Mitigating alarm fatigue and improving clinical productivity – the role of intelligent middleware in delivering efficient care


Much has been written about the danger of alarm (or alert) fatigue as it relates to patient safety. Often overlooked, however, is the extent to which productivity is negatively impacted when caregivers are overwhelmed by unending alarms, many of which are nuisance or non-actionable events. This paper looks at the ways in which alarm fatigue impedes efficient care. It also offers a solution in the form of intelligent middleware—easily integrated software that can overcome those challenges and promote optimal caregiver productivity.

"At John Hopkins Hospital, one 12-day alarm system analysis registered 58,764 alarms, an average of 350 per patient per day." 

When technology gets in the way

Patient care has been transformed by advanced technology that can record and report almost any patient event. From monitors to pulse oximeters to infusion pumps, these devices send alerts that demand caregivers’ attention.

While such technology has improved patient care through more immediate response to patient events, the sheer number of alarms has actually created roadblocks for caregivers. Faced with a barrage of work interruptions and competing priorities, clinicians are forced to become increasingly more reactive in delivering care and often frustrated by unnecessary calls to action.

Common interruptions with enormous impact

When a caregiver is repeatedly interrupted during his or her routine, the individual’s efficiency obviously suffers. Take a simple task: a nurse redressing a surgical wound. In approaching that task, the nurse will perform hand hygiene according to facility protocol and put on protective equipment or clothing required for that procedure. If a patient monitor alarm sounds from another room, the nurse, who may not know the priority level of the alert, may decide to err on the side of safety by stopping the redressing procedure and checking in with the other patient. This interruption thus would necessitate repeating the hygiene and protectiveclothing procedure process, which, of course, is extremely inefficient. This simple interruption reveals the magnitude of potential productivity loss. Given a number of related issues, including the shortage of nurses, potential for burnout and negative effects on job satisfaction, it is critical that alert fatigue be addressed operationally to meet the needs of personnel and to promote organizational viability.

"Consider if a hospital has 100 nurses and each of those nurses encounters just three five-minute work interruptions per day, it adds up to a staggering 9,125 hours of lost productivity per year—the equivalent to more than four staff positions."

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Ascom Holding AG is a telecommunications company focusing on wireless on-site communications. Ascom are also a sponsor of Australian Healthcare Week 2019. For more information visit