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BMJ Qual Saf 21:357-360 doi:10.1136/bmjqs-2012-000783
  • Editorial

The science of interruption

  1. Enrico Coiera
  1. Correspondence to Professor Enrico Coiera, Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW 2055, Australia; e.coiera{at}unsw.edu.au

There has been a steady growth of research into interruption spanning two decades. The first observations indicating that interruptions appeared to be commonplace in busy clinical settings like the emergency department1–5 were soon followed by a potential link between interruptions and clinical error.6 We now know that the act of interruption is pervasive,7–9 perhaps universal, in clinical practice (and indeed most of life). Even apparently quiet and controlled spaces like the operating theatre are home to frequent interruption.10 11 There are now also robust studies demonstrating the sometimes negative impact of interruption on clinical work,12 and in the genesis of error.13–15

Interruption science is thus important in its own right. As importantly, it also provides us with a model for how we can approach the broader study of socio-technical systems in patient safety. The realisations that clinical work is complex, and that safety is an emergent property of local context, are all mirrored in the study of interruption. There is thus much to be learnt from the specific analysis of interruptions for the broader study of clinical work and patient safety.

Studying interruptions is, however, challenging.16 17 It is still hard to predict the impact of interventions designed to minimise the effects of interruptions, or even to understand when such interventions are needed. Untangling this nuanced story could take a while, were it not for the work of researchers from other disciplines. Psychology, in particular, has a large corpus of research, often from controlled laboratory studies, that tease apart the mechanics of how interruption disrupts cognition.18 19 The field of human computer interaction (HCI) explores how interruption disrupts the way we interact with technology, how technology design can be interruptive (think pager or mobile phone) and, crucially, how technology can be designed …

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