Improving Alarm Management Practices: Wireless Bed Exit Alerts on Medical-Surgical Units.

Abstract

This study reviewed the application of sociotechnical models and frameworks to reduce wireless calls without introducing risk and impacting patient care, supplementing the findings of the study conducted by Clodfelter (Studies in Health Technology and Informatics 2024;315:463-467). This study was conducted at an 815-bed Magnet-recognized facility with comprehensive trauma, children's, and stroke services. Two models, both by Sittig and Singh, were applied to evaluate interdependent and interrelated concepts of human and technical components in the sociotechnical work system of medical-surgical nursing units. Sittig and Singh's (2010) eight-dimensional sociotechnical model comprehensively represents the factors influencing the design, development, use, implementation, and evaluation of health information technology. Interventions were piloted on three medical-surgical units with like hardware and software wireless integrations. The quantitative analysis demonstrated the effectiveness of the interventions, showing significant reductions in nuisance alerts without introducing new risks. Furthermore, there were no unintended consequences identified following the implementation of the intervention. There are direct, qualitative benefits related to decreased nuisance alarms and clinician experience. Return on investment and the value proposition reflect both tangible and intangible costs. Workflow changes, policy revisions, and system data were used to demonstrate meaningful improvement without unintended consequences. Tailoring workflows by addressing sociotechnical factors can reduce nuisance alerts and improve usefulness of systems.