Background: The 2016 Surviving Sepsis Campaign guidelines recommend antibiotic administration within 1 hour of emergency department (ED) presentation for patients with sepsis. While early antibiotics are associated with reduced mortality, the 1 hr policy has been criticized for its one-size-fits-all approach and risk for over-diagnosis and treatment. Clinicians and quality leaders have called, instead, for [...]

Background: As the day progresses, clinicians may experience decision fatigue that impairs clinical reasoning. Such impairment may exert its greatest effects on clinicians’ abilities to identify and effectively treat heterogeneous clinical syndromes with high diagnostic uncertainty, including sepsis. We therefore examined the association of time of day with antibiotic initiation among hospitalized ward patients with [...]