If you were to propose a metric with which to assess the degree to which a hospital or clinical unit avoids unnecessary and/or false alarms (and thus decreases the probability of desensitation and inadequate or delayed responses to alarms), what would you propose?
We (EMS in Genoa) use several indicators, the main one being a correlation between sending code and health evaluation on site.
Thanks Andrea!
I understand that you are referring to alarms in the sense of "code calls", indicating patient emergencies (e.g. cardiac arrest). I should have been more specific in formulating my question. I am interested in alarms issued by devices (monitors, perfusion pumps, ventilators etc.).
These, in particular with the high rate of non-actionable alarms - create a lot of work, stress, frustration and desensitization. However, the only metric that seems to be used here, is number of alarms per patient and day (average figures 150-350!), which hardly is an absolute measure of quality.
I'm sorry ... I thought you were talking about alarms as emergency calls
For industrial control rooms, alarm management is well established (IEC 62682). Two main metrics here are avarage alarm rate (< 1 alarm per 10 minutes) and peak alarm rate during plant upset (
In industrial processes we apply ISA 18.2 which uses as main metric Alarms / 10 minutes during normal conditions. There are another metrics during abnormal conditions: Standing Alarms 30 minutes after the abnormal condition, etc. For more information please refer to our webpage where you can find explanatory videos subtitled in English: http://auroratech.com.co/industry/
http://auroratech.com.co/industry/
Thanks to both of you, Martin (sorry, missed your answer) and Carlos.
I am aware of the metrics for alarms in industrial contexts, but - unfortunately - the clinical world is much (MUCH) different. Basically the metrics cannot be transfered even with modifications.
The reasons for the impossibility are manifold:
To begin with, there are many alarms in an ordinary ICU, most of them "false alarms". The literature cites between 80 and 350 alarms par patient and day, which translates into 500 to 5000 alarm per day. Of which between 60 and 97% have no consequence.mThis leads to Alarm fatigue, a state where caregivers respond inadequately to alarms.
Another reason is the role of the alarm recipients: In most ICUs, these are nurses and alarms are just a part of their responsibilities. Which also means that they may not be at the patient triggering an alarm or at the nursing station.
Still, thank you both.
Dear Dirk Hueske-Kraus , maybe this Covid pandemic brings some experiences and answers toward your initial question.
HOW WILL BE THE ALARM MANAGEMENT PROGRAM OF THE FUTURE Implementation of a successful alarm management program can seem complex in the beginning. Knowing where and how to start can be a daunting experience.
●When and how to start with your alarm management program
●How the recent pandemic is affecting remote operations
●How to be up to date with the most recent regulations
●Key benefits for a proper alarm management program ...
https://discover.honeywell.com/index.php/email/emailWebview
I know that Philips is a lider in this field. For the followers of your research question, this is fine story!
A holistic approach to alarm management strategy and reducing alarm fatigue
https://www.philips.sa/en/healthcare/consulting/articles/customer-story/augusta-alarm-management
The case study by Philips is presented.
http://images.philips.com/is/content/PhilipsConsumer/Campaigns/HC20140401_DG/Documents/Decreasing_non-actionable_alarms_and_alarm_fatigue_at_AU_Health.pdf?_ga=2.248786884.254992417.1607377461-1158829709.1607377461
By the way, I was reading your article Measuring Alarm System Quality in Intensive Care Units .
https://www.pflegeinnovationszentrum.de/wp-content/uploads/2018/12/17.-Measuring-Alarm-System-Quality-in-ICUs.pdf
Conference Paper Measuring Alarm System Quality in Intensive Care Units Work ...
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