After putting the task force's changes in place, the number of audible cardiac alarms on 7 North plummeted 89%, from nearly 90,000 to roughly 10,000 over the course of a six-week pilot. The hospital also saw a modest jump in patient-satisfaction scores. BMC has since implemented the program in its nine remaining medical-surgical floors, resulting in a 60% drop in audible alarms across the hospital.
Other hospitals are approaching alarm safety in a number of ways. Some are using a central place, or “war room,” where technicians review all monitor alarms. Other hospitals put monitor watchers on each unit or they route alarms through clinicians' pagers or cellphones to cut down on noise, Piepenbrink said.
Those tactics were not viable options for BMC because the safety net hospital lacked the resources to layer on more technology, he said. More importantly, the task force wanted to find a way to make sure that alarms were relevant and provided useful clinical information.
“If you route alarms through a smartphone or a pager, you don't address the fundamental issue that you have a broken process,” Piepenbrink said.
BMC's initiative drew praise from James Keller, vice president of health technology evaluation and safety for ECRI Institute. The Plymouth Meeting, Pa.-based not-for-profit safety group has included alarm fatigue on its annual list of top 10 technology hazards since the list's inception in 2007.
Next on the agenda for BMC's task force are two more projects. One will look at setting appropriate alarm parameters for tachycardia, or a sustained heart rate above the normal range, which accounts for 33,000 alarms a week hospital-wide, Whalen said. The second will work to fine-tune alarms for pulse oximetry, which the task force says accounts for another 200,000 alarms.
“Before the rollout of the pilot, there were 1 million alarms a week across the hospital,” she said. “Now it's down to 400,000 a week. These projects will hopefully put us under 200,000 a week this year.”
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