Mental Workload in Primary Care
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This project represents collaboration between the Department of Industrial and Systems Engineering and the Wisconsin Research and Education Network (WREN).
Medical error and associated harm are prevalent in healthcare, in general, and in primary care (or family practice) specifically. Error prevalence in primary care may in part result from its “chaotic, messy and complex” nature and the resultant burden placed on primary care physicians.
Physicians in primary care see a large number of patients of varying age, acuity, needs, and other characteristics (e.g., ethnicity, education, communication skills, mood, etc.). Additionally, each patient is likely to have several problems that need to be addressed during the visit, with one study estimating as many as 3 problems per patient encounter on average and up to 4.6 for certain patient populations (Beasley et al 2004).
To add to the “complexity” of primary care, patient encounters are closely spaced and at times emotional, unpleasant, and even “draining.” Thus, a physician’s work day can be characterized by tremendous mental demands, and barring control factors (e.g., social support, technological support, rest breaks) or individual ability to manage demands, these demands result in mental workload. Excessive mental workload can lead to stress, fatigue, burnout, performance decrement, and long-term health problems for the physician as well as errors and patient harm (both physical and psychological). The Figure portrays one simplified causal model relating primary care complexity, mental workload, and physician and patient outcomes.
