CU Faculty Promote “Ecology of Attention” in New England Journal of Medicine Article

Patients need and deserve the undivided attention of clinicians providing their care, but frequent interruptions and pressure to be responsive to colleagues can have detrimental impacts on the quality of care.

In a Perspective article published today by the New England Journal of Medicine, three members of the University of Colorado Anschutz Medical Campus offer a list of ways to promote an “ecology of attention” in clinical settings.

Mark Kissler, MD, Katherine Kissler, MS, and Marisha Burden, MD, outline examples that would improve care by prioritizing quality of communication over frequency, by designing physical spaces that foster attention, by better integrating attention into organizational culture, and by optimizing electronic health records.

“Evidence from cognitive science is clear: fractured attention leads to increased processing time spent on complex tasks, impaired working memory, and bias."

“Evidence from cognitive science is clear: fractured attention leads to increased processing time spent on complex tasks, impaired working memory, and bias,” the authors write. “In medicine, distraction contributes to lapses in judgment, insensitivity to changing clinical conditions, and medication errors.”

While exact allocations of the impact of attention shifting are challenging to measure, the advantages of focused concentration – to the patient and to the clinician – are sufficient that administrators should pay more attention to efforts to “help reduce the amount of multi-tasking and cognitive retriaging that occurs during a given workday.”

For patients, more attention leads to better, more personalized care. For clinicians, optimized attention may address the “disenchantment that comes from being increasingly separated from the core work of healing.”

Mark Kissler, MD, is an instructor in the Division of Hospital Medicine of the CU School of Medicine, Katherine Kissler, is a PhD candidate at the CU College of Nursing, and Marisha Burden, MD, is head of the Division of Hospital Medicine at the CU School of Medicine.