Daylight Savings Time (DST)

Twice a year we shift time... and frustrate clinical timekeeping. On March 10, 2024, clocks turn forward 1 hour at 02:00 to become 03:00. Then, on November 3, 2024, clocks turn backward 1 hour at 02:00 to become 01:00. 

Clinicians need to be aware of these shifts and unique implications for clinical information system (CIS) behaviours. While ambulatory care is little affected by what happens in the early hours of the morning, emergent, inpatient, surgical and critical care contexts can be sensitive to the loss or gain of small time intervals. Linked at the bottom of this page, 1-pagers summarize key considerations around DST for prescribers, and guides provide further details.

Spring Forward (March)

Patients undergoing time-sensitive or time-limited therapies (e.g., continuous infusion of fluids or medications for a specified interval) are at risk for receiving a smaller intervention exposure than expected. Treatments or tests scheduled for the "skipped" hour need careful attention to ensure that they occur, are sequenced and are not co-administered if meant to be separated in time.

Critical Situations and Downtime Procedures

Patient Tracking and Event-to-Event Timing

Volume Administration Calculations

Scheduled Medications

Graphs and Flowsheets

Decision Supports

Fall Backward (November)

DST ends in the fall when 02:00 becomes 01:00. 

Patients undergoing time-sensitive or time-limited therapies (e.g., continuous infusion of fluids or medications for a specified interval) are at risk for receiving a longer intervention exposure than expected. Of greater concern, there is a theoretical risk that treatments or tests occurring in the "doubled" hour could be lost, replicated or otherwise mis-counted. Any variances in how connected devices handle the "fall back" can introduce further opportunity for error.

Accordingly, the end of DST in the fall (usually first Sunday in November) may be handled with scheduled downtimes for specific applications, with downtime procedures for prescribers applicable (see downtime notice for details, posted 2 days before). 

Resources