To read: ~ 5 minutes
Technology skepticism is well-justified in hospitals, as efficiency and staff satisfaction aren’t the only outcomes on the line. If technology breaks down in a clinical setting, it also compromises patient safety, putting lives at risk. As a result, hospital leaders are wise to approach it with caution.
However, there is a fine line between healthy skepticism and counterproductive resistance. Avoiding advancement too heavily could lead hospitals to fall behind and miss out on all of the benefits it carries. When new technologies, like modern alarm management systems, are implemented successfully, they aren’t simply benign. They can be immensely advantageous, improving the lives of staff and patients.
Yet even when leaders do purchase and implement new tools with the potential to optimize how work gets done, they are often abandoned or underutilized due to distrust among staff.
Monica Trepicone, who is a registered nurse, is familiar with the issue from the hospital and vendor sides. During her 18 years as a registered nurse, 15 of which she spent in the OR, she watched well-intentioned alarm management systems fail. Now, as one of our Clinical Informatics Specialists, she helps hospitals avoid failure and maximize their tech investments, for the sake of their clinicians and patients.
See it to believe it
When alarm management solutions fail, it typically has little to do with the solutions themselves. More often than not, failure is actually rooted in distrust among the clinicians meant to use them.
This distrust is both innate and learned.
Nurses are naturally and rightfully wary of new systems they haven’t physically validated themselves. “You can’t just bring in something that we haven’t touched or felt before. We have to understand how the tool works,” Trepicone says, reflecting on her time as an OR nurse. “We need to see how it’s actually going to work in our day-to-day activities.”
Even if hospitals get alarm management systems up and running, misalignment with the nuances of their specific clinical workflows can gradually erode confidence in the system. Trepicone has seen hospitals route alarms to “everybody, all of the nursing staff, all the technicians at once,” overwhelming nurses with non-actionable or irrelevant alerts and making it difficult to identify truly critical patient events.
When alarm management systems create alarm fatigue and inhibit rapid response, nursing teams lose trust. They abandon the system that was supposed to help them and develop complex workarounds just to get through their shift. While this demonstrates their ingenuity and resilience, it defeats the purpose of putting new tech in place.
The importance of earning trust
To implement alarm management systems that clinicians actually want to use, hospitals must earn and maintain the trust of nursing teams. “If you don’t have buy-in from the nursing staff that will utilize the equipment, it’s not going to be a successful project,” Trepicone states.
We help hospitals achieve this by embedding technical and clinical experts, like Trepicone, to engage with clinical staff throughout the implementation process. These experts can help establish trust early on and maintain it by creating alarm management systems that genuinely work in practice.
Below, we outline our implementation process to showcase how we build clinician trust every step of the way.
How to implement a trustworthy alarm management system
Step 1: On-site assessment.
Every hospital is unique, so Connexall’s team starts with an on-site assessment. This allows them to figure out what they are working with before they design or build anything.
The team takes great care to involve nursing staff at this discovery stage. This provides them with a realistic view of the current environment, and it also offers an opportunity to demonstrate clinical expertise and build trust with the people who will eventually use the system.
For example, they identify who will use the alarm management system in each unit and, importantly, what they call themselves. In many cases, different units use different job titles for the same role. One unit might have a “nursing supervisor,” while another might have a “nurse manager,” with both people performing the same duties.
Trepicone’s team works with hospitals to understand their naming conventions across units, as this helps avoid issues with alert routing when setting up the system later on.
Step 2: Workflow observation and documentation
Once they get the lay of the land, they observe key players to understand how they operate and interact with alerts in their day-to-day work.
Connexall’s team typically enters this stage with a variety of questions to answer, like:
- What type of alerts are used in this unit?
- Who typically receives them first: a nursing assistant, a unit clerk, someone else?
- Are they going to a group of people: the respiratory therapy team, the ICU, another group?
- How do physical constraints, time pressure, or competing priorities affect their ability to respond?
Trepicone recalls watching a nurse perform trach care while wearing their PPE to see how they would handle an alert when it popped up on their phone.
Step 3: System configuration
The information Connexall’s team gathers during their workflow observation helps them determine who should receive which alerts and when. This allows them to configure the alarm management system in a way that aligns with how work actually happens.
For example, Trepicone shares that they typically set up a three-level routing system based on how nurses report to each other. The system will send an alert to a patient’s primary nurse first. If they don’t respond, it will go to a secondary point of contact. If neither is available, it will go to a backup, typically a charge nurse or nurse manager.
They also establish clear protocols to ensure that the timing and escalation of alerts align with their level of urgency. While a critical code blue alert will climb to the top more quickly, or immediately trigger all three levels simultaneously, a routine request for water will not. This helps prevent alarm fatigue by ensuring that the right alert gets to the right person at the right time without creating unnecessary noise in the process
Step 4: Hands-on testing with clinical staff
Finally, the team puts the system to the test by deploying it in a real patient care setting. This is the only way to see whether it will help or hinder clinicians managing real patients under real pressure.
“What looks good on paper may not actually work in the actual scenario,” Trepicone says, noting situations can arise that they hadn’t considered or expected during earlier stages. For example, they’ve seen cases where alarms weren’t even reaching the Connexall alert system due to loose wires in the underlying hardware.
Her team treats these scenarios as opportunities for ongoing improvement. They work with hospital staff and other vendors to continuously adjust the system, until it fully blends into everyday operations.
Technology that truly serves clinicians
Getting clinicians to adopt new technologies comes down to building and maintaining trust.
By engaging with clinicians at each stage of the alarm management implementation process, from information gathering to design to testing, Connexall’s team establishes trust early on and delivers a solution that doesn’t break it.
This helps hospitals avoid the all-too-common problem of their brand-new tool sitting unused, either because clinicians feared it or ran into problems trying to make it work. Instead, hospitals get what they actually need: an alarm management system that clinicians want to use, because it genuinely makes their job easier and allows them to deliver better patient care.
