Interruptions in healthcare: Theoretical views

Grundgeiger, Tobias and Sanderson, Penelope (2009) Interruptions in healthcare: Theoretical views. International Journal of Medical Informatics, 78 5: 293-307. doi:10.1016/j.ijmedinf.2008.10.001

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Author Grundgeiger, Tobias
Sanderson, Penelope
Title Interruptions in healthcare: Theoretical views
Journal name International Journal of Medical Informatics   Check publisher's open access policy
ISSN 1386-5056
Publication date 2009-05
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.ijmedinf.2008.10.001
Volume 78
Issue 5
Start page 293
End page 307
Total pages 15
Editor C. Safran
J. Talmon
Place of publication Ireland
Publisher Elsevier Ireland
Collection year 2010
Language eng
Subject C1
1799 Other Psychology and Cognitive Sciences
970117 Expanding Knowledge in Psychology and Cognitive Sciences
Formatted abstract
Background
Researchers in healthcare have begun to investigate interruptions extensively, given evidence for the adverse effects of work interruptions in other domains and given the highly interruptive hospital environment. In this paper, we reviewed literature on interruptions in critical care and medication dispensing settings in search of evidence for a relationship between interruptions and adverse events.

Methods
The literature search included the databases MEDLINE, CINAHL + Pre CINHAL, Health Sources: Nursing Academic Edition, EMBASE, PsycINFO, ISI Web of Science and Ergonomics Abstracts. The paper titles and abstracts were subsequently reviewed. After the initial search, we reviewed paper titles and abstracts to define the subset for review.

Results
We currently lack evidence in healthcare of the extent to which interruptions lead to adverse effects. The lack of evidence may be due to the descriptive rather than causal nature of most studies, the lack of theory motivating investigations of the relationship, the fact that healthcare is a complex and varied domain, and inadequate conceptualizations of accident aetiology. We identify two recent accident theories in which the relationship between activity and medical errors is complex, indicating that even when it is sought, causal evidence is hard to find.

Discussion
Future research on interruptions in healthcare settings should focus on the following. First, prospective memory research and distributed cognition can provide a theoretical background for understanding the impact of interruptions and so could provide guidance for future empirical research on interruptions and the planning of actions in healthcare. Second, studying how interruptions are successfully rather than unsuccessfully overcome may better help us understand their effects. Third, because interruptions almost always have positive and adverse effects, more appropriate dependent variables could be chosen.
Keyword Interruptions
Distractions
Prospective memory
Healthcare
Communication
Patient safety
Error theory
Accident model
Medication dispensing
Distributed cognition
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Psychology Publications
 
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Created: Wed, 07 Apr 2010, 12:02:52 EST by Lucy O'Brien on behalf of School of Psychology