phat 17(10): e2

Research Article

Reducing alarm fatigue: exploring decision structures, risks, and design

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  • @ARTICLE{10.4108/eai.13-7-2017.152886,
        author={Mustafa Hussain and James Dewey and Nadir Weibel},
        title={Reducing alarm fatigue: exploring decision structures, risks, and design},
        journal={EAI Endorsed Transactions on Pervasive Health and Technology},
        keywords={Alarm fatigue, cognitive heuristics, cost-benefit analysis, design considerations, fast-and-frugal trees, patient monitoring systems},
  • Mustafa Hussain
    James Dewey
    Nadir Weibel
    Year: 2017
    Reducing alarm fatigue: exploring decision structures, risks, and design
    DOI: 10.4108/eai.13-7-2017.152886
Mustafa Hussain1,*, James Dewey2, Nadir Weibel3
  • 1: UC Irvine, 6210 Donald Bren Hall, Irvine, CA, USA
  • 2: Florida Polytechnic University, 4700 Research Way, Lakeland, FL, USA
  • 3: UC San Diego, 9500 Gilman Dr, La Jolla, CA, USA
*Contact email:


Automated patient monitoring systems su er from several design problems. Among them, alarm fatigue is one of the most critical issues, as evidenced by the Sentinel Event Alert that The Joint Commission – the U.S. hospital-accrediting body – recently issued. In this study, we explore fast-and-frugal heuristics that may be used to prioritize patient alarms, while continuing to monitor patient physiological state. By using a combination of human factors methodologies and the theory of Distributed Cognition (DCog), we studied alarm fatigue and its relationship to the underlying hospital systems. We identified three specific factors that we envision to be helpful for clinical personnel: ventilator presence, number of intravenous drips, and number of medications. We discuss their application in daily hospital operation. We also address cost-benefit considerations and possible monitor designs.