Observational studyBMJ quality & safety2018
Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.
Observational study in BMJ quality & safety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 115 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
115 citing papers in PubMed, 1 synthesis or guideline pooled it, 292 citations in OpenAlex.
- Effectiveness of non-technical skills training for healthcare professionals in emergency departments: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Pooled it
- User centered clinical decision support to implement initiation of buprenorphine for opioid use disorder in the emergency department: EMBED pragmatic cluster randomized controlled trial.BMJ (Clinical research ed.) · 2022Trial
- Anodal tDCS augments and preserves working memory beyond time-on-task deficits.Scientific reports · 2021Trial
- Patient safety incidents and medication errors during a clinical trial: experience from a pre-hospital randomized controlled trial of emergency medication administration.European journal of clinical pharmacology · 2020Trial
- Trial
- Classifying Unsafe Health and Care Behaviors in the Context of Just Culture: A Comparative Video-Based Vignette Study.Healthcare (Basel, Switzerland) · 2026Article
- Evaluating longitudinal data accuracy in postpartum venous thromboembolism risk assessments: a retrospective observational study.Research and practice in thrombosis and haemostasis · 2026Observational
- Quantifying and Visualizing Emergency Physician Workflow: Observational Time-Motion Study.JMIR medical informatics · 2026Observational
- Parental involvement in patient safety events in paediatric emergency care: a multi-method analysis.BMJ paediatrics open · 2026Article
- Factors contributing to electronic prescribing errors in healthcare settings: a qualitative study.BMC medical informatics and decision making · 2026Article
- Secure Messaging Workload and the Effect of an Enhanced Workflow Intervention Among Hospitalist Clinicians.Journal of general internal medicine · 2026Article
- A Safety-II approach to learn from practice variation in the diagnostic process in the emergency department: an action research study.Diagnosis (Berlin, Germany) · 2026Article
- Culture eats evidence for breakfast: how culture influences implementation of evidence-based practices.Implementation science communications · 2026Article
- Associations Between Interruptions and Medication Administration Errors Among Nurses in Hospital Settings: A Scoping Review of Quantitative Studies.Journal of advanced nursing · 2026Article
- Interruptions and multitasking in anaesthesia nursing: a prospective observational study of cognitive strain and workflow patterns.BMJ open quality · 2026Observational
- TRIAGE: Trustworthy Reporting and Assessment for Clinical Gain and Effectiveness of AI Models.Diagnostics (Basel, Switzerland) · 2026Review
- Impact of Resident Doctors' Strike on Psychological Outcomes Among Paramedics in Teaching-Hospital Emergency Departments: A Nationwide Multicenter Survey.Healthcare (Basel, Switzerland) · 2026Article
- Beyond Working Memory Capacity: Attention Control as the Underlying Mechanism of Cognitive Abilities.Journal of Intelligence · 2026Review
- Reduced overtriage is associated with increased patient flow at pediatric emergency department.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Observational
- IN SITU: Evaluation of the feasibility and impacts of in situ simulation in emergency medicine, a mixed method study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
55 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied.
objectiveTo assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors.
methods36 emergency physicians were shadowed over 120 hours. All tasks, interruptions and instances of multitasking were recorded. Physicians' working memory capacity (WMC) and preference for multitasking were assessed using the Operation Span Task (OSPAN) and Inventory of Polychronic Values. Following observation, physicians were asked about their sleep in the previous 24 hours. Prescribing errors were used as a measure of task performance. We performed multivariate analysis of prescribing error rates to determine associations with interruptions and multitasking, also considering physician seniority, age, psychometric measures, workload and sleep.
resultsPhysicians experienced 7.9 interruptions/hour. 28 clinicians were observed prescribing 239 medication orders which contained 208 prescribing errors. While prescribing, clinicians were interrupted 9.4 times/hour. Error rates increased significantly if physicians were interrupted (rate ratio (RR) 2.82; 95% CI 1.23 to 6.49) or multitasked (RR 1.86; 95% CI 1.35 to 2.56) while prescribing. Having below-average sleep showed a >15-fold increase in clinical error rate (RR 16.44; 95% CI 4.84 to 55.81). WMC was protective against errors; for every 10-point increase on the 75-point OSPAN, a 19% decrease in prescribing errors was observed. There was no effect of polychronicity, workload, physician gender or above-average sleep on error rates.
conclusionInterruptions, multitasking and poor sleep were associated with significantly increased rates of prescribing errors among emergency physicians. WMC mitigated the negative influence of these factors to an extent. These results confirm experimental findings in other fields and raise questions about the acceptability of the high rates of multitasking and interruption in clinical environments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.