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Single Tasking

The myths of multitasking and the dangers of distractions

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We live in a world of multitasking. In the laboratory, this means performing tests on several instruments at once while answering the telephone, collecting specimens, and maybe reading email, too. Doing more sure feels more efficient. But research suggests that multitasking does the opposite and increases the chance for serious error. It's time to start single tasking instead.

Laboratory Multitasking
An interviewer may ask a situational question to assess your multitasking skills, e.g. "You're running a STAT cross-match from the ED and the main chemistry instrument breaks down. An arterial blood gas sample arrives, and the OR calls to request a unit of blood STAT. The ED calls to have blood drawn. What do you do?"

Experienced techs mentally juggle how many tasks they'll perform simultaneously by parsing the situation into time and task:  while the antibody screen is incubating a unit of blood is delivered to the OR, while the cell washer washes the cells the ED sample is collected, after the arterial sample is pushed into the analyzer tech support is called. It's common in laboratories to multitask, especially on off shifts.

Such questions assess problem solving skills and also show how multitasking is part of laboratory culture.

Computers vs. Humans
Multitasking is a term borrowed from computing that means "sharing a single processor between several independent jobs."1 The speed of modern computers makes it seems like many tasks happen concurrently when they are really scheduled one at a time. Computer multitasking is largely an illusion.

Human multitasking is very similar. We schedule and switch between tasks in much the same way as a computer. In the above example, the tech guesses it will take less than ten minutes to run the unit of blood to the OR, there is time to collect the ED sample while the cells wash, and other tasks can be delayed or stacked at points where distractions are minimized. But the tech only performs one task at a time.

What happens when the antibody screen is positive, the cell washer fails, the OR patient needs more blood, or the ED patient requires multiple sticks? Distractions and unexpected variation can sabotage the best multitaskers. When your computer responds slowly the same thing happens, shattering the illusion.

The Myth of Multitasking
Truth is we can't multitask. According to MIT neuroscientist Earl Miller, we switch our attention rapidly from one task to another. "People can't multitask very well, and when people say they can, they're deluding themselves," he told NPR in 2008.2 In some cases, such as reading and talking on the telephone, the brain struggles with tasks competing to use the same region.

Task juggling can make you feel energized and efficient, but that's an illusion, too. Switching focus between tasks creates a state of what consultant Linda Stone coined "continuous partial attention," in which we are constantly scanning to keep on top of new information. Psychiatrist Dr. Edward Hallowell describes "Attention Deficit Trait" with symptoms similar to Attention Deficit Disorder. Skimming information and tracking too much information adversely affects memory and learning.3

Paying less attention when we think the opposite is happening is dangerous. According to Dr. Paul Hammerness and Margaret Moore, multitasking makes us miss cues and lose information in working memory, increasing the chance of making a medical error.4 One study at a 400-bed hospital concluded that doctors multitask 12.8% of the time, increasing time on task.5 And a study of RNs conducted at two Midwestern hospitals found nurses multitasking 34% of the time with an error rate of 1.5 per hour, a potential cause and effect.6

Single Tasking
The opposite of multitasking is single tasking: focusing completely on one task until it is completed. Instead of frenetically switching attention between tasks, complete one task or carry it through to a stop point where failure is minimized. In the above, for example, this can mean telephoning for help to deliver the unit and carrying the cross-match through to completion of serological testing. Single tasking makes good sense in the blood bank but applies to all lab testing.

Single tasking can seem inefficient at first, especially if you're used to multitasking. Blocking your time to perform tasks increases your focus and productivity, allowing you to perform them faster.7 Fewer distractions means fewer errors. And your mind isn't cluttered in the meantime with needless mental overhead of juggling multiple tasks.

Computers single task, too. MS-DOS and Palm OS are two older systems that ran one program at a time, forcing users to prioritize their computer time. While most systems today are multitasking, single tasking is still used in specialized electronics or machinery.8

To get started single tasking, Dr. Jim Taylor, a psychologist at the University of San Francisco, advises rethinking the structure of our workday and prioritizing our activities. By ranking tasks and estimating the time to complete each, says Taylor, we might be pleasantly surprised at how much is accomplished if we commit to finishing the highest ranking tasks regardless of distractions. He also suggests making changes to your immediate environment:9

-              Close your office door or position your workspace so it not facing coworkers.

-              Create a setting that is comfortable and well-lit. Sit in a comfortable chair.

-              Organize your workspace to reduce clutter, allowing you to work efficiently and access what you need to get the job done.

-              Clear your workspace of everything but what's related to the task at hand.

Single tasking can be challenging when working a shift alone, of course, but that doesn't mean it's impossible. Like tasks can be grouped together to minimize distractions e.g. rapid serology testing and true single tasking reserved for high risk tasks such as blood banking. Let everyone know you intend to give whatever you're doing 100% of your attention, and they'll eventually get the message, especially when you finish sooner with fewer errors. This will give you extra time to move to the next task, eventually providing better patient care.

References:

1.            Dictionary.com. Multitasking. Available at: http://dictionary.reference.com/browse/Multitasking.

2.            Hamilton J. Think you're multitasking? Think again. Available at: http://www.npr.org/templates/story/story.php?storyId=95256794.

3.            Rosen C. The myth of multitasking. Available at: http://www.thenewatlantis.com/publications/the-myth-of-multitasking.

4.            Skerrett P. Multitasking - a medical and mental hazard. Available at: http://www.health.harvard.edu/blog/multitasking-a-medical-and-mental-hazard-201201074063.

5.            Westbrook JI et al. The impact of interruptions on clinical task completion. (Abstract) Available at: http://www.ncbi.nlm.nih.gov/pubmed/20463369.

6.            Kalisch BJ, Aebersold M. Interruptions and multitasking in nursing care. (Abstract) Available at: http://www.ncbi.nlm.nih.gov/pubmed/20235414.

7.            Jayne AK. Single-tasking vs. multitasking. Available at: http://smallbusiness.chron.com/singletasking-vs-multitasking-32781.html.

8.            Carey D. Different types of operating systems. Available at: http://www.life123.com/technology/internet/operating-systems/different-types-of-operating-system.shtml.

9.            Taylor J. Multitasking is out, single tasking is in. Available at: http://www.huffingtonpost.com/dr-jim-taylor/single-tasking_b_845809.html.


 

Interesting.

Frank July 08, 2014




     

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