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Redesigning Hospital Alarms for Reliable and Safe Care

  • Paul Barach
  • Juan A. Sanchez
Chapter

Abstract

Alarms contribute significantly to noise pollution in healthcare and “alarm fatigue” limits a care provider’s capacity to identify and prioritize these signals. The exceedingly high rates of clinically irrelevant alarms and high background noise levels in clinical environments contribute to staff desensitization resulting in response failures.

Monitoring devices that process complex data should produce clinically relevant alarm signals. This chapter identifies multiple levels of influence and opportunities for system intervention and innovation to facilitate timely and reliable alarm responses. These include addressing the broader acoustic context, clinician responsibility, deployment and teamwork training, threshold-setting guidelines, improved user interfaces, and algorithms balancing alarm specificity and sensitivity. Monitoring devices that process complex data streams should produce clinically relevant alarm signals, in environments optimized for discernment and attribution, with user interfaces designed for timely interpretation, prioritization, and prompt action. Hospitals need a system-wide alarm management policy and protocols that define the alarm management strategy for alarmed medical equipment, and delineate how caregivers/nurses should respond to alarm conditions and signals. It is imperative that a human factors approach based around the hospital’s culture is used that actively engages architects, designers, acoustical engineers, facility engineering, staff, and clinicians to address alarm fatigue and the implications of the physical built environment. Involving patients in the redesign of hospital acoustic environments may improve patient experiences and satisfaction with their care.

Keywords

Noise Alarm fatigue Patient safety Harm Human factors Medical errors Systems 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Clinical Professor, Children’s Cardiomyopathy Foundation and Kyle John Rymiszewski Research ScholarChildren’s Hospital of Michigan, Wayne State University School of MedicineDetroitUSA
  2. 2.Department of SurgeryAscension Saint Agnes Hospital, Armstrong Institute for Patient Safety & Quality, Johns Hopkins University School of MedicineBaltimoreUSA

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