Accept or Reject? Moderators That Influence the Decision-Making Process of Interruptions

College

College of Sciences

Department

Psychology

Graduate Level

Doctoral

Graduate Program/Concentration

Human Factors Psychology

Presentation Type

Oral Presentation

Abstract

Interruptions are a common occurrence in the workplace but when they happen during high-stakes critical tasks they can have serious consequences. In the field of healthcare, it has been shown that interruptions can lead to serious adverse events or medication errors (Kukielka et al., 2019; Makary & Daniel, 2016). An interruption consists of suspending progress on one task to address a secondary task where there was an intent was to complete the initial task. The interruption process begins with a signal (e.g., an alarm or co-worker initiating conversation). After the signal is processed information included with the signal is interpreted (Latorella, 1999; Sarter, 2013; Woods, 1995). Finally, a decision is made to either reject the interruption and continue working on the primary task or accept the interruption and address the requirements of the new task/activity. Research on interruption management strategies address the potentially harmful outcomes of interruptions but often fail to account for the initial decision to accept or reject the interrupting task, and when they do, they rarely address moderators that influence the decision.

The current study used a healthcare paradigm to examine the interruption decision-making process. The decision to accept or reject an interruption was investigated using three moderators: priority, cost of the interruption, and method of the interruption. Participants’ primary task was to monitor two patient EKG displays while simultaneously entering medication information into a patient chart. While working on the primary tasks, participants were interrupted four times throughout the experiment. Participants were assigned to groups where their interruptions were manipulated by one of three moderators. Priority of the interrupting task could be high or low. Cost was manipulated by the need to perform a task located inside the laboratory or located outside the lab far away. The method of interruption was either trigged by an alarm or having the experimenter make the request in person (face to face). After the experiment, participants filled out the NASA TLX (Hart & Staveland, 1988) as a subjective workload measure.

Sixty undergraduate psychology students with no formal healthcare experience were recruited. The decision to accept or reject an interruption was investigated using the Cochran’s Q test. There was a significant difference for decision-making in the priority condition where low priority tasks were rejected more than the high priority tasks. In addition, high-cost interruptions were rejected more often than the low-cost interruptions and face-to-face interruptions were accepted more often than the alarm interruptions. Multiple one-way ANOVAs were run to investigate differences in subjective workload among the interruption conditions. Participants in the cost condition thought they performed better those participants in the priority condition and those in the priority condition felt more frustrated than those in the cost condition. Understanding what influences the decision-making aspect of interruptions is the first step to design a system where life threatening emergencies are communicated by means in which they will be likely more accepted. Separating these interruptions can help reduce the attentional resources needed deciphering the interrupting signal and instead redirect attention to safety-critical tasks.

Keywords

Interruptions, Decision-making, Healthcare

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Accept or Reject? Moderators That Influence the Decision-Making Process of Interruptions

Interruptions are a common occurrence in the workplace but when they happen during high-stakes critical tasks they can have serious consequences. In the field of healthcare, it has been shown that interruptions can lead to serious adverse events or medication errors (Kukielka et al., 2019; Makary & Daniel, 2016). An interruption consists of suspending progress on one task to address a secondary task where there was an intent was to complete the initial task. The interruption process begins with a signal (e.g., an alarm or co-worker initiating conversation). After the signal is processed information included with the signal is interpreted (Latorella, 1999; Sarter, 2013; Woods, 1995). Finally, a decision is made to either reject the interruption and continue working on the primary task or accept the interruption and address the requirements of the new task/activity. Research on interruption management strategies address the potentially harmful outcomes of interruptions but often fail to account for the initial decision to accept or reject the interrupting task, and when they do, they rarely address moderators that influence the decision.

The current study used a healthcare paradigm to examine the interruption decision-making process. The decision to accept or reject an interruption was investigated using three moderators: priority, cost of the interruption, and method of the interruption. Participants’ primary task was to monitor two patient EKG displays while simultaneously entering medication information into a patient chart. While working on the primary tasks, participants were interrupted four times throughout the experiment. Participants were assigned to groups where their interruptions were manipulated by one of three moderators. Priority of the interrupting task could be high or low. Cost was manipulated by the need to perform a task located inside the laboratory or located outside the lab far away. The method of interruption was either trigged by an alarm or having the experimenter make the request in person (face to face). After the experiment, participants filled out the NASA TLX (Hart & Staveland, 1988) as a subjective workload measure.

Sixty undergraduate psychology students with no formal healthcare experience were recruited. The decision to accept or reject an interruption was investigated using the Cochran’s Q test. There was a significant difference for decision-making in the priority condition where low priority tasks were rejected more than the high priority tasks. In addition, high-cost interruptions were rejected more often than the low-cost interruptions and face-to-face interruptions were accepted more often than the alarm interruptions. Multiple one-way ANOVAs were run to investigate differences in subjective workload among the interruption conditions. Participants in the cost condition thought they performed better those participants in the priority condition and those in the priority condition felt more frustrated than those in the cost condition. Understanding what influences the decision-making aspect of interruptions is the first step to design a system where life threatening emergencies are communicated by means in which they will be likely more accepted. Separating these interruptions can help reduce the attentional resources needed deciphering the interrupting signal and instead redirect attention to safety-critical tasks.