• Mark J Kissler, Samuel Porter, Michelle Knees, Katherine Kissler, Angela Keniston, and Marisha Burden.
• Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado (M.J.K., S.P., M.K., A.K., M.B.).
• Ann. Intern. Med. 2024 Jul 1; 177 (7): 941952941-952.

BackgroundThe concept of attention can provide insight into the needs of clinicians and how health systems design can impact patient care quality and medical errors.PurposeTo conduct a scoping review to 1) identify and characterize literature relevant to clinician attention; 2) compile metrics used to measure attention; and 3) create a framework of key concepts.Data SourcesCumulated Index to Nursing and Allied Health Literature (CINAHL), Medline (PubMed), and Embase (Ovid) from 2001 to 26 February 2024.Study SelectionEnglish-language studies addressing health care worker attention in patient care. At least dual review and data abstraction.Data ExtractionArticle information, health care professional studied, practice environment, study design and intent, factor type related to attention, and metrics of attention used.Data SynthesisOf 6448 screened articles, 585 met inclusion criteria. Most studies were descriptive (n = 469) versus investigational (n = 116). More studies focused on barriers to attention (n = 387; 342 descriptive and 45 investigational) versus facilitators to improving attention (n = 198; 112 descriptive and 86 investigational). We developed a framework, grouping studies into 6 categories: 1) definitions of attention, 2) the clinical environment and its effect on attention, 3) personal factors affecting attention, 4) relationships between interventions or factors that affect attention and patient outcomes, 5) the effect of clinical alarms and alarm fatigue on attention, and 6) health information technology's effect on attention. Eighty-two metrics were used to measure attention.LimitationsDoes not synthesize answers to specific questions. Quality of studies was not assessed.ConclusionThis overview may be a resource for researchers, quality improvement experts, and health system leaders to improve clinical environments. Future systematic reviews may synthesize evidence on metrics to measure attention and on the effectiveness of barriers or facilitators related to attention.Primary Funding SourceNone.

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