Excel Medical Blog

Reports, alarm counts, and phones have not made a difference to Alarm management. Why not?

Mary's pic

I am a pragmatist. If you are not honest about obstacles – how can you change them?

Six reasons AM programs have not made a huge difference:

  1. Because alarm management is complex
  2. Getting your baseline alarm count is not easy
  3. Just simply knowing your numbers has never changed outcomes
  4. Just sending alarms to phones – will drive all clinicians mad
  5. The programs need to be directed across teams – not just a nursing issue
  6. There is no silver bullet- it takes time
  7. Must be C suite Champions- behavior change is complicated

Technology (physiological monitoring) was well intended over 60 years ago but has unintended consequences. Today where the entire hospital’s level of acuity is higher- more patients are monitored outside of the ICU. We tend to use monitors as an insurance policy. 40% of them according to the literature are not needed.

Questions you need to ask- so we can make a difference:

  • Who do we monitor and for how long?
  • Once a patient who does need monitoring is on the floor – how do we work in responding to alarms?
  • What does your team do in response to alarms?
  • Are we pro-active? Do we wait until something rings?
  • Do we use the data? How is it used?
  • Do we communicate the information across teams?
  • Do we use monitoring data to manage patients, risk and staffing?
  • Are we pro-active with skin hygiene, lead and battery change?
  • How do we handle off-monitor for any reason - across teams, transfers, procedures, bath?
  • Do you even have an alarm management committee - a multi-disciplinary serious committee?

A clue…. the reality does not look like your stated policy or even evidence-based practice. That is why we include current state workflow as an integral part of alarm management - you must be pragmatic.

  • We know so much today about evidence-based practice
  • We can pull alarm counts across the system
  • We know defaults by disease, unit and some basic principles to follow across personalization of default settings.
  • We know that skin hygiene and proactive lead changes make a difference. i.e. changing tele batteries before they die.
  • We know that current state (the reality) is discoverable.
  • We know we can plan for future state
  • We know that this is a problem across multi-disciplinary teams
  • We know we must move from reacting to being predictive
  • We need C suite involvement

We have a knowledge base for alarm management that is based on 2015 and forward evidence-based data. Send me an email. Mary.baum@excel-medical.com and we can talk.