The DOI matches its Crossref record; 50 of the 52 references it cites were found in a registry or an index.
Alarm system management: evidence-based guidance encouraging direct measurement of informativeness to improve alarm response
Abstract
Although there are powerful incentives for creating alarm management programmes to reduce ‘alarm fatigue’, they do not provide guidance on how to reduce the likelihood that clinicians will disregard critical alarms. The literature cites numerous phenomena that contribute to alarm fatigue, although many of these, including total rate of alarms, are not supported in the literature as factors that directly impact alarm response. The contributor that is most frequently associated with alarm response is informativeness, which is defined as the proportion of total alarms that successfully conveys a specific event, and the extent to which it is a hazard. Informativeness is low across all healthcare applications, consistently ranging from 1% to 20%. Because of its likelihood and strong evidential support, informativeness should be evaluated before other contributors are considered. Methods for measuring informativeness and alarm response are discussed. Design directions for potential interventions, as well as design alternatives to traditional alarms, are also discussed. With the increased attention and investment in alarm system management that alarm interventions are currently receiving, initiatives that focus on informativeness and the other evidence-based measures identified will allow us to more effectively, efficiently and reliably redirect clinician attention, ultimately improving alarm response.
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In the citing paper
“Our findings suggest that responses to textual alerts in EHRs are similar to previously documented responses to audible and visual alarms. [16–18]”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [16]
In the citing paper
“it is well-established in the human factors literature that false alarms reduce responsiveness to alarms and may also reduce overall performance on tasks interrupted by alarms. [16–18]”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [16]
In the citing paper
“Uninformative alerts are similar to false alarms”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [16]
In the citing paper
“The human factors literature in other settings shows that high false alarm rates reduce responsiveness as the individual learns, consciously or unconsciously, that the alarm is unreliable [16–18].”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [16]
In the citing paper
“In other settings, low alarm informativeness and increased cognitive workload predict poor alarm response.”
From Effects of workload, work complexity, and repeated alerts on alert fatigue in a clinical decision support system (2017) · cites this paper as [16]
Citations
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Singh, A. K., & Malviya, R. (2023) · Wiley eBooks · doi:10.1002/9781394200344.ch3 · Cited by 1
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046864
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046852
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046867
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046870
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046855
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046861
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046849
Santry, H. P., Strassels, S. A., Ingraham, A. M., Oslock, W. M., Ricci, K. B., Paredes, A. Z., Heh, V. K., Baselice, H. E., Rushing, A. P., Diaz, A., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13046858
Elmore, B., Ikuma, L. H., Nahmens, I., Jagneaux, T., & D’Antonio, C. (2026) · IISE Transactions on Healthcare Systems Engineering · doi:10.1080/24725579.2026.2622417
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Movahedi, A., Alikhah, H., Rezaiy, S. G., Partash, N., Abavisani, M., Zirak, M., & Maghsoodi, E. (2026) · Nursing Forum · doi:10.1155/nuf/3997936
Sang, M., Wang, S., Weng, F., Ya'nan, L., Qiao, W., Sheng, G., Ren, Y., & Wei, J. (2026) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2026.10.006
Metadata
- Authors
- Rayo, M. F., & Moffatt-Bruce, S. D.
- Affiliations
- The Ohio State University (US)
- Corresponding author
- Rayo, Michael F
- ORCID
- Rayo, Michael F
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2015-03-02
- Volume
- 24
- Issue
- 4
- Pages
- 282-286
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- OpenAlex
- W2096457720
- Cited by
- 115
- References
- 52
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 5 · 2023: 17 · 2022: 6 · 2021: 10 · 2020: 16 · 2019: 11 · 2018: 13 · 2017: 9 · 2016: 10 · 2015: 3
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- alarm fatigue, alarm system, alarm response, alarm system design, patient safety
- MeSH terms
- Attention, Attitude of Health Personnel, Equipment Failure, Humans, Monitoring, Physiologic, Nursing Staff, Hospital, Reaction Time, Workload, Safety Management, Clinical Alarms
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