Decision Fatigue in Out-of-Hours Primary Care

• Research type

  Research Study

• Full title

  Decision Fatigue in Out-of-Hours Primary Care: detecting changes in decision making over the work period

• IRAS ID

  315464

• Contact name

  Julia Allan

• Contact email

  j.allan@abdn.ac.uk

• Sponsor organisation

  ResearchGovernance, University of Aberdeen

• Clinicaltrials.gov Identifier

  DaSH 510, DaSH reference number; 2-087-22, Sponsor number

• Duration of Study in the UK

  2 years, 2 months, 1 days

• Research summary

  Demands on healthcare workers are high: services are stretched, shifts are long, and doctors regularly work lengthy periods without a break. In addition to reducing wellbeing, spending time continuously ‘on task’ changes decision making in predictable ways. Specifically, people make decisions that are progressively easier or more conservative as the period of time worked without a break increases; a phenomenon known as ‘decision fatigue’. In the healthcare context, this could lead health professionals to make different, and sometimes less appropriate treatment and management decisions later in their shifts if adequate breaks are not provided. This shift in decision making can have negative consequences on patients' health outcomes, health professionals' job satisfaction, and lead to unequal access to health care and ineffective allocation of resources. The present project aims to explore decision fatigue in General Practitioners (GPs) and Advanced Nurse Practitioners (ANPs) working in the out-of-hours primary care setting within the Grampian NHS board, two essential professional groups, currently under high, and increasing levels of demand.
  This project takes a mixed methods approach where routinely collected out-of-hours consultation data will be used to model changes in GPs’/ANPs’ decisions over time (i.e., we will examine whether there are changes in clinical decision making from the start to the end of shifts; quantitative part A). We will also interview primary care professionals, regularly working within this setting, about their experiences of working for extended periods (qualitative part B). This will help us gather more in-depth information and allow us to find out whether health care professionals are aware of decision fatigue in their context and whether they already utilise any mitigating strategies. By studying when GPs’/ANPs’ decision making starts to change during a work shift, we will be able to estimate how often they should take breaks during periods of continuous work to maintain their clinical judgement at the best possible level.

• REC name

  East of England - Cambridge East Research Ethics Committee

• REC reference

  22/EE/0259

• Date of REC Opinion

  17 Oct 2022

• REC opinion

  Further Information Favourable Opinion