We thank Ms. Benda and Dr. Fairbanks for their interest in our work.

The provision of safe, efficient patient care in the emergency department (ED) depends on high-quality task completion and task-switching skills. In their letter, the respondents discuss the complexity and breadth of factors that influence task completion and recall in the ED, using the framework of attention. This serves to further highlight the need to look to the cognitive and behavioral sciences for insight into and solutions for this complex problem.

The concept of attention as it applies to efficient task switching is indeed important. This must be discussed in the framework of working memory and cognitive load because attention and working-memory capacity are interrelated, if not inextricably linked. ED tasks can have similarity, interruptions cannot always be predicted, and there is variability in the type and import of both primary and secondary tasks. Attention affects the function and capacity of working memory in this rapidly changing environment.

In their examples, they discuss additional factors important in the interplay of attention, cognitive load, and working memory. In their first example, of perceiving or storing information versus making or acting on decisions, the respondents touch on ideas of complexity and purpose of information processing. Not all cognitive load is created equal, as we discuss in our article. In the second example, they describe differences in modality of information input and output, visual versus auditory, otherwise known as dual-channel processing, which we did not explicitly discuss, although acknowledge has influence on capacity and functioning of working memory. In the third, similar tasks and increased effectiveness in completion of tasks with like stimuli and like responses are discussed. Although it may be true for the example they provide (transcription of data), there are issues beyond attention with like tasks. Task similarity can lead to incompletion of task steps or false recall that tasks are complete.

We very much look forward to seeing further work and suggestions on improved practice from their group, particularly in regard to the effect of attention on task completion in the ED setting, and appreciate their insight into the interesting aspect of task switching.