Rethinking hospital alarms

May 27, 2016

WASHINGTON, D.C., May 27, 2016 - Hospital alarms are currently ranked as the "top medical technology hazard" within the United States. On average, there are about 480,000 patients in hospitals -- each generating about 135 clinical alarms per day. But studies show that more than 90 percent of these alarms result in no action. Alarm errors -- either alarms that sound and receive no response or alarms that fail to sound when they should --occur roughly 8 million times per day.

During the Acoustical Society of America's Spring 2016 Meeting, May 23-27, in Salt Lake City, Ilene Busch-Vishniac, an acoustical consultant, will present a model that predicts how often alarm errors will occur based on several recent studies of hospital alarms.

The error model she developed is rudimentary -- either alarms sound or they don't.

"In each case, alarms reflect a medically urgent situation or they don't," she explained. "For each situation, the response is either appropriate or inappropriate. This means there are eight possible scenarios associated with alarms, so we can estimate how often each occurs and how often errors occur."

In current studies, "the fraction of alarm errors reported as adversely affecting patients is extremely low," said Busch-Vishniac. "But alarms often don't serve the purpose for which they're intended: to alert medical staff to urgent situations. Instead, alarms go off all the time and rarely indicate truly urgent situations. And while the focus has been on ensuring that the hospital staff responds to all alarms, studies show that it's more common for alarm errors to occur because alarms that should sound fail to do so. This means that responding to all alarms won't eliminate most alarm errors."

There's also concern that alarms within hospitals have a negative impact on patient recovery, she pointed out, although insufficient data is available at this time to really answer the question.

Since 2014, hospitals within the U.S. are required to develop and review their alarm management policies on a regular basis.

"Our work suggests that it's time to rethink alarm strategies entirely -- with a goal of reducing the number of alarms to those that truly reflect urgent situations, while balancing the need to alert staff with the need to establish quieter hospital environments," she added.

Busch-Vishniac has outlined an "alarms of the future" research program she intends to pursue.

"The first task is to compare the medical outcomes of patients when alarms sound within their area vs. when alarms are intentionally muted and sent to staff via pagers or cell phones," she said. "This will help to establish whether alarms potentially harm patients, as well as save lives. We'll also explore when alarms should sound, which sounds should be used, and ways to make alarm systems more intelligent by combining information from multiple medical devices."

Her goal is to design optimum alarm systems for hospitals that can be integrated into hospital equipment within 20 years.

Presentation #5aAA8, "Death by alarm: An error model of hospital alarms," by Ilene Busch-Vishniac will take place on Friday, May 27, 2016, at 9:50 AM MDT in Salon I. The abstract can be found by searching for the presentation number here: http://acousticalsociety.org/content/spring-meeting-itinerary-planner
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ABOUT THE MEETING

The 171st Meeting of the Acoustical Society of America (ASA) will be held May 23-27, 2016, at the Salt Lake Marriott Downtown at City Creek Hotel. It will feature more than 900 presentations on sound and its applications in physics, engineering, music, architecture and medicine. Reporters are invited to cover the meeting remotely or attend in person for free.

USEFUL LINKS

Main meeting website: http://acousticalsociety.org/content/spring-2016-meeting

Itinerary planner and technical program: http://acousticalsociety.org/content/spring-meeting-itinerary-planner

WORLD WIDE PRESS ROOM

In the coming weeks, ASA's World Wide Press Room will be updated with additional tips on dozens of newsworthy stories and with lay-language papers, which are 400-900 word summaries of presentations written by scientists for a general audience and accompanied by photos, audio, and video. You can visit the site, beginning in early May, at (http://acoustics.org/current-meeting).

PRESS REGISTRATION

We will grant free registration to credentialed journalists and professional freelance journalists. If you are a reporter and would like to attend, contact John Arnst (jarnst@aip.org, 301-209-3096) who can also help with setting up interviews and obtaining images, sound clips, or background information.

LIVE MEDIA WEBCAST

A press briefing featuring a selection of newsworthy research will be webcast live from the conference on Tuesday, May 24. Topics and time of webcast to be announced.

ABOUT THE ACOUSTICAL SOCIETY OF AMERICA

The Acoustical Society of America (ASA) is the premier international scientific society in acoustics devoted to the science and technology of sound. Its 7,000 members worldwide represent a broad spectrum of the study of acoustics. ASA publications include The Journal of the Acoustical Society of America (the world's leading journal on acoustics), Acoustics Today magazine, books, and standards on acoustics. The society also holds two major scientific meetings each year. For more information about ASA, visit our website at http://www.acousticalsociety.org.

Acoustical Society of America

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