“Persuading hospitals and manufacturers to adopt better alarms aside from the standard is to persuade them that this is important and that it’s cool to do so, and that this is what everybody is doing and it’s a selling point for you if you’re using better alarms or more safe alarms or your false alarm rates are lower. Because that’s a key problem with the whole alarm problem, it’s this very high false alarm rate, so there are a number of ways in which you can persuade people to change their practice. But they’re not necessarily what you think.”– Professor Judy Edworthy
Recently I had the chance to moderate a panel in The Power of Sound club on Clubhouse about sound in healthcare called “Alarms are Killing Us,” and it was quite the discussion. My panelists came from all sectors of the health industry and included Dr. Joseph Schlesinger, Dr. Elif Özcan, Professor Judy Edworthy, and Professor Michael Schutz, who’s been featured as a guest on this podcast.
We talked about how sound has a profound effect on us, for better and for worse. Hospitals have been described as “beeping hellscapes,” which isn’t surprising, considering how many machines there are in the typical hospital and all the noises that they make. But do they really have to make that much noise? And do they have to make the same noises that they’ve been making since the 1950s (when there were a lot less of them)? When does an alarm become too alarming? What effect does all that sound pollution have in an environment that’s supposed to heal us? How can we fix it? Do notifications need to sound like alarms? Join my expert panelists and me as we discuss how the medical soundscape got so bad, and what we can do to change things. This is an important topic for all of us and I hope you’ll get a lot from it. Let’s hope that new standards are adopted widely – and soon!
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Too Many Alarms
We start the discussion with an introduction from each of our panelists and their thoughts about solving the medical alarm problem. “People have difficulty talking about sound,” Judy says as she tells us about her team’s early challenges in overcoming preconceptions about hospital sounds. “They have difficulty describing what the sound should be like. We didn’t have a set of metrics against which to evaluate any new set of alarms.” Dr. Özcan agrees and tells us about her hands-on research into just how many sounds, most of them false alarms, exist in a hospital setting. “We measured up to 12,000 alarms in one unit,” Elif says, “and that’s too many alarms for anyone to handle.”
Sculpting a Better Sound
Dr. Schlesinger introduces himself next, and he relates his own firsthand experience as a doctor and how the number of false alarms can not only affect the staff but how the patients perceive the staff’s response to them. “What’s the perception of the quality of care,” he asks, “if we seem lackadaisical to these alarms?” Michael tells us about how he met the rest of the group, and he describes his work in researching and creating a better soundscape in hospitals. As he puts it, “what I’m doing a lot of is looking at sort of the nuance to see how we can sculpt the sound to make it better.”
A Culture Shift
The first question for our group concerns the resistance that change can bring, especially when some of the sounds involved have been around for many decades. “It’s difficult to persuade people with science,” Judy tells us, “because some people will just say ‘oh yes, but I don’t believe that.’” Her solution is to go deeper than the science and appeal to people on a more intuitive level: as she puts it, “the best way to get a change in behavior is to bring about a culture shift.” Dr. Özcan tells us about how her work with nurses helped lead to a new silent patient monitor, and the importance of involving the people who work with sound directly in understanding and improving them “Without the help of psychology,” she says, “we really cannot understand how people interact with the products.”
As the first half of the discussion comes to a close, Dr. Schlesinger tells us about how the new sound standards that our panelists helped create are leading to change, and how the individual differences in each hospital environment, from building to building and even from one patient’s room to the next, can lead to very different acoustic results. “You have to be human-centered,” he explains, “you have to think about the guideline of it, the end user, the exposure of it to everyone involved.”
- How limitations in the 1950s created our current medical soundscape
- Past attempts and a recent success at creating a new sound standard
- False alarms, unactionable alerts, and what they mean for patients
- Involving doctors and staff in the process of creating a better system
- The psychology of sound and inspiring an audio cultural shift
Tune in next week for the second half of the discussion as we take questions about the role reviews play in bringing about change, how medical alarms might be designed to do a better job of conveying their message, and how new synthetic sounds are reshaping the entire alarm philosophy.
Connect with the Guests
Connect with Judy Edworthy on LinkedIn: https://www.linkedin.com/in/judy-reed-edworthy-56b88a87/
Connect with Dr. Elif Özcan on LinkedIn: https://www.linkedin.com/in/elifozcanvieira/
Connect with Dr. Joseph Schlesinger on LinkedIn: https://www.linkedin.com/in/joseph-schlesinger-md-fccm-ba38774b/
Follow Dr. Joseph Schlesinger on Twitter: https://twitter.com/drjazz615/
Professor Michael Schutz’s website: https://michaelschutz.net/
Connect with Professor Michael Schutz on LinkedIn: https://www.linkedin.com/in/dr-michael-schutz/
MAPLE Lab: https://maplelab.net/
“Death By Beep” on TEDx Talks: https://youtu.be/Ap8geRll6F0/
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This interview episode was very skillfully made to sound beautiful by the talented Humberto Franco.