SCH: INT: Collaborative Research: Foundations for Caregiver-in-the-loop Suppression of Non-Informative Alarms

在医院和家庭环境中，用于持续监测生命体征的系统会发出警报，旨在警告护理人员、医院的临床医生或家中的父母，有必要立即引起他们的注意。然而，这些警报中只有不到1%被认为是可采取行动或提供信息的，这导致临床警报疲劳被列为十大卫生技术危害之一。虽然在人的因素、操作因素和技术因素方面取得了独立的进展，但它们之间的相互依存关系尚未得到集体考虑。因此，当前旨在解决临床报警疲劳的报警抑制系统通常不可扩展，采用率低，并且/或者在实践中表现不佳。本课题旨在为下一代智能报警器的设计奠定基础。智能警报2.0将利用护理人员在环报警抑制系统来减少诊所和家中非信息性警报的频率。实现有效的护理人员在环报警抑制系统需要在鲁棒报警抑制设计方法和护理人员在环建模和分析方面取得根本性进展。本文评估了所提出的设计和分析技术在警报抑制应用的医疗场景中的潜在影响，涵盖儿科病房和支气管肺发育不良（BPD）患者的家庭监测。该项目将为设计护理人员在环报警系统奠定基础，在该系统中，医生、护士和家长可以使用最佳报警设置，在正确的时间监测正确的儿童，以最大限度地提高信息量。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Systems used to continuously monitor vital signs in hospitals and home settings generate alarms intended to warn caregivers, clinicians in the hospital, or parents at home of conditions that warrant their immediate attention. However, less than 1% of these alarms are considered actionable or informative, which has led to clinical alarm fatigue being ranged as one of the Top 10 Health Technology Hazards. While there have been advances in human factors, operational factors, and technical factors independently, their interdependencies have yet to be collectively considered. Consequently, current alarm suppression systems aimed at addressing clinical alarm fatigue are generally not extensible, suffer from low adoption rates, and/or have poor performance in practice.This proposal aims to develop foundations for the design of next generation smart alarms. Smart Alarms 2.0 will utilize caregiver-in-the-loop alarm suppression systems to reduce the frequency of non-informative alarms in-clinic and at home. Realizing an effective caregiver-in-the-loop alarm suppression system requires fundamental advances in robust alarm suppression design methodologies and caregiver-in-the-loop modeling and analysis. The potential impact of the proposed design and analysis techniques is evaluated in medical scenarios for alarm suppression applications, spanning pediatric wards and at-home monitoring of Bronchopulmonary dysplasia (BPD) patients. This project will lay the foundations for designing caregiver-in-the-loop alarm systems in which physicians, nurses, and parents monitor the right children, at the right times, using optimal alarm settings to maximize informativeness.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.