Attention Among Health Care Professionals : A Scoping Review

Ann Intern Med. 2024 Jul;177(7):941-952. doi: 10.7326/M23-3229. Epub 2024 Jun 18.


Background: The concept of attention can provide insight into the needs of clinicians and how health systems design can impact patient care quality and medical errors.

Purpose: To 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 sources: Cumulated Index to Nursing and Allied Health Literature (CINAHL), Medline (PubMed), and Embase (Ovid) from 2001 to 26 February 2024.

Study selection: English-language studies addressing health care worker attention in patient care. At least dual review and data abstraction.

Data extraction: Article information, health care professional studied, practice environment, study design and intent, factor type related to attention, and metrics of attention used.

Data synthesis: Of 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.

Limitations: Does not synthesize answers to specific questions. Quality of studies was not assessed.

Conclusion: This 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 source: None.

Publication types

  • Review

MeSH terms

  • Attention*
  • Health Personnel*
  • Humans
  • Medical Errors
  • Quality of Health Care