024.

So, yes, clinicians need practical boundaries. However, leaders also need to redesign the systems that create constant context switching in the first place.

Why interruptions at work are now a healthcare leadership issue

Interruptions at work aren’t new in healthcare. A nurse gets stopped during medication administration. A physician steps out of an exam room to answer a “quick” inbox question. A medical assistant routes a portal message, then a second message, then a third follow-up message before the first one is answered. It’s all familiar.

But here’s the problem: Familiar doesn’t mean harmless.

A 2025 JAMA Internal Medicine study of more than 280,000 ambulatory physicians found that primary care physicians received a mean of 24 patient calls and 16 patient medical advice request messages per week, while electronic health record and inbox time remained a persistent source of physician work.

And that wave of distractions isn’t without risk. For example, during medication-related tasks, interruptions can increase the risk of error, especially when clinicians are prescribing, dispensing, or administering medications.

In other words, the “front door” to care is now digital, physical, and continuous. Therefore, reducing interruptions at work isn’t about making clinicians less available. It’s about making access safer, clearer, and more sustainable.

Not every interruption is bad

Before leaders launch a “stop interruptions” campaign, it’s worth saying this plainly: some interruptions are necessary.

A nurse should be interrupted for a true patient-safety concern. A physician should be notified quickly about a critical result. A pharmacist should speak up if something looks wrong. In healthcare, the goal isn’t zero interruptions. Instead, the goal is fewer avoidable interruptions and better routing of necessary ones.

That’s why health systems should define which interruptions are appropriate, which can wait, and which should be handled by someone other than the physician or bedside nurse. ECRI and ISMP recommend defining critical tasks, improving workflows, reducing unnecessary alerts, optimizing phone systems, managing patient questions, and reassessing interruptions over time.

It’s important to protect focus where focus protects patients.

Reducing interruptions at work in the patient portal era

Patient portals are here to stay. That’s a good thing. They can improve access to care, transparency, and patient engagement. However, without clear boundaries, they can also turn into an always-on inbox that patients experience as immediate access and clinicians experience as unfinished work.

Here are boundaries healthcare teams can set without damaging trust.

1. Clarify that the portal is not for urgent or emergency needs

Patients often don’t know how portal messages are staffed, triaged, or prioritized. Therefore, the first boundary should be clear and repeated:

“The portal is for nonurgent questions. For urgent symptoms or emergencies, use the urgent care, emergency, or on-call process described by your care team.”

This is exactly the kind of expectation-setting healthcare organizations need. AMA guidance recommends telling patients what can and can’t be handled by portal message, how long responses usually take, and when a visit is needed instead.

2. Set response-time expectations in plain language

Patients may send repeat messages because they don’t know whether anyone saw the first one. So, response-time expectations should be specific.

For example:

“We typically respond to nonurgent portal messages within two to three business days. Please don’t send duplicate messages during that window, because it can delay routing.”

A word of warning: Be sure that response-time expectations match clinic capacity. Some teams may respond by the end of the day, while others may need three to five days. Don’t overpromise, then underdeliver.

3. Ask patients to send one issue per message

One portal message with five unrelated concerns can quickly become an unpaid, asynchronous visit. It can also increase the chance that something gets missed.

A simple boundary helps:

“Please send one medical concern per message. If you have several concerns, we may ask you to schedule a visit so we can address them safely.”

That’s not a barrier to care. It’s a safer care pathway.

4. Explain when a message needs an appointment

Some patient questions are too complex for portal messaging. New symptoms, worsening conditions, medication changes, forms, disability paperwork, and multi-part clinical questions may need a visit.

Meanwhile, patients may hope to resolve changing health statuses via messages.

“If my clinic staff have messaged more than three times with a patient about a topic, and we’re not getting to the answer we need, it’s time for the patient to come in for an appointment.”

Gray added that many patients will view their portal chats as text messaging. With that in mind, create a rule that works for you and your colleagues.

5. Prepare patients for immediate test-result release

The 21st Century Cures Act and modern portal design have made rapid access to test results a common patient experience. However, patients may see results before the clinician has reviewed them. That can drive anxiety and follow-up messaging.

A 2025 JAMA Network Open study found that patients repeatedly refreshed the portal for 25.9% of reviewed test results and that refresh behavior was associated with messaging clinicians within 24 hours for non-urgent information.

So, clinicians and systems should explain the process before results appear:

“You may see results before your clinician has reviewed them. We’ll contact you promptly about urgent findings. For non-urgent results, please allow the care team time to review and comment.”

That one message can prevent a lot of avoidable portal back-and-forth.

What hospital systems and employers can do to limit interruptions at work

Clinicians can set boundaries, but they can’t solve interruption overload alone. In fact, asking individual doctors and nurses to fix systemic interruption problems is part of the problem.

