May 21st, 2010

The Perils of Multitasking

How often do you find yourself trying to do so many things at once that you either make, or come close to making, a mistake in patient care? In an article recently published in the Archives of Internal Medicine, nurses who were interrupted during medication administration were more likely to make a medication error. Is this just another example of research supporting common sense, or are there implications here for fellows and faculty alike? 

I’m currently on service in the CCU, traveling to give a talk at the AHA’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke meeting, finalizing our rank list, and trying to get our research group’s abstracts ready for submission…. Oh, and I’m also late getting this blog posted for CardioExchange! Is it any surprise that I sometimes have to stop myself from multitasking while seeing a patient? 

We faculty ask our fellows to multitask as well. We give you major service obligations — and expect you to read and actively learn, move your research projects forward, and prepare a series of formal presentations. Meanwhile, your pagers beep incessantly.

How many errors of judgment are due to this frenetic pace and the multitasking that seems to be required? Would fellows (and faculty) learn and perform better if we eliminated the distractions caused by multitasking? Is this just an inevitable byproduct of modern society? Or do solutions exist to minimize patient risk? 

We’d love to learn your thoughts on this very modern problem. 

3 Responses to “The Perils of Multitasking”

  1. Multi-tasking definitely has a down side

    Really great post. I’m starting to think that the kind of ‘focused’ multi-tasking that we do as doctors on the wards or in clinic is different and less prone to problems than the cross-disciplinary multi-tasking that we try to do as fellows (or faculty) when we try to manage service obligations at the same time as non-service related tasks. Here are two interesting related posts that others may also have seen:
    These have definitely made me think a bit differently about what it means to try to get a lot of different things done efficiently and effectively. Now, how to translate this into practice…

  2. Multitasking… maybe a risk factor to be avoided…

    Well, we may need to recognize that risk increases when we multitask – it may be simple mental errors that just end up wasting our time – but they could be errors that hurt patients, cause accidents and so on. I know the temptation (My name is Harlan and I am a multitasker) – but we need to do something about how distractions are infiltrating all aspects of our lives. I found the Archives study to be fascinating and deserves discussion in every hospital in the country. I am interested if anyone has really made a dramatic change in their workstyle and been able to reduce the distractions.

  3. But how could you fix this?

    Great post- this is such an interesting topic and the article really makes you think. Inherently, I believe that people who are drawn to and practice medicine are multi-taskers. Our brains need to be as flexible and mind-bending (excuse the pun) as acrobat performers in order to balance patient care, teaching, community and administrative responsibilites as well as family. There is no doubt that when you multi-task, areas will suffer. One can compare it to the analogy of juggling all those glass balls, and which one are you going to drop? However, more importantly,is how can you possibly control or limit this? For ex. – a nurse is mixing a medicine then administering it- you develop a rule that you cannot interrupt him or her. Her patient next door is coding but whoops! I’m sorry, you have to wait until she’s done administering the medicine.

    Rather than controlling the outside forces (which- let’s be frank- hardly seems possible in our busy lives), being cognizant may be the key. Educating physicians and medical personnel that this is a risk may not be the solution, but could help us recognize that when we are being distracted and multitasking, we may need to focus a bit more. But then again…let’s add that on ours and our trainees to do list as one of our many tasks…