Multitasking by Clinicians in the Context of CPOE and CIS Use

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.

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