title: Challenges in measuring the impact of interruption on patient safety and workflow outcomes.
abstract: OBJECTIVE
  To examine the problem of studying interruption in healthcare.
  
  
  METHODS
  Review of the interruption literature from psychology, human-computer interaction; experimental studies of electronic prescribing and error behaviour; observational studies in emergency and intensive care.
  
  
  RESULTS
  Primary task and interruption variables which contribute to the outcomes of an interruption include the type of task (primary and interrupting task); point of interruption; duration of interruption; similarity of interruptive task to primary task; modality of interruption; environmental cues; and interruption handling strategy. Effects of interruption on task performance can be examined by measuring errors, the time on task, interruption lag and resumption lag.
  
  
  CONCLUSIONS
  Interruptions are a complex phenomenon where multiple variables including the characteristics of primary tasks, the interruptions themselves, and the environment may influence patient safety and workflow outcomes. Observational studies present significant challenges for recording many of the process variables that influence the effects of interruptions. Controlled experiments provide an opportunity to examine the specific effects of variables on errors and efficiency. Computational models can be used to identify the situations in which interruptions to clinical tasks could be disruptive and to investigate the aggregate effects of interruptions.
authors.affiliation: Centre for Health Informatics, University of New South Wales, Sydney 2052, Australia. f.magrabi@unsw.edu.au
authors.forename: F
authors.initials: F
authors.lastname: Magrabi
authors.forename: S Y W
authors.initials: SY
authors.lastname: Li
authors.forename: A G
authors.initials: AG
authors.lastname: Dunn
authors.forename: E
authors.initials: E
authors.lastname: Coeira
mesh_terms: D003198:Computer Simulation; D017598:Efficiency, Organizational; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D050316:Medical Order Entry Systems; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000379:methods*; D010818:Practice Patterns, Physicians'; D012449:Safety; D013647:Task Performance and Analysis; D014584:User-Computer Interface; D057188:Workflow