SHM Converge Scientific Abstract ePoster Gallery-Quiet!

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The project addressed hospital alarm fatigue, a patient safety issue caused by excessive, unactionable monitor alarms that desensitize providers. Using DMAIC methodology, the team reviewed institutional alarm policies, equipment manufacturer recommendations, and internal alarm data to identify the main sources of noise.<br /><br />Their first major intervention focused on pulse oximetry alarms, which accounted for 60–65% of alarms. The oxygen saturation threshold was lowered from 92% to 88%, with flexibility for providers to adjust based on patient condition. Implemented in 2014, this reduced alarms from 1.36 million per month to 914,261 by October 2019, a sustained 33% decrease.<br /><br />In 2019, the team repeated a similar process for cardiac monitoring. Working with GE, they reviewed alarm nomenclature and removed redundant audible alarms for tachycardia, SV tachycardia, and bradycardia. They also standardized heart rate alarm limits across multiple units, lowering the lower limit from 50 to 45 bpm and increasing the upper limit to 130 bpm. Pilots showed no increase in patient harm or safety events, and the changes were implemented institution-wide in November 2019.<br /><br />These efforts reduced cardiac monitor alarms from 800,000 per month in November 2019 to 628,287 by October 2022, an additional 20% reduction in unactionable alarms. Overall, the institution achieved a 50% reduction in audible alarm noise over the past decade, and the improvements were sustained through the COVID-19 pandemic despite increased use of physiologic monitoring.

Asset Subtitle

Vijay Duggirala

Meta Tag

Author List Vijay Duggirala

Category Innovations

Concept Alarm Fatigue

Concept Pulse Oximetry

Concept Physiologic Monitor Alarms

Concept Unactionable Alarms

Concept Cardiac Monitoring

Distinguished Non-Finalist

Presenter Organization Ohio State University

Presenting Author Vijay Duggirala

Track Quality Improvement

Keywords

hospital alarm fatigue

patient safety

DMAIC methodology

pulse oximetry alarms

oxygen saturation threshold

cardiac monitoring

alarm reduction

audible alarm noise

physiologic monitoring

monitor alarms

Alarm Fatigue

Pulse Oximetry

Physiologic Monitor Alarms

Unactionable Alarms

Cardiac Monitoring