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Journal of Healthcare Engineering
Volume 4 (2013), Issue 1, Pages 127-144
Research Article

The Effects of Interruptions on Oncologists' Patient Assessment and Medication Ordering Practices

Patricia L. Trbovich,1,2,3 Melissa C. Griffin,1 Rachel E. White,1 Venetia Bourrier,4 Dhali Dhaliwal,4 and Anthony C. Easty1,2

1HumanEra, Techna, University Health Network, Toronto, Ontario, Canada
2Institute of Biomaterials and Biomedical Engineering, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
3Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
4Cancer Care Manitoba, Winnipeg, Manitoba, Canada

Received 1 December 2011; Accepted 1 October 2012

Copyright © 2013 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. L. T. Kohn, J. M. Corrigan, and M. S. Donaldson, Eds., Err is Human: Building a Safer Healthcare System, Institute of Medicine, National Academy Press, Washington, D. C., 2000.
  2. D. L. B. Schwappach and M. Wernli, “Medication errors in chemotherapy: incidence, types and involvement of patients in prevention. A review of the literature,” European Journal of Cancer Care, vol. 19, pp. 285–292, 2010. View at Google Scholar
  3. ISMP Canada, “Fluorouracil incident root cause analysis,” 2007,, Accessed November, 2012.
  4. R. B. Womer, E. Tracy, W. Soo-Hoo, B. Bickert, S. DiTaranto, and J. H. Barnsteiner, “Multidisciplinary systems approach to chemotherapy safety: Rebuilding processes and holding the gains,” J Clin Oncol, vol. 20, pp. 4705–4712, 2002. View at Google Scholar
  5. P. L. Trbovich, V. Prakash, J. Stewart, K. Trip, and P. Savage, “Interruptions during the Delivery of High Risk Medications,” Journal of Nursing Administration, vol. 40, no. 5, pp. 211–218, 2010. View at Google Scholar
  6. D. H. Hickam, S. S. Severance, A. Feldstein et al., “The Effect of Health Care Working Conditions on Patient Safety,” Agency For Healthcare Research and Quality, vol. 74, 2003. View at Google Scholar
  7. Summary of Information Submitted to MEDMARX in the Year 2001: A Human Factors Approach to Understanding Medication Errors. Rockville, MD: United States Pharmacopeia, December 2002.
  8. United States Pharmacopeia, “USP Patient Safety CAPSLink September 2003,” USP Patient Safety CAPSLink, Accessed November, 2012.
  9. L. L. Leape, D. W. Bates, D. J. Cullen et al., “Systems Analysis of Adverse Drug Events,” JAMA, vol. 274, no. 1, pp. 35–43, 1995. View at Google Scholar
  10. American Society of Clinical Oncology: The Oncologist's Field Guide to Selecting and Implementing an Electronic Health Record. Alexandria, VA, ASCO, 2008,,+June+2,+2008+Section+B/ASCO+Develops+Practical+Guide+for+Selecting,+Implementing+Electronic+Health+Records.
  11. L. N. Shulman, R. S. Miller, E. P. Ambinder, P. P. Yu, and J. V. Cox, “Principles of Safe Practice Using an Oncology EHR System for Chemotherapy Ordering, Preparation, and Administration, Part 1 of 2,” J Oncol Pract, vol. 4, no. 4, pp. 203–206, 2008. View at Google Scholar
  12. D. Liu, T. Grundgeiger, P. M. Sanderson, S. A. Jenkins, and T. A. Leane, “Interruptions and blood transfusion checks: lessons from the simulated operating room,” Anesthesia and Analgesia, vol. 108, no. 1, pp. 219–222, 2009. View at Google Scholar
  13. P. R. Ebright, E. S. Patterson, B. A. Chalko, and M. L. Render, “Understanding the complexity of registered nurse work in acute care settings,” J Nurs Adm, vol. 33, no. 12, pp. 630–638, 2003. View at Google Scholar
  14. F. A. Drews, “The frequency and impact of task interruptions in the ICU,” in Proceedings of the 51st Annual Meeting of the Human Factors and Ergonomics Society, pp. 683–686. View at Google Scholar
  15. N. Osborne, T. Shin, H. Guo, and S. Gerlain, Remote Analysis of Team Environments (RATE), University of Virginia, 2004,,
  16. J. I. Westbrook, E. D. Coiera, E. D. W. T. M et al., “The impact of interruptions on clinical task completion,” Qual Saf Health Care, vol. 19, pp. 284–289, 2010. View at Google Scholar
  17. G. Alvarez and E. Coiera, “Interruptive communication patterns in the intensive care unit ward round,” Int J Med Inf, vol. 74, no. 10, pp. 791–796, 2005. View at Google Scholar
  18. C. D. Chisholm, A. M. Dornfeld, D. R. Nelson, and W. H. Cordell, “Work interrupted: A comparison of workplace interruptions in emergency departments and primary care offices,” Ann Emerg Med, no. 38, pp. 146–151, 2001. View at Google Scholar
  19. J. Parker and E. Coiera, “Improving clinical communication: A view from psychology,” JAMIA, vol. 7, no. 5, pp. 453–461, 2000. View at Google Scholar
  20. I. Burmistrov and A. Leonova, “Do interrupted users work faster or slower? the micro-analysis of a computerized text editing task,” in Human-computer interaction: theory and practice (Part I), J. Jacko and C. Stephanidis, Eds., pp. 621–625, Lawrence Erlbaum Associates, Mahwah, New Jersey, 2003. View at Google Scholar
  21. F. Magrabi, S. Y. W. Li, R. Day, and E. Coiera, “Errors and electronic prescribing: a controlled laboratory study to examine task complexity and interruption effects,” Journal of the American Medical Informatics Association, vol. 17, pp. 575–583, 2010. View at Google Scholar
  22. T. M. Pape, D. M. Guerra, and M. Muzquiz, “Innovative Approaches to Reducing Nurses' Distractions During Medication Administration,” The Journal of Continuing Education in Nursing, vol. 36, no. 3, pp. 108–116, 2005. View at Google Scholar
  23. E. Relihan, V. O'Brien, S. O'Hara, and B. Silke, “The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration,” Qual Saf Health Care, vol. 1 9, no. 5:e52, 2010. View at Google Scholar
  24. T. Grundgeiger and P. Sanderson, “Interruptions in healthcare: Theoretical views,” Int J Med Inf, vol. 78, no. 5, pp. 293–307, 2009. View at Google Scholar
  25. W. Coiera, R. Jayasuriya, J. Hardy, A. Bannan, and M. Thorpe, “Communication loads on clinicians in the Emergency Department,” Medical Journal of Australia, vol. 176, no. 9, pp. 415–418, 2002. View at Google Scholar
  26. J. Parker and E. Coiera, “Improving clinical communications: A view from psychology,” Journal of the American Medical Informatics Association, vol. 7, no. 5, pp. 453–461, 2000. View at Google Scholar
  27. E. Coiera and V. Tombs, “Communication behaviours in a hospital setting: an observational study,” British Medical Journal, vol. 316, pp. 673–676, 1998. View at Google Scholar
  28. H. M. Parsons, “What happened at Hawthorne?” Science, vol. 183, no. 4128, pp. 922–932, 1974. View at Google Scholar