Collaborate to Reduce 'Smart Pump Alert Fatigue'

Amart pump alerts are an important tool to maintain patient safety, but it is important for health systems to take a collaborative and data-driven approach to reducing unnecessary alerts, according to a presentation given during a satellite symposium at the 2018 ASHP Midyear Clinical Meeting in Anaheim.

Todd A. Walroth, PharmD, the pharmacy manager of clinical services for Eskenazi Health in Indianapolis, discussed how data from smart pump technology could be used to drive clinical practice changes, in particular, highlighting a collaborative initiative to reduce alert fatigue.

Alert fatigue, Dr. Walroth explained, occurs when a smart pump device triggers a high number of clinically insignificant alerts. This has the potential to create a “dulling effect” among health-system workers, leading them to ignore legitimate safety issues.

In an effort to minimize clinically insignificant alerts, Eskenazi Health and 5 neighboring health systems—known collectively as the Indianapolis Coalition for Patient Safety (ICPS)—worked together to create a standardized, city wide process for managing smart pump libraries. By analyzing and sharing data, Dr. Walroth said, the ICPS was able to identify best practices and establish of a list of recommendations for a shared drug dosing libraries review process, which noted:

• Pharmacists, nurses, and medication safety officers should all be involved in the review process.
• All drug profiles should be reviewed at least once per year.
• At a minimum, top 10 drug lists, formulary updates, bedside audits, and compliance data should all be reviewed; data from good catches, patient outliers, ISMP action alerts, and medications errors should also be reviewed when available.
• Recommended changes should be approved by an interdisciplinary committee consisting of medication safety officers, patient safety officers, and smart pump committee members.
• Communication should be enhanced both within and across health systems.
• Changes should be reviewed and assessed for improvements.

According to Dr. Walroth, 5 years after implementing these recommendations, the health systems of the ICPS experienced a 50% reduction in alerts per device per month. Given this success, the ICPS plans to follow up on their efforts by evaluating specific alert reduction strategies while putting a greater emphasis on benchmarking quantitative metric.

Asserting that the ICPS’ approach can help other health systems to reduce both clinically insignificant alerts and alert fatigue, Dr. Walroth ultimately emphasized the importance of collaborative data analysis to maximizing patient safety.

“The most important takeaway here is that interdisciplinary idea sharing can yield additional projected aimed at reducing alert fatigue and opportunities to leverage smart pump data,” Dr. Walroth concluded.

Reference

Walroth T. Using Smart Infusion Device Data to Facilitate Clinical Practice Changes. Presented at: 2018 ASHP Midyear Clinical Meeting. December 2-6, 2018. Anaheim, California.