Jeanne Venella’s Alarm Fatigue Commentary in AAMI Horizons

jeanne VenellaAlarm signals are disrupting patients’ recovery and exhausting clinical staff, according to a commentary published by Bernoulli Chief Nursing Officer Jeanne Venella, DNP, MS, RN, CEN, CPEN, in the Spring 2017 issue of AAMI Horizons.

“Drawing Up a New Game Plan to Reduce Alarm Fatigue” notes that 85 percent to 99 percent of alarms require no intervention on the part of clinical staff. In addition to alarm fatigue, this growing problem represents a significant risk to patient safety if caregivers arbitrarily adjust threshold settings on devices or shut them off completely.

The problem has become so severe that the Joint Commission made clinical alarm management a priority with its National Patient Safety Goal (NPSG.06.01.01), mandating that hospitals take definitive steps to implement policies and procedures to safely reduce and prioritize clinical alarms.

Venella explores the logical steps hospitals and health systems should take to get their alarm issue under control, including:

  • Assessing the current state of the clinical alarm environment, identifying and developing targets for reduction, and evaluating appropriate interventions, policies, and standards.
  • Performing a baseline alarm management study to separate clinically relevant alarms from non-actionable alarms and managing the ever-growing number of alarm-enabled medical devices.
  • Devising standards and strategies for executing on a clinical alarm management program

Writes Venella, “Alarm management is a classic example of interdisciplinary leadership, involving clinical, IT, biomedical engineering, and other departments. Alarm management is also much more than simply reducing non-actionable alarms; it’s a gateway for more seamless care and a way for hospitals to leverage hard data to make continuous improvements to its care and response processes.”


The Spring issue of AAMI Horizons is now online for AAMI members and subscribers. Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Continuous Monitoring of Patients at Risk for Respiratory Depression

Bernoulli CNO and CAO co-author article on continuous monitoring of patients at risk for respiratory depression published in AAMI Horizons Spring 2017 issue

AAMI Horizons 2017The use of middleware for the continuous monitoring of patients at risk of respiratory depression was the subject of a paper just published by Bernoulli Chief Analytics Officer John Zaleski, PhD, CAP, CPHIMS, and Chief Nursing Officer Jeanne Venella, DNP, MS, RN, CEN, CPEN, in the Spring 2017 issue of AAMI Horizons.

“Using Middleware to Manage Smart Alarms for Patients Receiving Opioids” explores the risks hospitals and health systems are exposed to due to inadequate monitoring of post-operative patients who receive opioids.

Although continuous monitoring of these patient populations is recommended as a best practice by the Joint Commission, Anesthesia Patient Safety Foundation, the Association for the Advancement of Medical Instrumentation, and other healthcare advocates and governing agencies. However, continuous monitoring of these patient populations, particularly outside the critical care unit setting, remains the exception to the rule.

Why? The adoption of this best practice is beset by significant business and clinical challenges, including the implementation of costly physiologic device technology, the possible addition of full-time direct-care clinical staff, and the difficulty of capturing holistic, real-time patient data in order to facilitate early intervention.

Zaleski and Venella explore the viability of comprehensive and cost-effective solutions, including:

  • The use of Smart Alarm technology to provide caregivers with an accurate, real-time picture of a patient’s condition, while attenuating alarm signals that communicate contextual patient-safety specific information and minimize spurious signals that can lead to alarm fatigue.
  • Leveraging multi-parameter physiologic monitors—such as capnography and pulse oximetry—as a sensitive and early indicator of opioid-induced respiratory depression.
  • Assessing the core standards required of device-agnostic middleware platforms for interfacing with bedside devices and combining it with other data from the patient record to create a more holistic and complete picture of the current patient state.

Write the authors: “Combining analysis with real-time data collection at the point of collection creates a powerful tool for prediction and decision support, particularly if this tool can also integrate data from other sources (e.g.: laboratory, electronic health record) to bring more context to bear relative to the patient under consideration.”

The Spring issue of AAMI Horizons is now online for AAMI members and subscribers. Follow Bernoulli on LinkedIn and Twitter for the latest news and updates.

Team-based approach to health IT implementations

CNO Jeanne Venella published in Minority Nurse

jeanne Venella | Team-based approach to health IT implementationsToo many hospitals fail to include front-line clinical staff in health IT projects, leading to poor technology adoption or implementation failure, writes Bernoulli Chief Nursing Officer Jeanne Venella, DNP, MS, RN, CEN, CPEN, in an article published in Minority Nurse.

