Interruptions and distractions in healthcare: review and reappraisal.
OBJECTIVE
To systematically review the peer-reviewed literature on interruptions in healthcare settings to determine the state of the science and to identify the gaps in research.


METHODS
Inclusion criteria were determined, and the online databases PubMed and Web of Knowledge-CrossSearch were searched.


RESULTS
Thirty-three papers were reviewed. Several important findings were identified: (1) interruptions occur frequently in all healthcare settings, (2) an important gap exists: only seven studies examined outcomes related to interruptions, (3) interruptions in healthcare have only been studied from the viewpoint of the person being interrupted and (4) few studies explicitly or implicitly examined the cognitive implications of interruptions.


CONCLUSIONS
The high frequency of interruptions coupled with information content may simply be indicative of the high need for constant communication and coordination in healthcare. Many interruptions may be necessary for safe, high-quality care; thus, trying to eliminate all interruptions is unwise. That said, there may be situations, such as during high-risk procedures, when limiting interruptions may be warranted. Taking a complex sociotechnical systems approach will help researchers view interruptions more holistically and will result in more comprehensive studies that take into account the complexity of interruptions and the many variables in healthcare settings.
Rivera-Rodriguez
A J
AJ
Industrial Engineering, University of Wisconsin-Madison, 1513 University Avenue, Room 3218, Madison, WI 53706, USA.
Karsh
B-T
BT
D001288:Attention; D003142:Communication; D003695:Delivery of Health Care; D019981:Health Care Sector; D006801:Humans; D007400:Interprofessional Relations; D061214:Patient Safety; D011787:Quality of Health Care; D013647:Task Performance and Analysis