Last winter I got into it with the clinical leader of a consulting company about the difference between alarms and alerts. Over the years I’d come to believe that nurse calls were in many respects no different than phone calls, or alarms from a patient monitor. Consultants, vendors, and hospital customers often get hung up on the difference between “messaging,” “alarms,” “notifications” or “alerts.” Throw in ringtones, vibrations, popups, flashing lights, tones of any kind, these mechanisms are intended to take your attention away from one thing and put it on another. Whether from man or machine (computer, smartphone, beeper, nursecall, patient monitor, tablet, etc..) these sensory bursts are conveyors of status changes, new details, signposts that there is something to be communicated, sometimes unnecessarily. Each message has varying degrees of criticality, running the spectrum of trivial, to life or death. In the cacophony of a nursing unit of any hospital on any day, it’s all noise. It makes it almost impossible to figure out what’s important.
As we finish up the 2nd decade of the 21st Century, we are being crippled under the weight of these messaging streams, and it is dangerous. Be it personally or professionally, few have the tools, the discipline, the constitution, or the training to manage these streams effectively. Be it my 82-year-old mother who has thousands of unread messages and notifications on her phone that she simply doesn’t know how to deal with, or the nursing supervisor at a community hospital who is deluged with escalated messages from nursing units simply unable to respond because of capacity or a faulty unreviewed workflow.
And while we might be tolerant or amused by the “continuous state of half attention” at dinner tables, or watching the football game on Sunday, as we indulgently stare at our phones clamoring for likes on Facebook, Snapchat or Instagram, this “half attention” as not defensible for anyone involved with activity that can impact the life or safety of others. Be it a long haul trucker, a pilot, doctor or nurse. I’m not suggesting that professionals are paying too much attention to their Twitter feeds in the workplace (and yes that goes on), it’s all part of a bigger wash. All of this is distracting. It adds up. And we are all distracted.
I think we all know that a messaging deluge is going on. How much of it is going on, and the impact of it, and the tools techniques for taming it, is an essential area that we as technologists owe it to our customers to develop, share, and collaborate on.
Here are 10 tips that your organization can do now to minimize distraction:
- Consider broadening existing cross-disciplinary alarm committee initiatives to include notification/messaging and interruptions.
- Analyze and review workflows that include notification. Prioritize & eliminate when possible.
- Establish notification/alarm threshold KPIs and revisit regularly to ensure compliance.
- Use native and 3rd party analytics to audit message streams and look at the correlation between staffing levels, patient census, and time of day. Data can show you where to optimize.
- Model suspend or delay scenarios to factor in self correction and false alarms/notifications.
- Educate staff about notification/alert management techniques.
- Survey staff regarding messaging, notifications and alarm fatigue and encourage them to report excess and inefficiency.
- Observe staff in context, including patient care areas to validate issues, behaviors, and areas for improvement.
- Create no interruption zones, especially for sensitive activities that require precision.
- Modify/tweak source system thresholds when possible to optimize event and notification rules.
Kenny Schiff, is Managing Partner and Founder of CareSight. A 20-year veteran of the healthcare technology business, Kenny is considered by his customers and peers to be a no-nonsense trusted resource who can be counted on to deliver complex solutions with high impact. His team pioneered managed services to clinical communications customers starting in 2003. Visionary always, but never afraid to be hands on, CareSight is a great creative platform for Kenny’s entrepreneurial and technical passions.