Context-Aware Clinical Decision Dynamics and Their Influence on Patient Outcomes, Safety Margins, and Care Continuity Across Medical Specialties

Abstract

Context-awareness in clinical decision-making—the ability of healthcare providers and systems to recognize and adapt to relevant situational factors—is increasingly recognized as critical for improving patient outcomes, maintaining safety margins, and ensuring continuity of care across specialties. This mixed-methods study analyzes how real-time contextual cues and decision dynamics influence care processes and outcomes in internal medicine, surgery, and emergency care. Drawing from over 15,000 patient records, clinician workflow observations, and in-depth interviews, we find that context-aware decisions enhance early risk recognition, reduce adverse events, and strengthen coordination across care transitions. Conversely, lack of context-awareness contributes to safety lapses and fragmented continuity, especially during handoffs and high workload periods. Our results highlight the value of context-sensitive tools and training tailored to specialty-specific decision environments, emphasizing their role in resilient healthcare delivery.