Even the sharpest and most dedicated clinicians can be driven to distraction when it matters most. Focus zones and cross monitoring can help maintain patient safety.
The other day, after reading a vitriolic Facebook post from an in-law which implored me and other "friends" to unfriend this person if we disagreed, I found myself unable to concentrate on my morning routine.
By the time I made my way to the car, my mind was filled snarky comebacks, questions about what might happen at our next family gathering, and thoughts about how unfriending this person might affect my relationship with other family members.
Preoccupied, I hit the highway. When I arrived at my office about half an hour later, I found that my laptop case was not in its usual place in the trunk of my car. For the first time in 10 years, I had become distracted enough to leave it at home.
Michelle Feil, MSN, RN, CPPS, senior patient safety analyst at the Pennsylvania Patient Safety Authority in Harrisburg calls this a prime example of distracted behavior.
"You may not realize you are being distracted by your own thoughts until after the error occurs… If you see a post on social media that you keep thinking about, you may forget that you have to go to a medical appointment, and [you] drive to work instead of the doctor's office."
This drama plays out daily in all industries, and social media is just one distracting factor, says Mindy Yoder, DNP, RN, FNP-BC, dean of the school of health sciences at University of Saint Francis in Fort Wayne, IN.
"There's a lot going on in our culture, and distractions are prevalent. It's a faster-living society…. There is lots of information coming at us," she says. A study Yoder published in 2012 found that nurses are interrupted on average eight to 15 times per hour. Common distractions include call lights, phone calls, colleagues, patients, and their families.
Not Your Average Distraction
The healthcare environment is inherently distracting, says Feil.
"We have technology and processes in place that are actually designed to distract us. We use these to communicate with each other and patients, or for them to communicate with us. These tools (cell phones, pagers, and intercoms) are supposed to distract us to get our attention," she says.
And that's not even taking into consideration self-initiated distractions, such as being preoccupied by politics, family matters, or social media activity.
"Anything that can take a worker's mind off of the task at hand can be a threat," Feil says.
The consequences can be heavy. Few other professions have the lives of others in their hands to the degree that clinicians do. "We've seen examples where patients receive the wrong blood type in a transfusion or have surgery on the wrong side of their body."
Visual Aids
Yoder suggests creating visual cues indicating that a worker is trying to focus is one way to help improve both worker and patient safety.
One way of doing this is to designate an area away from the usual work stations as a focus-zone. "Creating signage around these areas… is very helpful," she says. Yoder also suggests that clinicians and pharmacists wear a disposable bib, hat, or flashing light on their arm while they are preparing medication or doing other tasks that require focus.
These signals are intended to prevent interruptions and a break in focus.
See Something, Say Something
Anyone can become distracted—and it's everyone's responsibility to keep an eye on their coworkers to make sure they're both mentally and physically present, says Feil.
"Everyone should be doing cross monitoring. It's part of constantly scanning for safety risks, and a way of saying to your coworkers, 'I've got your back, I'm looking out for you,' " she says.
It is not just management or HR's responsibility to cross monitor. "All workers should be doing this as a part of safety culture."
Lena J. Weiner is an associate editor at HealthLeaders Media.