Hospitals have dedicated tremendous resources to create an integrated clinical environment that results in better patient treatment and outcomes, reduces readmissions and hospital utilization, and bends the overall cost of healthcare down.

Unfortunately, health IT projects either fall short of business and clinical goals or are completely abandoned at an astonishing rate. Studies vary, but failure-rate estimates range from 35 percent to 75 percent.

Venella argues that fostering a team of internal champions from a myriad of departments – including patient-facing clinical staff – significantly increases the chances of a sustainable health IT solution.

Writes Venella, “The seamless integration of technology requires that patient-facing clinical staff have influence in the design and testing of equipment and applications. Involving end-users in the early stages of system analysis and design specifications can lead to better adoption of new technology, as well as identifying how current technology can be adapted for greater user acceptance.”

Venella also recently hosted a Bernoulli-sponsored webinar on the topic of team-based approaches to technology adoption. The archived webinar can be found here.


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John Zaleski article | continuous monitoring for respiratory arrest and depression

John Zaleski article: continuous monitoring for respiratory arrest and depression in HIMSS FutureCareThe use of opioids for treatment of acute post-operative pain is rather commonplace, but patients with obstructed sleep apnea are at risk for respiratory arrest and depression, which can lead to anoxic brain injury or death if left unattended, writes Bernoulli Chief Analytics Officer John Zaleski, PhD, CAP, CPHIMS, in an article published in HIMSS FutureCare.

However, continuous electronic monitoring of these patient populations presents considerable challenges to many hospitals and health systems, including lack of continuous bedside monitoring devices, alarm fatigue and lack of coverage for patients at risk.

Zaleski explores the technology, staff education, and real-time data requirements necessary to improve this patient safety threat.

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real time healthcare delivery

Physician Advisors to Consult on Real-Time Healthcare Delivery & Patient Safety Issues

Expertise will Provide Valuable Insights on Supporting Clinical Workflow and Driving Improved Quality of Care

Bernoulli, the leader in real-time solutions for patient safety, announced that two prominent physicians will join the company as consultants to explore issues related to real-time healthcare delivery and increased patient safety.

Neil A Halpern MD & Amar Setty MD

Neil A. Halpern, MD, MCCM, FCCP, FACP, is Director of the Critical Care Center, Chief of the Critical Care Medicine Service and Medical Director of Respiratory Therapy at Memorial Sloan Kettering (MSK) Cancer Center in New York. Dr. Halpern oversees a team of highly experienced doctors, nurse practitioners, physician assistants, respiratory therapists, research and bedside nurses, and critical care programmers who help provide care for patients in MSK’s adult medical-surgical intensive care unit (ICU).

Since 2000, he has co-chaired the hospital’s Clinical Device and Product Evaluation Committee, and since 2014, the Alarm Committee at MSK. Between 2005 and 2007, he chaired the multidisciplinary ICU Design Committee that developed the plan and monitored the construction of MSK’s 20-bed medical-surgical adult ICU, which opened in April 2007.

“There is a clear need in healthcare for greater connectivity, interoperability and comprehensive real-time data to support improved patient safety, enhanced care team collaboration and proactive clinical intervention,” said Dr. Halpern. “I look forward to advising Bernoulli on the applications and services that will have the greatest impact.”

Amar Setty, MD, is the CEO of AnesthesiaStat, a Baltimore-based anesthesia consulting and management company operated by practicing, Board Certified anesthesiologists. In addition to an active private practice, Dr. Setty serves as the immediate-Past President of the Maryland Society of Anesthesiologists, where he continues to be an advocate.

He is working to develop data-centric applications for patient-advocated value-based care, ultrasound/video-based artificial intelligence for medical procedures, as well as an app for patient empowerment in chronic pain. He has a unique interest in the use of technology to improve the perioperative experience and is working to build a new system of surgical risk prediction and management. He hopes to improve the quality and care of patients before and after discharge.

“The complexity and exponential growth of patient-generated data in modern care settings can be overwhelming, and even act as a barrier to real-time patient care and interventions if not properly managed,” said Dr. Setty. “I am excited to sharing my perspectives and experiences as a physician with Bernoulli to better facilitate the use of comprehensive real-time patient data to improve patient safety, quality and cost of care.”

“Many of the challenges facing healthcare providers – including mitigating patient safety threats, embarking on value-based care initiatives, and streamlining clinical workflows – require comprehensive real-time data, surveillance and analytics,” said Janet Dillione, CEO of Bernoulli. “Dr. Setty and Dr. Halpern’s clinical expertise will help uncover valuable insights, enabling us to better align our solutions with the needs of hospitals and health systems.”

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