3 April 2023

More than 66% reduction in the number of medical alarms per day at Treant Zorggroep

Every parent knows: babies move frequently and unpredictably. That is why it is a challenge for every hospital to organize alarm reduction in the neonates and children’s wards. Especially at a time when a new modern monitoring system leads to an abundance of alarm signals. Angelique Kroeze (head of the Parent and Child Center, the Clinic, the Day Treatment and the Pediatric Outpatient Clinic) can share her thoughts on this. Together with itemedical, she and her team succeeded in bringing peace back to the Treant Zorggroep.

The Treant Zorggroep has three hospital locations – in Hoogeveen, Emmen and Stadskanaal – supplemented by 17 locations for housing and care. The 6,000 employees strive together for a ‘vital and meaningful life’. Also in the children’s department, with a separate neonatology department. Here, 32 beds and incubators in baby rooms, sterile boxes or wards are ready to receive babies and children from 0 to 18 years old.


That children’s ward was confronted with a number of challenges at the same time, Angelique Kroeze looks back: “Both the Nursing Call System (VOS) — with which patients can call for assistance, service or resuscitation — and the outdated monitoring system suddenly turned out to be out of service. As a result, monitoring of the patients was not possible. To solve this situation in the short term, we opted for a new Medical Alarm System (MAS) from CLB and new patient monitoring monitors from Dräger. All alarms soon flowed through connections between the Dräger gateway and the mobile devices of the healthcare personnel on duty.”

Soon a new problem emerged: alarm fatigue. The technology of the new monitors turned out to be more advanced and sensitive than before, so that employees were completely inundated with alarm signals: “The smallest patients cause the most alarms from patient monitoring monitors because they pick at cables or ECG stickers. In addition, babies are constantly moving – or crying a lot and making noise – triggering alarms. Because baby’s skin is often greasy, the ECG leads come off sooner. This causes unreadable results or disturbances in the VF image (cardiac arrhythmia), causing a false alarm.”

If you completely forward that stream of signals to the nurses, you get an overload of irrelevant alarms. “Through the link, 1,798 alarms flowed daily from the patient monitoring monitors to the healthcare staff. No one can handle that number. At the same time, these alarms also caused enormous noise nuisance at the beds of the patients. And that made recovery more difficult, since small children especially need rest.”

From one way to gateway

The avalanche of alarms led to despondency among the entire team. That is why Angelique asked for help from a supplier: “Itemedical had already supported us in the ICs and OR with medical IT solutions in the past. For example, they implemented MetaVision (as a Patient Data Management System) and MediScore software (to analyze, for example, hospital days and procedures in the Intensive Care Unit). To tackle alarm fatigue, the MediScore Medical Device Data Gateway (MDDG) proved to be the remedy.”

“The MDDG is based on a ‘route approach’”, Angelique explains to her team. You assume that every alarm follows an optimal route: “The gateway collects all data from the medical equipment. This makes the data available for the applications and analysis in the dashboards of MediScore Analytics. Based on this, the MDDG can delay or enrich alarm data. A high priority alarm is about the shortest and fastest route directly to your smartphone. In the case of a low-priority alarm, the signal goes over the motorway, through a roundabout, and then makes an extra round and only then continues (or goes back). In this way, only the relevant signals go to the mobile devices. This way, patient safety is guaranteed, while we prevent alarm fatigue.”

Multidisciplinary success

After a year of preparation, the solution went live in the children’s department in the summer of 2021. The noise level dropped quickly. What’s more, there is now no sound at all around the bed of the patients. Because the alarms only arrive at the Central Post and the mobile devices of the nurses. The latest analysis shows that there are now 599 alarms per day: a reduction of more than 66%. As a result, peace returned to the department.

This success had many fathers (and mothers): “The solution is the result of good cooperation between nurses, a paediatrician, a clinical physicist, ICT, medical technicians, application managers and experts from itemedical”, Angelique adds. “A multidisciplinary team is needed, because a medical alarm system has an impact on all links in the chain. In addition, itemedical provided short consultation lines – even at night if necessary – and adapted training.”

Results immediately clear

After going live, there was a regular follow-up to analyze the alarm data, to increase insight and to refine the system.

“With detailed reporting from itemedical about our alarm data, you can estimate trends and adjust the work process. For example, if many artifacts appear, it may be necessary to choose other EKG patches. But you can also look at and measure the responsiveness of the healthcare staff. If a nurse cannot immediately attend to a baby, the signal goes to a buddy. But how does she react to that? Is it obvious that no one is with the baby or did the buddy just forget to turn off the alarm?

A Medical Alarm Coach from itemedical can further optimize the work process with ready-to-use advice. This Alarm Coach supports the nurses in the workplace. “We are still thinking about how to use this. An Alarm Coach can train our healthcare employees and further train them internally via the ‘train-the-trainer’ principle. In this way, the knowledge in the department and the support for consciously dealing with alarms will grow. That ensures satisfied nurses.”


Prevent alarm fatique in your children’s department?