Identifying the Causes and Effects of Decision Fatigue through a Systematic Review (Extended Abstract)

Abstract

The aim of this systematic review is to investigate the causes and effects of decision fatigue from the existing literature that can be generalized across different organizational domains. A comprehensive literature search in three databases identified 589 articles on decision fatigue. After screening the articles using PRISMA and JBI appraisal methods, 18 articles that investigated decision fatigue across various domains were selected. The selected articles were investigated through root cause analysis and thematic synthesis. Findings revealed eight causes of decision fatigue which were classified as individual, organizational, and external causes, and four primary effects and seven secondary effects of decision fatigue

Introduction

Organizational decision-making can be natural and subconscious at times, but it often involves conscious planning and cognitive effort due to the varying degrees of complexity. Past studies revealed that decision-making in high-risk domains like healthcare, fire control, law enforcement, and rescue operations is challenging due to the significant impact of the decision-maker’s choices on outcomes (Penney et al., 2022). These intricacies give rise to the phenomenon called decision fatigue, which refers to the deteriorating quality of decisions an individual makes after a prolonged decision-making period (Pignatiello et al., 2020). Decision fatigue reduces workplace performance and leads individuals to make less optimal choices under fatigued conditions (Linder et al., 2014). Hence, exploring the causes and effects of decision fatigue across different occupational domains is critical. The objective of this study is to investigate the causes and effects of decision fatigue from the existing literature in an effort to increase the accuracy and efficiency of organizational decision-making.

Methodology

A systematic search of scientific databases across Scopus, APA PsycInfo and Google Scholars resulted in 589 studies that directly or indirectly addressed decision fatigue and organizational decision-making. The literature search involved using keywords “decision fatigue” and “decision-making,” MeSH terms for decision fatigue such as “cognitive fatigue,” “compassion fatigue,” and “alert fatigue,” and the use of Boolean operators. Journal articles published between 2000 and 2023 in the English language were only considered. Articles were then screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, and quality was critically assessed using the Joanna Briggs Institute (JBI) appraisal method. Literature review and conceptual analysis articles, along with other articles that were irrelevant to the scope of this study or scored less than 7 (out of 10) in the JBI appraisal process, were excluded. Out of the initial 589 articles, 18 satisfied all the inclusion criteria and were analyzed.

Results

The synthesis of findings from the 18 articles revealed eight causes of decision fatigue: (a) presence of alternative decisions, (b) frequency of decision-making, (c) order of decisions, (d) duration of decisions (time of the day), (e) responsibilities involved with decision, (f) complexity of decision-making, (g) availability of breaks, and (h) uncertainty of decisions. These eight causes were broadly classified as individual, organizational, and environmental causes of decision fatigue, depending on the origin of these causes. Several effects of decision fatigue were identified from the literature and categorized as primary and secondary effects, with secondary effects stemming from primary effects. The four primary effects of decision fatigue are (a) ineffective decision-making, (b) conservativeness in decision-making, (c) erroneous decisions, and (d) perceived complexity in decision-making. Seven secondary effects of decision fatigue were identified, which include reduced efficiency in decision-making, choosing the easiest option, wrongful decisions, inconsistencies in decision-making, choosing the option perceived as the safest, increased cognitive effort during decision-making, and a lower rate of decisions.

Discussion

Previous literature has scarcely explored decision fatigue, although they highlighted that catastrophic errors result from improper decision-making. For example, over 98,000 deaths occur in the U.S. due to errors and biases associated with diagnostic decision-making (Kohn et al., 2000), fatigue being one of the leading causes of such errors. Unlike previous studies, which focused on specific professions, our research offers a broader investigation of the causes and effects of decision fatigue. For instance, Persson et al. (2019) examined the impact of decision fatigue on surgeons, finding a significant decrease in the likelihood of scheduling surgeries as their work shifts progressed. Trinh et al. (2021) observed similar effects in physicians, with a decline in antibiotic prescriptions toward the end of shifts. Knowledge of all probable causes of decision fatigue can help smoothen the decision-making process. Moreover, understanding the effects of decision fatigue can help develop interventions to overcome or mitigate them. Future research can benefit from objectively measuring decision fatigue and quantifying the relation between the causes and the degree of decision fatigue.