Alarm Management Showcase
March/April 2011
Alarm Management Showcase:
Being Everywhere at Once
Caregivers can’t be everywhere, but with integrated alarm notification systems, they can respond quickly when needed.
Until you know there is a problem, it’s much harder to respond to it. For patients, alarm notification systems can undoubtedly be lifesaving. But with the right core technology, they can also be early warning systems that help to prevent patients from deteriorating to a critical point. For the hospital, these systems improve patient safety and clinical outcomes—allowing patients to get better faster and go home sooner. As Jim Welch, VP of patient safety initiatives at Masimo Corporation, Irvine, Calif., points out, “For caregivers, alarm notification systems increase care efficiencies and provide another layer of vigilance that affords everyone more peace of mind—enabling them to focus on their core competency and what they truly love—bringing patients back to health!”
Reid Mayo, director of marketing for Dalcon Communication Systems, Nashville, Tenn., notes, “Any medical device in the patient room that generates an alarm can be monitored by an alarm notification system like Dalcon Alert, so it is up to the hospital to decide which devices they want to integrate based on facility safety and quality of care goals. Generally, hospitals choose which devices to integrate based on the needs of individual nursing units. However, integrating common devices such as beds for fall prevention or IV-pumps is typically considered standard.”
Alarm systems can do even more. Peter Härdi, vice president, international marketing, Ascom Wireless Solutions in Gothenburg, Sweden, explains, “For the hospital, people, processes, and technologies can be aligned to improve workflows. Alarm notification makes it possible to send critical information through to the designated staff and complete logging, audit trails, dashboards, and reports can be generated to measure staff productivity or to determine root cause analysis of a particular event. For example, reports can be generated for when messages were sent, who received, who accepted and acknowledged, who declined etc. to provide hospital management with the required data in case of any question on procedures.”
Welch adds, “Based on our work over the years to define alarm management, we believe that the impact of smart alarms with adaptive thresholds has the potential to eliminate alarm fatigue. The problem is that alarm threshold settings have historically been one-size-fits-all. As a result the alarm behavior of a patient with a normal baseline SpO2 of 98%, for example, is treated by pulse oximeters the same as a patient with a baseline of 93%. In either case, regardless of the patient’s individual normative values, a single drop below a low alarm threshold of 90% will generate an alarm event, even though the former case may be more clinically significant. This limitation contributes to the number of non-actionable alarms because the same alarm rule is applied to all patients in a given care area. And, although setting individual patient alarms is the recommended practice to reduce alarms, it burdens the nursing staff workload.”
Mayo agrees, “Our alarm management software automatically ranks and organizes alarms from the wide variety of integrated systems and devices into a single source that is easier for caregivers to manage. As patient monitor device technology continues to improve, creating less false alarms and providing alarm notification systems with better alarm information, our alarm management technology will only become more efficient.”
Next generation alarm notification systems will not simply capture, manage, and send alarm related notifications to caregivers, but include a full suite of notifications that will help clinicians provide better care. According to Alan Bingham, senior product manager at Alimed, Dedham, Mass., “The next generation systems will communicate critical patient status information directly from the bedside, wirelessly, to the caregiver who will receive the information on a smart phone. Currently some clinical staff receive messages by pager, but the smart phone technology is rapidly obsoleting the pager. So the clinician will know almost immediately if a patient is in the process of arising or if any of their critical support devices have ceased operating appropriately.”
With the constant cost-push in facilities, the ability to enable staff with technology makes them more efficient and informed and that will lead to improved patient management and from that it is expected better quality outcomes. These systems are in development currently and will deliver a higher level cost-effectiveness and clinical efficacy. As Mayo says, “Patient monitor device technology continues to improve, creating fewer false alarms and providing alarm notification systems with better alarm information, and therefore our alarm management technology will only become more efficient and more desirable.”
Unfortunately, Bingham explains, “The current adoption of these technologies is impacted by the poor interoperability and communications of many forms of clinical instrumentation and products. In addition, low reimbursement rates in many facilities, especially nursing homes, has denied management the funding to afford the systems, even though they deliver an excellent ROI. Many facilities are ‘making do’ and this has the effect of slowing adoption.”