Temporal Variability of Human Care Delivery and Its Association with Patient Outcomes, Decision Accuracy, and System Resilience Across Medical Specialties

Abstract

Temporal variability—fluctuations in the timing of care delivery—plays a key role in patient outcomes, decision accuracy, and system resilience across medical specialties. This mixed-methods study analyzes over 15,000 patient encounters alongside clinician observations and interviews in internal medicine, surgery, and emergency care. Results show that increased temporal variability raises cognitive load and error risk, especially during off-peak hours, negatively impacting patient safety. Yet, resilient systems manage variability through adaptive scheduling, communication tools, and standardized protocols. Our findings highlight the importance of incorporating temporal variability into healthcare quality efforts to improve patient care and system robustness in dynamic clinical settings.