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The “Boston Globe” Spotlight team had a 2015 article on Massachusetts General Hospital (MGH) surgeons who schedule two operations at the same time. The article made it clear that MGH is not unique in doing this and the hospital defended its practice. (2015) Anyone who has had extensive dental procedures is familiar with dentists who operate on two or more patients at the same time.
The procedure is common. Is it good practice? What MGH has done is to institutionalize, allow, and even pride itself on its multi tasking surgeons.
What are the implications for you as a leader and for your organization?
What is the Evidence?
Every day we multi-task. It is not good or bad. We do it.
But when two or more tasks require concentration, then interruption of one train of thought is required in order to focus on something else.
And that is what this article addresses today.
Eric Blumberg and his colleagues cite that there can be as many as twelve interruptions per hour in a typical work day. The article describes how interruptions lead to greater task error and longer completion times. It is well documented that interruption of nurses while they are on duty leads to patient medication errors. (2014)
If the brain is good at multi-tasking then interruptions should not be major problems.
Portions of the brain do a spectacular job of multi-tasking.
If you read this article while camping in the forest, your brain is doing a masterful job of multi tasking:
(1) grasping the ideas of the essay, (2) determining your breathing rate, (3) determining your heart rate, (4) remaining alert for stimuli that might signal danger (5) remaining alert that the fire you created continues to burn at the proper intensity.
All these five tasks are being done by your brain at the same time. The brain is a multi-tasking wizard.
Surgeons and dentists and business leaders can easily point to the brain’s multi-tasking ability to justify their behavior.
Yes, But….
Noble Prize Winning psychologist Daniel Kahneman helps us understand the beauty and limitation of multi-tasking in his 2011 book, Thinking Fast and Slow.
In the book he argues that there is part of the brain that thinks very fast and does multi-tasking with amazing ability. This “fast” part of the brain is the more primitive part of our brains. The “slow” part of our brains structures ideas and is excellent in making decisions that require analytical thinking. According to Kanehman the cerebral cortex does a terrible job of multi tasking.
Thus in the example above, the cerebral cortex is only engaged in one task: reading this article. The fast part of your brain is doing its usual excellent job in multi tasking.
If you interrupt the cerebral cortex in the middle of a task, it will recover. But there will be a reduction of efficiency, such as nurses making more patient medication errors.
Performing more than one operation at the same time can be justified if there is close to a 100% certainty that the procedure is so well known to the surgeon, it is almost muscle memory. Some dentists can look at routine fillings as examples. Cleaning teeth would be an example. Muscle memory means the activity is so well learned, the cerebral cortex need not be involved.
Taking These Ideas to Work:
Given the evidence, how can you manage yourself and others to create a culture that respects the cerebral cortex’ need to focus on one thing at a time yet thrive in a culture that promotes multi tasking?
Circulate this article to your colleagues and use the article to justify buying a sliding sign that says “Welcome” or “Please Call Back Later.” You slide it to the appropriate message on your door or cubicle. Find something else like it if you can. The idea of the sign is to send signals to others when to interrupt and when not to interrupt..
Signs like these can be purchased online.
If you manage a department, how about buying the same sign for everyone in the department to place on his/her office door, cubicle or work space. Give everyone the ability to focus on the task at hand without interruption.
Your being the one who gives the sign transforms the sign from one individual being “antisocial" to a cultural norm of respecting the need to have no interruptions.
This issue becomes important with the current office design preference in having work colleagues share open spaces. Such open spaces require even more explicitness about boundaries without being offensive.
Remember that corporate justification is the evidence that interruption of concentration reduces efficiency and increases error.
Management of Your Team:
As part of the on-going structure for managing in-person or virtual team meetings, state the following at the beginning of every meeting. “Please turn off your devices for the next thirty minutes so that you can help us focus.
Your team may believe that they can read emails and listen to their colleagues’reports. Indeed they can as long as both are routine. But if both the email and the reports require involvement of the cerebral cortex then responses to both will suffer. The brain as a whole is built for multi tasking: the cerebral cortex is not.
Structure job descriptions to include this phrase “the incumbent will be a collaborative member, seeking to assist team members within our group and in other areas touching customer service.” Make it clear that having a reputation for responding to emails while at team meetings works against the accountabilities of the job. It is not about being rude. It is about not doing one's job.
The Fifty Minute Hour:
If meetings are to be an hour, allow for a ten minute break thirty minutes into the meeting for people to use the Rest Room or to check up on their emails/texts. They may even use their ten minutes to engage in side-bar conversations that could benefit the team. Put the break in the middle of the hour and not at the end to capitalize on side-bar conversations. You want people to be speaking with each other and you do not want to be known as someone who deprives your team of the ability to respond to urgent emails and texts.
Moving to a fifty minute hour does not mean you will accomplish less. Given the attention loss you currently suffer through the ways you structure traditional meetings, you may actually accomplish more in fifty minutes than you have accomplished in sixty.
Teachers might consider moving to a 50 minute hour as well.
Taking These Ideas Home:
If you are working at home and have small children, buy yourself an unusual hat to be worn only when you wish your children to “pretend I am invisible.” One of the authors used a bright red deerstalker cap for this purpose. And it was only worn to convey the message “no interruption please.” The positive message “pretend I am invisible” is easier to explain to children than the negative “please do not interrupt me.”
The late Brandeis University psychologist Abraham Maslow used the same technique when he was working at home with his small children. He employed a fireman’s helmet.
You do want a hat that can only be used for this one purpose and you want to remove it when appropriate.
If you like the fireman’s hat idea, Google the term. You can order real and toy version of the hat.
Remember that overuse of the hat creates problems. Keeping your door sign permanently on "Come Back Later" also creates problems.
These are tools. Use tools with judgement. That is what your cerebral cortex is for.
References:
Boston Globe Spotlight: Two Operations at Once? http://www.boston.com/news/local/massachusetts/2015/10/25/globe-spotlig…
Blumberg, E. J., Foroughi, C. K., Scheldrup, M. R., Peterson, M. S., Boehm-Davis, D. A., & Parasuraman, R. (2014). Reducing the disruptive effects of interruptions with noninvasive brain stimulation. Human Factors: The Journal of the Human Factors and Ergonomics Society, 0018720814565189.
Kahneman, D. (2011). Thinking, fast and slow. Macmillan.
My Door Sign. http://www.mydoorsign.com/MDS/QS/welcome_please_call_back_later_signs.a…
