title: Multitasking by clinicians in the context of CPOE and CIS use.
abstract: Interest in studying distractions and interruptions in the context of clinician workflow has increased in light of evidence that these events may negatively impact patient safety. Additionally, many recent informatics-based studies analyze computer provider order entry (CPOE) and clinical information system (CIS) implementation and its effects on clinician workflow. This study expands the development and use of a taxonomy to characterize distractions to clinicians and their subsequent actions in the context of CPOE/CIS use. We found a total of 75 distracting events in 406 minutes of observational data of which 32 led to interruptions and 30 led to continued multitasking. The above primary actions led to 5 tasks not completed and 4 episodes of clinician's lack of recall. Differences in the distribution of the source of distractions and primary action of the distracted clinicians may be a function of clinical setting and clinician type using the CPOE/CIS. Nine secondary actions, potentially resulting in a slip or a mistake, suggest that CPOE may necessitate different forms of safety nets than traditional clinician communication.
authors.affiliation: Columbia University School of Nursing, Department of Biomedical Informatics, and New York Presbyterian Hospital, New York, New York 10032, USA. sac2125@columbia.edu
authors.forename: Sarah
authors.initials: S
authors.lastname: Collins
authors.forename: Leanne
authors.initials: L
authors.lastname: Currie
authors.forename: Vimla
authors.initials: V
authors.lastname: Patel
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bakken
authors.forename: James J
authors.initials: JJ
authors.lastname: Cimino
mesh_terms: D001288:Attention; D006751:Hospital Information Systems; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D050316:Medical Order Entry Systems; D010564:Personnel, Hospital / Q000523:psychology; D013647:Task Performance and Analysis; D000078329:Workforce