3 tips for mindful patient interactions in the age of digital distraction

Brian Zimmerman -

Entertainment and information are more accessible than ever with the rise of the smartphone. While this technology has facilitated advancement in nearly every arena of modern life, it has also ushered in an era of distraction.

Technological distraction has become ubiquitous, impeding our ability to communicate personally and even, in some cases, operate a motor vehicle. The problem has even found its way into healthcare. For example, the Agency for Healthcare Research and Quality in 2011 detailed a sentinel case that involved a medication error related to digital distraction. A nurse resident was in the middle of discontinuing a dementia patient's blood thinner order when she received a text message. The nurse responded to the text and never finished discontinuing the order. The patient later required open heart surgery.

Digital distraction is so pervasive, it's plausible to think electronics may be a contributing factor in Western culture's growing emphasis on mindfulness, which many people pursue in both their personal and work lives.

Now is the time to also achieve mindfulness in healthcare to improve patient engagement, ensure patient safety and boost overall quality, according to Peter Papadakos, MD, a professor in the department of anesthesiology at the University of Rochester (N.Y.) Medical Center. Dr. Papadakos is a contributor and co-editor of the book "Distracted Doctoring: Returning to Patient Centered Care in the Digital Age." The book's purpose is to help healthcare organizations achieve patient-centered care and eliminate digital distraction.

"The book is meant to help educate physicians, nurses and technicians because this is a problem that transcends every healthcare position involved in patient care," says Dr. Papadakos.

The book, published in July, is comprised of 17 chapters written by multiple contributors, including physicians, patient safety experts and psychologists. The book offers detailed insight into the problem of digital distraction in healthcare and offers readers techniques and strategies to help eliminate the issue.

Here are three tips for better electronic etiquette and improved patient interactions, as outlined by Dr. Papadakos in the book.

1. Acknowledge device dependency: Before a hospital can properly address electronic etiquette for patient interactions, staff must become self-aware of their own device dependency. At the University of Rochester, Dr. Papadakos and colleagues use a modified version of the CAGE questionnaire, which clinicians have used to screen for alcoholism since the 1970s. The modified questionnaire replaces the word "drink" with the acronym PED, which stands for personal electronic device.

"This is highly eye-opening," writes Dr. Papadakos. "Many have never realized how life-changing their device is and how it is at the center of their life … The vast majority cannot even explain why it is the first they pick up in the morning and the last thing they put down at night. This … is a wake-up call to many."

2. Promote proper interaction with the EMR: The implementation of EMRs has significantly enhanced healthcare delivery over the past few decades, according to Dr. Papadakos. Emergency departments, intensive care units and operating rooms have particularly benefited from capabilities, such as real-time data capture of vital signs and updated records. However, the emphasis on digital data in healthcare can result in distractions for some providers as they can feel compelled to interact with the computer — or so-called "digital patient" — during moments that call for personal interactions.

In the book, Dr. Papadakos recalls observing patient rounds at the medical center where "large groups of healthcare providers clustered in front of computers looking and trying to type into their devices, never speaking to their patients or their families." He believes this type of behavior dehumanizes care and weakens the inherent bond of trust between patients and providers. Instead, providers should conduct patient interviews with direct eye contact and introduce the computer as the third person in the room, so the patient understands its use as a medical tool, according to Dr. Papadakos.

3. Develop electronic use policies for each unit: Each care unit should develop specific electronic etiquette policies tailored to suit the needs of each unit. Representatives from every segment of the care team should contribute to the development of these policies, according to Dr. Papadakos. Additionally, leaders should empower the unit's staff to correct colleagues if they witness a breakdown in these electronic etiquette policies.

To learn more about the book, click here.

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