Here’s what healthcare employers can do.

1. Build team-based inbox management

Not every portal message requires a physician response. Some messages need scheduling support. Others need refill protocols, nursing triage, lab routing, or patient education. There’s no federal regulation requiring only physicians to respond to all patient portal messages, and team-based message management can expedite responses, reduce administrative burden time, and reduce burnout.

This is where healthcare leaders can make a real difference. Define who handles what, then give teams routing protocols, escalation criteria, and protected time to do the work.

One 2025 general internal medicine study found that a multipronged in-basket intervention reduced messages per physician clinical full-time equivalent by 16% and decreased carbon-copy messages by 65%.

2. Stop treating the inbox like invisible work

Inbox work is work. Portal messages are work. Test-result review is work. Refill routing is work. Yet, in many organizations, this labor is squeezed into lunch, after-hours time, or the margins between visits.

That’s not sustainable.

AHRQ has identified inbox management, electronic health record time, work outside work, workflow fragmentation, and usability as key categories for measuring documentation burden.

So, leaders should schedule inbox coverage the same way they schedule clinic sessions. Otherwise, the work doesn’t disappear. It just moves into clinicians’ evenings.

3. Reduce electronic health record alerts and notification sludge

Healthcare organizations often interrupt clinicians through their own technology. Alerts, carbon copies, FYIs, refill notifications, secure chats, inbox folders, and automated routing rules can all pile up.

AMA coverage of recent physician inbox data highlights the need to eliminate redundant notifications, empower nurses to manage many messages, and help patients choose the right communication channel.

In practical terms, leaders should audit whether/which:

• Alerts are clinically necessary
• Messages are duplicative
• Notifications go to physicians but could be handled by another role?
• Messages reach clinicians only because no one owns the workflow?
• Which “FYI” messages create liability without creating action?

Then, remove what doesn’t add value.

4. Protect medication administration and other safety-critical windows

Hospitals can create “quiet zones,” visual cues, scripted expectations, and unit norms that protect high-risk tasks. However, the policy has to be specific. “Don’t interrupt nurses” is too vague. “Don’t interrupt medication administration unless there’s an urgent safety concern” is much better.

ECRI and ISMP recommend defining critical tasks, managing patient questions, limiting unnecessary alarms and alerts, improving systems and processes, and educating staff about interruption risks.

The strongest programs don’t rely on posters alone. They redesign workflows so fewer people need to interrupt clinicians in the first place.

5. Give patients better front-end guidance

Many patient interruptions happen because the system hasn’t explained where patients should go.

For example, a patient may use the portal for urgent symptoms because the portal button is easy to find and the triage line is not. Another patient may send three messages about a refill because they don’t know whether to contact the pharmacy, the practice, or the specialist.

That’s fixable.

Health systems should build clear, repeated guidance into portal landing pages, after-visit summaries, phone trees, discharge paperwork, and automated replies. Portal use is widespread now, and many patients manage multiple portals at once, which makes simple channel guidance even more important.

Reduce interruptions at work with a 30-60-90-day plan

First 30 days: Find the interruption hotspots

Start with observation and data. Shadow medication administration, inbox workflows, discharge processes, and clinic sessions. Review portal message categories, duplicate messages, after-hours electronic health record time, and phone volume. Most importantly, ask staff which interruptions they feel are necessary and which should be handled by the system.

Next 60 days: Set rules and redesign routing

Create clear definitions for urgent, same-day, routine, and administrative messages. Then, build routing protocols by role. Decide what medical assistants, nurses, pharmacists, physicians, schedulers, and centralized teams can resolve.

Also, publish patient-facing portal expectations, including response times and when a visit is required. Obviously, not all patients will follow instructions. But some will, and that will help.

By 90 days: Pilot, measure, and adjust

Pick one clinic or unit. Test protected medication administration windows, team-based inbox routing, portal auto-replies, and response-time expectations. Then, measure message volume, interruptions per hour, staff satisfaction, patient complaints, response times, and after-hours work.

The goal isn’t a perfect policy. It’s a safer, more sustainable workflow.

Reducing interruptions at work takes boundaries and better systems

Doctors and nurses can absolutely set better boundaries. They can protect high-risk tasks, batch nonurgent communication, reset after interruptions, and teach patients how to use portals appropriately.

However, healthcare leaders have the bigger lever.

If hospitals and practices want fewer interruptions at work, they need to design fewer interruptions into the work. That means team-based inbox management, protected clinical focus time, smarter EHR routing, clearer portal expectations, better staffing, and measurement that treats interruption burden as a safety and workforce issue.

Patients still deserve access. Clinicians still deserve focus. With the right systems in place, healthcare organizations don’t have to choose between the two.