For years, complicated workflows were designed around the purely anecdotal assumption that workers doing several things at once would accomplish more in less time with fewer mistakes. But if you’ve kept up with the research over the last ten years or so, it may not come as a surprise that—from driving to studying for an exam—multi-tasking is the wrong way to go about it. There are, however, contexts in which no alternative is available. Chief among those are medical contexts, in particular emergency and critical care.
An upcoming Applied Ergonomics (Volume 59, Part A, March 2017) study released in part by Science Direct analyzed the findings of both healthcare and non-healthcare multi-tasking studies to suggest considerations for future medicine-specific investigations. The authors found three key considerations for multi-tasking in healthcare.
1. Long on time, short on results
No matter whether multi-tasking is concurrent or interleaved (one task directly after another), the analysis found that tasks took longer to complete than they would as stand-alone objectives. Emergent contexts should balance the necessity of multiple factors needing attention at once with the urgency of the medical situation. If, for instance, expediency is a major consideration, ancillary tasks should be kept to a minimum or delegated to another member of the team.
Studies in every context also arrived at the conclusion that multi-tasking of any kind garners inferior results to those of single-focus tasks. Variation in exactly how much worse the results were could be seen between the two varieties of multi-tasking, with the interleaved variety showing slightly more success.
2. Self-starters finish first
A surprising piece of insight from the analysis was that, regardless of the variety of multi-tasking being performed, results were better if the initiative came from the person accomplishing the task. A directive from another may inspire two detrimental effects. First, the directive itself is a distraction that adds to the risk of a current task being dropped and left unfinished. Second, the tasked worker must integrate the information and roll it into a plan, creating some measure of time-consuming cognitive work. In other words, participants were better able to configure their process in advance if they had a sense of either what tasks needed to be completed simultaneously or of what succession interleaved tasks would take. “Control over their task flow might also leave them less vulnerable to errors resulting from external prompts,” according to the study.
3. Great minds don't think alike
We know that learning styles differ depending upon presentation. Some retain information better if presented in words and others if the presentation is more visually based. In that vein, analysis of largely non-medical multi-tasking studies revealed insight about multi-tasking in healthcare… Task modality played a significant role in outcome. If both tasks (or multiple tasks) remained exclusively within a fixed modality (i.e. verbal communication, tactile input, visual information), there were inferior results in time to completion, errors, and a significantly higher chance that any task would slip through the cracks. For example, a physician asking diagnostic questions (verbal) while reviewing a sonogram (visual) would be more effective overall than a physician asking diagnostic questions in concert with giving verbal orders to a nurse. Think neurologically here. “If information from competing tasks is in a different modality, or the responses to them require different formats, the likelihood of errors and augmented response times may be decreased.”
Overall, this study is a springboard for further research. Information regarding multi-tasking in healthcare was scanty and what research was available to the authors was largely observational in nature and used an insufficient number of subjects to be taken as indisputable fact. For now, the analysis may help in planning effective workflow and may have critical importance for refining how physicians communicate with their teams and delegate the necessary, and multiple, tasks of critical care.
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