A Discount Approach to Reducing Nursing Alert Burden.

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Quality Improvement in Healthcare

Background:

• Clinical decision support (CDS) programs often create alert burden and fatigue.
• Existing solutions require extensive resources, making them difficult for hospitals to replicate.
• There is a need for efficient strategies to manage alert fatigue.

Purpose of the Study:

• To reduce nursing alert burden using a focused quality-improvement approach.
• To target high-volume alerts with a primary nurse informaticist and a small team.
• To demonstrate an efficient method for managing CDS alert overload.

Main Methods:

• Identified high-volume alerts accounting for 43% of interruptive alerts.
• Applied the Five Rights of CDS framework for alert design modifications.
• Conducted concurrent work, in situ usability testing, and stakeholder approvals.

Main Results:

• Reduced total interruptive nursing alert firings by 58%.
• Increased action taken on alerts from 8.1% to 17.3%.
• Decreased estimated time spent resolving alerts from 197 to 114 hours/month system-wide.

Conclusions:

• Effective CDS implementation requires clear evaluation and monitoring frameworks.
• An empowered nurse informaticist can lead efficient alert burden reduction efforts.
• This approach substantially reduced nursing alert burden without clear benefits being compromised.