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AMBULATORY CARE: How time of day affects quality of care and what to do about decision fatigue

Quality of care deteriorates over the course of the day due to the combination of shared cognitive biases, hurried visits, and mounting decision fatigue…”

Studies show that the quality of outpatient care decreases over the course of the clinic day. Patients seen later in the day are likely to have fewer appropriate services ordered and, also, more low-value inappropriate services ordered. A difference in diagnostic accuracy has also been found based on time of day. How to counteract this time-of-day trend by incorporating alerts into the electronic health record, by using social norm interventions, by optimizing use of telehealth and mail, and by changing payment models are discussed.

Source: Allison H. Oakes, and Mitesh S. Patel. “Time to Address Disparities in Care by Appointment Time.” Healthcare 9(1), (Mar. 2021). https://www.sciencedirect.com/science/article/pii/S2213076420301068

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