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DOI: 10.1055/a-1892-1437
Measuring and Maximizing Undivided Attention in the Context of Electronic Health Records
Funding This research was supported, in part, by the National Library of Medicine of the National Institutes of Health, U.S. Department of Health and Human Services under Award Number R01LM012854.Undivided attention is a clinician's superpower.[1] Often called deep work,[2] being in the flow, or being in the zone—when health professionals are able to perform their responsibilities with full focus and presence,[3] the care itself is safer and the care process is more satisfying to patients and clinicians alike.[4] The opposite of this state is split attention, moments when clinicians lose focus and, as a result, risk missing important incoming data—whether a cue from the patient's body language or tone of voice,[5] a relevant element of the past medical history, or an abnormal test result.
The design of the clinical environment can support or undermine clinicians' ability to provide undivided attention. It is readily apparent when, for example, the environment impedes a physician's ability to listen intently to his/her patient's symptoms, context, and concerns or a pharmacist's ability to perform medication reconciliation without interruption. Yet we currently have no standard metrics for this important state of work. Without such measures, there is no basis to assess current levels of undivided attention or the impact of efforts to increase undivided attention with associated benefits in terms of safety, patient and clinician experience, and other important outcomes.
This commentary identifies two key interactions where undivided attention is both critical and rare—the clinician–patient interaction and the clinician–electronic health record (EHR) interaction. We then propose proxy metrics of undivided attention during these interactions—ATTNPT and ATTNEHR ([Table 1]). These metrics, derived from the EHR, can be used for both operational improvements and research, by characterizing the current clinical environment, determining the association between undivided attention and other outcomes, and optimizing the care environment.
Publikationsverlauf
Eingereicht: 18. April 2022
Angenommen: 30. Juni 2022
Accepted Manuscript online:
05. Juli 2022
Artikel online veröffentlicht:
11. August 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
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