Why alarm fatigue is a pivotal issue that affects the acoustical design of healthcare facilities

Abstract

The U.S. FDA and Joint Commission designated “alarm fatigue” the “#1 priority in healthcare technology” in 2011–2012, acknowledging that this acoustical problem results in hundreds of patient deaths and thousands of injuries. The healthcare facilities industry has been slow to recognize that “alarm fatigue” is partly a facility design issue: i.e., a cacophony of recurrent noises from myriad uncorrelated medical devices, set at maximum loudness, occurring in hard-walled, reverberant spaces (such as patient rooms, ORs, and ICUs) produce elevated stress, sleep impairment, disorientation, and dangerously irrational, potentially deadly behavior. “Alarm fatigue” has been addressed as a human factors problem elsewhere: e.g., nuclear plant control rooms (after Three-Mile Island) and aircraft cockpits. In healthcare, it is imperative to engage architects, designers, acoustical engineers facility engineering staffs, and clinicians, who represent the “first line of defense” as the medical device industry requires 5–10 years to implement solutions. The presenter co-led a delegation of 12 distinguished members of the acoustics profession to the national summit on “alarm fatigue,” Washington DC, 2011 and has co-authored peer-reviewed medical journal articles and a forthcoming FGI white paper on the subject. This presentation focuses on solutions, challenges, and the research roadmap needed to address “alarm fatigue.”