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Reducing alarm fatigue for optimal performance: analysis of a multi-unit health system process improvement
Descriptive
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Title
Reducing alarm fatigue for optimal performance: analysis of a multi-unit health system process improvement
Name
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Roberts
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Laura D.
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Laura D. Roberts
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author
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Srinivasan
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Shankar
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Shankar Srinivasan
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Advisory Committee
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chair
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Coffman
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Frederick
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Frederick Coffman
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Advisory Committee
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internal member
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Roye
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G. Dean
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G. Dean Roye
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Advisory Committee
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outside member
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Sweeney
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Joseph
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Joseph Sweeney
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Advisory Committee
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outside member
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Rutgers University
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degree grantor
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School of Health Professions
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school
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Text
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theses
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ETD doctoral
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2021
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2021-01
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2020
Language
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English
Abstract
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Technology in healthcare greatly enhances service delivery, safety, and efficacy yet when systems are not optimized any benefits of the technology are lost. This dissertation examines remote temperature monitoring systems and the inefficiencies of the alarms generated. Using Six Sigma methodology for performance improvement in healthcare, this dissertation focuses process improvement, specifically, reducing alarm/alert fatigue in healthcare generated by temperature monitoring systems. Extant research fails to examine non-patient alarms as distractions endured by healthcare professionals. Temperature and humidity control of the environment is critically important in clinical environments for infection control, pharmaceutical and food storage, and equipment function, among other reasons. Manual monitoring is resource-laden and error-prone, and automated environmental monitoring offers significant time-savings and reallocation of resources to other job tasks. However, without a robust infrastructure and implementation rules problems may arise. The case analysis of a multi-unit health system redesign of automated environmental monitoring highlights the complexity and inherent failures related to alarm management. Further, this case study examines alarm redeployment following11,000 environmental excursion alerts occurred each month with only 22% of those alerts being addressed. Using qualitative data from stakeholders, three research hypotheses were developed and examined relative to an end user:
1. The presence of user policies or procedures for use impacted the number of alarms generated;
2. Regular review of monitoring requirements and consistent system interaction impacted the number of alarms generated; and
3. Alert parameters determined by expert definition or empirically based system use impacted the number of alerts with corrections documented.
Baseline data is compared to post-improvement data to validate hypotheses and determine efficacy of real-time improvements. Continued improvement throughout the course of the project is measurable and sustainable. The author also proposes enhancements and improvements can be realized using six sigma methodology for technology installations that become out-moded to provide optimal performance.
1. The presence of user policies or procedures for use impacted the number of alarms generated;
2. Regular review of monitoring requirements and consistent system interaction impacted the number of alarms generated; and
3. Alert parameters determined by expert definition or empirically based system use impacted the number of alerts with corrections documented.
Baseline data is compared to post-improvement data to validate hypotheses and determine efficacy of real-time improvements. Continued improvement throughout the course of the project is measurable and sustainable. The author also proposes enhancements and improvements can be realized using six sigma methodology for technology installations that become out-moded to provide optimal performance.
Subject
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Topic
Alarm fatigue
Subject
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Topic
Biomedical Informatics
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Rutgers University Electronic Theses and Dissertations
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ETD_11308
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1 online resource (xii, 90 pages) : illustrations
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Ph.D.
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Includes bibliographical references
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School of Health Professions ETD Collection
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rucore10007400001
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doi:10.7282/t3-kjw8-ea88
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Rights
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The author owns the copyright to this work.
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Name
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Roberts
GivenName
Laura
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Permission or license
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2020-11-17 17:25:48
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Name
Laura Roberts
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Affiliation
Rutgers University. School of Health Professions
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
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Copyright protected
Availability
Status
Open
Reason
Permission or license
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