Showing posts with label Distraction. Show all posts
Showing posts with label Distraction. Show all posts

Tuesday, December 20, 2011

Electronic devices distract doctors. So do other things.


Another hand-wringing piece about the dangers of distraction by electronic devices, this time from The New York Times, prompts these comments.

According to the article, Dr. Peter J. Papadakos, an anesthesiologist and director of critical care at the University of Rochester Medical Center reportedly said he had seen nurses, doctors and other staff members glued to their phones, computers and iPads. It goes on to say the following:

“My gut feeling is lives are in danger,” said Dr. Papadakos, who recently published an article on “electronic distraction” in Anesthesiology News, a journal. [Anesthesiology News, a journal? Since when?]

This is interesting coming from an anesthesiologist, whose colleagues were notorious in the analog age for doing crossword puzzles and reading the [print] Wall Street Journal during cases.

Here, via the AHRQ, is a nice example of an adverse event that occurred because of a distraction. A resident forgot to place an order to stop warfarin because she was interrupted by a text. Curiously, the electronic computer order entry program, while described as being “robust,” did not alert anyone. When his INR reached 8.5 three days later, the patient developed a hemopericardium requiring surgery. It’s a little disingenuous to blame a text for this complication when a team of doctors apparently forgot that a patient was receiving one of the most dangerous drugs around.

The Times article described a malpractice case from Colorado. It involved a neurosurgeon who was making personal phone calls during an operation which left the patient partially paralyzed. Where were the OR staff and the anesthesiologist while all these calls were being made? I doubt that I could even make one personal phone call during a case in my OR without the supervisor, the medical director and risk management being notified.

There is no question that electronic devices can be addicting and distracting if you let them. So can many other things like thinking of sex, which men apparently do at least 19 times a day or so a recent study says.

I will admit that it annoys me when I am talking to a resident or PA and she pulls out her phone to read an incoming text. And I certainly agree that 99.9% of all emails do not need to be viewed immediately.

That does not mean we should electronic devices from hospitals. I think the ability to look up a drug instantly or review management of a problem on UpToDate at a patient’s bedside far outweighs the potential for distraction.

I wonder if the same debate took place when radios were first placed in automobiles?