Hospitals can be chaotic environments both for patients and staff such as physicians and nurses. This high-tension environment is exacerbated by interruptions by alarms from physiologic monitoring devices and alerts from EHRs. Here is an excerpt from an article about alarms (see: Hospitals rank alarm fatigue as top patient safety concern):
Nineteen out of 20 hospitals surveyed rank alarm fatigue as a top patient safety concern, according to the results of a [recent] national survey....Alarm fatigue occurs when clinicians become desensitized to the constant noise of alarms or overwhelmed by the sounds and turn alarms down or off [of patient physiologic monitoring devices]. The problem has become so widespread that last month The Joint Commission...now requires accredited hospitals and critical access hospitals to improve their systems....The findings [of the survey] show hospital staff are exposed to an average of 350 alarms per bed, per day based on a sample from an intensive care unit at the Johns Hopkins Hospital in Baltimore....To reduce alarm fatigue and better manage alarms,...hospitals must develop a systemic approach that considers staffing patterns, care models, architectural layouts, patient populations and staff responsibilities....One way hospitals can combat the problem is to follow the lead of Boston Medical Center (BMC), which has reduced its weekly audible cardiac alarm rate by 89 percent simply by adjusting monitor alarms for bradycardia, tachycardia and heart rate limits
Here is an excerpt about the EHR alerts: (see: How EHR Alerts Benefit Physicians and Patients)
There has been a lot of discussion in the Health Information Technology (HIT) community lately regarding the number of [prescription and clinical-decision support] alerts physicians receive through electronic health records (EHR) systems. Discussions focus on the possibility of alert fatigue, which is caused by physicians’ frustration at receiving numerous alerts through EHR systems, sometimes leading to warnings being ignored....
For me, the best general advice about how to manage alarm/alert fatigue is the following from the first quote above: develop a systemic approach that considers staffing patterns, care models, architectural layouts, patient populations and staff responsibilities. This makes perfect sense but the advice is too general; what's needed is specific guidance about exactly what can be done to solve the problem. One of the best specific solutions is the adoption of so-called smart alarms and alerts that can differentiate between, say, a technical problem versus a change in a patient's medical condition, particularly one that places the patient at serious risk (see: Hospitals Mobilize To Tackle Alarm Fatigue).