Navigating Alert Fatigue: A Case Study in Electronic Health Record Alert Design Optimization.

Area of Science:

• Healthcare Informatics
• Clinical Quality Improvement
• Human-Computer Interaction

Background:

• Clinical decision support (CDS) systems are vital for patient care but often suffer from poor design.
• Inadequate CDS design leads to alert fatigue, where clinicians are overwhelmed by irrelevant or disruptive alerts, impacting efficiency and patient safety.

Purpose of the Study:

• To address nursing alert fatigue within electronic health records (EHR) through a quality improvement (QI) project.
• To strategically redesign high-firing, low-action alerts to improve clinical relevance and reduce clinician burden.

Main Methods:

• A mixed-methods approach was utilized, combining quantitative analysis with qualitative data.
• Virtual empathy mapping sessions with nurses were conducted to understand user experiences.
• User feedback and CDS design principles informed the alert redesign process.

Main Results:

• All four identified disruptive, high-firing nursing alerts were removed or redesigned.
• This initiative resulted in the reclamation of 877 nursing hours previously spent on unactionable alerts.
• Passive alerts were also redesigned to improve their utility.

Conclusions:

• Strategic redesign of CDS alerts is crucial for mitigating alert fatigue in healthcare settings.
• Effective alert management requires a focus on clinical relevance and user-centered design.
• Sustained organizational governance is essential for ongoing healthcare system optimization and alert management.