Hospitals have long struggled with “alarm fatigue,” when busy nurses become desensitized to the constant noise emanating from cardiac telemetry monitoring systems. Although less than 10 percent of alerts are immediately clinically relevant, important warning signs can be missed in the din of nuisance pings. Consequently, fewer than one in four patients survive an in-hospital cardiac arrest, according to the American Heart Association, with up to 44% of inpatient cardiac arrests not detected appropriately. Thus, alarm safety is now a hot topic in healthcare, and has been recently identified as a top technology hazard lurking in hospitals.
Centralized monitoring has emerged as the answer, as part of a “mission control” operation in which off-site personnel use advanced equipment, including sensors and high-definition cameras to monitor blood pressure, heart rate, heart rhythm, respiration, pulse oximetry and more. Risk stratification algorithms assimilate complex data to automatically generate alerts triggering on-site intervention, while filtering out many unimportant alarms. In 2016, results from the CMU’s first 13 months of using the standardized criteria were published by JAMA showing that there’s real hope of reducing rates of redundant or less significant alarms while improving clinical outcomes. During that time, the CMU monitored nearly 100,000 patients and detected serious problems and accurately notified on-site staff in advance of 79 percent of events. The study reported a robust 93% survival rate of cardiopulmonary arrests among patients for whom the central monitoring unit gave advance warnings.
Since then, further innovation is yielding a system that can double the number of monitored patients per technician, improve clinical outcomes, and decrease communication transit times. The results of the “eye in the sky” approach are capturing the attention and imaginations of hospitals around the world. All signs indicate that 2018 will mark the year that CMUs grow exponentially while continually adding new patient-saving capabilities.
Where Are They Now
Centralized monitoring units are now implemented in several major hospital systems to some extent.