A Patient-Centered Approach to Alarm Management—Texas Children’s Hospital’s Award-Winning Project
Texas Children’s Hospital (Houston, TX) was named the winner of ECRI Institute’s 10th Health Devices Achievement Award in February 2016 for its design and implementation of an alarm dashboard that has helped integrate alarm management decisions into patient care discussions.
The need to improve the management of clinical alarms has been identified by the Joint Commission, ECRI Institute, and others as a patient safety priority. And while past projects at Texas Children’s led to incremental improvements in reducing the number of unnecessary alarms, they did little to address the underlying need for a clinical alarm strategy that would consistently yield alarms that were both meaningful and actionable. Thus, Texas Children’s decided that a “reboot” of its alarm management program was in order.
Key aspects of Texas Children’s revamped program are that it:
- Shifted the mindset. By redirecting the focus from “alarm management” to “patient care,” the team at Texas Children’s brought the patient back into the center of the process. Conversations became less about the technologies that generated alarms and more about the needs of the patient.
- Engaged stakeholders from many different disciplines. The shift to a patient care mindset helped clarify that the issue is not just a technology management problem or a nursing challenge, but rather a patient care consideration that requires input from the whole care team.
- Assessed the environment of care to identify contributing factors. For example: The team discovered that trash can lids, of all things, were leading to unnecessary alarms.
- Developed a system for collecting, analyzing, and viewing alarm data. Texas Children’s helped develop an “alarm dashboard” that allowed it to integrate alarm data into patient care discussions. With this dashboard, the entire care team could review alarm information during rounds, evaluate the alarm settings as the patient’s condition changed, and change the settings as needed so that alarms remained actionable.
The program resulted in a sustained reduction in the number of alarms. It improved collaboration between the medical and nursing staff in their efforts to manage alarms. And it laid the groundwork for a scalable, enterprise-wide solution to allow for the improved management of clinical alarms.
ECRI Institute presents the Health Devices Achievement Award to recognize outstanding initiatives undertaken by member healthcare institutions to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology. For details about the other submissions that achieved recognition, see The Health Devices Achievement Award: Recognizing Exceptional Health Technology Management.