Internal Medicine · 2 h ago
ICU physician workload patterns linked to fatigue and mood in small study
A real-time observational study followed five physicians across 38 twelve-hour shifts in a German surgical ICU. Higher decision rates were associated with greater end-of-shift fatigue, while more clustered decision-making was associated with less mood disturbance; the authors describe the findings as exploratory.
- Five physicians were observed across 38 ICU shifts.
- Higher decision rates correlated with greater end-of-shift fatigue.
- More clustered decisions correlated with less mood disturbance.
- Small, single-centre study; findings are exploratory.
Researchers shadowed five physicians—two residents and three consultants—during 38 shifts, recording 17,953 decisions. Physicians rated fatigue, sleepiness and mood at three points during each shift, and completed a treatment-scenario task afterward. The team examined decision volume, the temporal clustering of decisions and task interruptions; decision severity was assessed with a study-specific, non-validated score.
An increase of 0.5 decisions per five-minute interval was associated with a 2.1-point higher end-of-shift decision-fatigue score (95% CI 0.6 to 3.6). A 0.10 increase in decision burstiness was associated with a 6.3-point lower mood-disturbance score (95% CI −10.2 to −2.3). Overall morning-to-evening changes in fatigue, sleepiness and mood were small and not statistically significant. More interruptions were associated with lower certainty in post-shift scenario responses; each 10 additional interruptions corresponded to a 0.29-point decrease (p=0.012).
The study was exploratory and involved only five physicians at one ICU, limiting generalisability. It did not establish effects on objective decision quality or patient safety. The authors say the findings require replication in larger, multicentre studies.
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Critical Care: Decision volume and temporal workload structure as dissociable correlates of fatigue and mood in intensive care physicians: a real-time observational study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.