Bernoulli smart alarms

Bernoulli Smart Alarms
A Powerful Clinical Decision Support Tool

Bernoulli is a driving force when it comes to real-time smart alarms.Our skills in real-time data collection,
manipulation, and application are patent-protected making Bernoulli unlike any other system.

Seeking Clinically-Significant Events

The various types of smart alarms and the flexible nature of the parameters surrounding their configuration are a key feature of the Bernoulli One™ platform. The smart alarms function on continuous real-time data. Here’s how. The Bernoulli system provides the ability to create unique alarm events by taking into consideration various features that are observed in the medical-device-originating raw data, versus simply filtering alarms as issued by bedside patient care medical devices (i.e. Limit Alarms). This enables the platform to issue custom alarm signals that are independent of the patient care medical device. Further, Bernoulli enables the creation of signals that are more clinically actionable by placing the power of alarm signal customization and tailoring in the hands of the bedside clinician. Therefore, these alarm signals are more clinically relevant to the specific conditions and patient cohort, staff workflow, and context of the clinical environment.

A Smart Alarms Clinical Use Case

To help explain how the system works, let’s look at an instance where Bernoulli detects consecutive patient events and sends an early warning alert to a clinician.

The Situation: Jill is a 32-year old female patient that has been involved in a car crash. She is currently conscious and receiving support on a mechanical ventilator in the Intensive Care Unit. When Jill coughs, this effectively causes a sharp peak pressure rise in the inspiratory tubing, resulting in an alarm being issued to the central nursing station. Individually, these coughs are episodic and do not pose a clinical threat to Jill, and intervention is not required. The situation, however, can change if sputum should block her breathing tube or if Jill’s movement should result in a kink in the inspiratory tubing. Either of these situations would result in a persistent high peak pressure measurement – several per minute, or more. These events can be dangerous to the patient as they would prevent Jill from receiving needed oxygen. Hence, a notification indicating multiple or consecutive peak pressure alarm signals within a specific, finite timeframe – three or more per minute, for example – may be identified as a policy by the house staff that these events, when indicated, would advise attention when detected. In either of the example causes listed above, intervention by respiratory therapy or nursing would be needed to either suction and clear the line or remove occlusions in tubing to ensure the free-flow of oxygen to Jill.

The Bernoulli Resolution: A parameter is set within the Bernoulli system to detect the consecutive occurrence of high peak pressure. When these occur within a one-minute timeframe, Bernoulli generates a new type of alarm – a “consecutive events smart alarm”. Then a “tap on the shoulder” message is sent to the appropriate clinician. Timely patient care yields a more positive experience and outcome.

The most common Bernoulli smart alarms include:

  • Trend Alarms – Occur when a given finding (patient measurement) violates an upper or lower percentage compared with the average value (normal) for a patient over a defined period of time.
  • Combination Alarms – Occur when two or more independent findings (patient measurements) violate specific limit thresholds simultaneously.
  • Consecutive Alarms – Occur when a value (patient measurement) goes in and out of a limit violation a given number of times, over a specified time period (one minute being the shortest duration, but above this, is variable and user-definable).
  • Sustained Alarms – Occur when a finding (patient measurement) violates a specified threshold for a specified minimum time period.
  • Smart ranked alarms – Alarms are ranked based upon whether they meet criteria for urgency or warning. These alarms can be displayed on the dashboard according to the level by which they exceed specific thresholds (urgent, warning).

A Central Location for Managing Alarms

With the Bernoulli One centralized clinical surveillance platform, individualized alarms can be set on a per-patient basis. The alarms can also be viewed, escalated, and acknowledged. However, simply acknowledging and viewing the alarms is not enough. Within Bernoulli there is a means for creating and setting alarm limits for remote clinicians that are distinct from the alarm limits on the medical devices. Bernoulli provides remote monitoring and management of alarm settings without affecting the default settings on the individual patient care medical device at the bedside. Moreover, hospitals and health systems can then consider how to best configure alarm settings across their entire fleets of medical devices in conjunction with the capabilities of the Bernoulli One platform. This helps in reducing nuisance alarms and alarm fatigue.

In summary, the Bernoulli One platform:

  • Enables clinicians to tailor remote monitoring of bedside devices to notify them on what they deem to be the occurrence of clinically-meaningful settings without changing or impacting bedside medical device alarm settings.
  • Collects and provides the aggregation point for multiple independent bedside device measurements with user-defined clinically-significant criteria that, when evaluated together, can support identification of deteriorating patient conditions.
  • Leverages continuous monitoring, real-time data acquisition and processing, and enables creating smart alarms on all collected parameters from bedside devices.

Our clinical experts can work with your staff to create custom clinical alarm conditions for your hospital. Together, we can help to prevent adverse events and improve patient care.

What Real-Time Data Could Have Done For These Patients

Blog author, John Zaleski, Ph.D., CAP, CPHIMS, Bernoulli Health’s Chief Analytics Officer, writes about his days at PENN and how real-time data and smart alarms could have improved patient care.

“The concepts behind smart alarms and use of real-time data to make better decisions are not new. Many people have had their experiences in the field of medicine and medical informatics but not all people and organizations have acted upon these experiences. Bernoulli is one organization that has.

My own experiences with conceptualizing smart monitoring and clinical surveillance go back more than 20 years to my days in school at PENN and the hospital. As part of my doctoral research and education, I was interested in…”

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