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Interruptions and multi-tasking: moving the research agenda in new directions
  1. Johanna I Westbrook
  1. Correspondence to Professor Johanna I Westbrook, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, University of New South Wales Medicine, Kensington, NSW 2052, Australia; J.Westbrook{at}

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When the media-savvy US psychiatrist Edward Hallowell first asked people to imagine how they would perform on a tennis court with two, three or even more balls in play, it seemed obvious that, no matter how talented or fit, everyone would be hard pressed to keep up, let alone execute any precision shots.1 Dr Hallowell's book, CrazyBusy, went a long way towards raising popular awareness of something that many people felt intuitively. That is, that multi-tasking—and the associated interruptions that demand we either switch between competing tasks or load one task on top of another, say by talking on the phone while responding to emails—really was contributing to feeling frantic.

Yet, since the book's publication in 2006, we've just kept raising the ‘busy-ness’ bar in our daily personal and professional lives. Email ushered in expectations that the instantaneous delivery of messages would elicit similarly instant responses. Now, in the communications-saturated environment of texting, Instagram, Snapchat, Tumblr, Facebook and Twitter, frequent interruptions and multi-tasking are so familiar that the absence of instant ‘connectivity’ can cause mild anxiety—or, for some of us, dismay and distress. But, despite the many unquestionable benefits of extraordinary connectivity, and the unprecedented access to information and interaction it enables, the cognitive and social demands of the rapidly evolving digital communication landscape come at a cost. In healthcare organisations, the relentless, competing demands for clinicians’ attention are not merely another source of workplace stress, but represent an issue that goes to the very heart of patient safety and quality of care.

Studying communication patterns in the healthcare sector is not only vital—it's fascinating. Healthcare delivery is largely reliant on the flow of clear, concise and accurate information across the many complex webs that link patients, different healthcare professionals and support staff via paper- and computer-based systems. …

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