A Stakeholder Focused Study on the Use and Design of Medical Device Alarms
Author: Wittner, Bernd
Supervisor: Clarkson, P. John
Institution: Department of Engineering, University of Cambridge
This thesis investigates the use and design of alarm systems for medical applications. Such alarm systems are part of the software system in medical devices and help safeguard patients during treatment and monitoring. Due to the expanding use of technology in the medical domain, alarm systems have become ubiquitous in most sectors of healthcare provision. Despite this widespread use, the clinical usability of such devices is frequently poor due to various design de ciencies. Such shortcomings are subject of ongoing criticism and concern, since they derogate the intended utility of device alarms, reduce the e ciency of patient treatments, and contribute to the incidence of serious errors and even fatalities. This thesis expands the available, fragmented knowledge on alarm systems with findings from a systematic, stakeholder-focused enquiry into the socio-technical system around the use and design of medical devices. Results from qualitative analysis of 59 in-depth interviews with healthcare professionals and device designers form a knowledge base which describes current practice from a stakeholder perspective. This knowledge base documents stakeholders' interactions within and beyond their work environments, and details their views on current and future devices and alarm systems. The use and utility of this knowledge base is exempli ed on a range of known alarm issues. Improvements to user training are proposed which facilitate alarm handling and increase patient safety. Reasons for the slow speed of technical innovation are discussed, and areas for improvement in design practice and decision making are highlighted. Changes to technical standards are proposed which increase their utility for the design process. Finally, a systems approach is developed which promotes sourcing of devices with improved alarm systems. The presented data advocates “big picture” thinking and facilitates informed decision making. Such practice will allow policy-makers to identify and implement future improvements to devices and procedures.