16 Feb McMaster Study Finds Musical Alarms Can Decrease Stress For Hospital Workers

MedicalResearch.com Interview with:

Dr. Schutz

Michael R. Schutz, Ph.D.
Professor of Music Cognition/Percussion at McMaster University
Founding director of the MAPLE Lab and
Core member of the McMaster Institute for Music and the Mind.
Prof. Schutz is also a professional musician and directs McMaster’s percussion ensemble.

MedicalResearch.com: What is the background for this study?

Response: Hospitals around the world are filled with devices generating a
constant stream of tones conveying information to medical staff.
overburdened healthcare professionals, and contributes to burnout in
medical staff.  The Emergency Care Research Institute (ECRI) regularly
includes problems with auditory alarms in their list of “Top 10 Health
Technology Hazards” and they  are so problematic an FDA survey
implicated them in hundreds of patient deaths.

While there is currently a lot of interest in how to improve alarm
management protocols, this study is different in that it looks at
improving the quality of the alarm sounds themselves.  For historical
reasons many default to simplistic “beeps” which are generally
annoying.  While annoying is useful for critical alarms requiring
immediate action, the vast majority of these messages are merely
intended to update medical staff of changes (i.e. blood pressure is
rising) or indicate other situations that do not require immediate
action. Unfortunately, many machines use the same simplistic and
annoying “beeps” regardless of whether the messages are urgent or
non-urgent.  This constant flood of annoying beeps negatively affects
both patients (extending recovery time due to interrupted rest) and
staff (who can develop “alarm fatigue” from the constant cacophony).

MedicalResearch.com: What are the main findings?

Response:  Here we show that changes to the structure of the tones used in these
machines can dramatically reduce their annoyance, increase their
detection, and preserve concurrent speech comprehension.   And because
these changes do not require changing the pitches or timings of the
sounds, they would not require significant additional training to use.
Doctors and nurses who recognize current alarms could recognize the
new sounds immediately.  They would just be less annoying and easier
to hear.

MedicalResearch.com: What should readers take away from your report?

Response: One retired nurse referred to her hospital as a “beeping hellscape”
due to the alarms-a term which aptly describes the working conditions
for many overburdened healthcare professionals.  Here we show that
improving the sounds used in alerting devices (independent of their
frequency or the specific sequences used)  can reduce their annoyance
and increase their detection while preserving the ability of medical
staff to communicate.  Because these changes are to specific tones
(rather than the sequences of sounds) they are backwards compatible –
meaning that staff who know the current alarms could recognize the
messages encoded in the new ones quite easily.  They would just be far
less annoying for patients and staff alike.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Many current alarm sounds were adopted without testing or
consideration of basic principles of auditory perception.
Consequently we have created significant unnecessary stress and
problems in healthcare that could be avoided by simply using better
sounds.  Music serves as an ideal vehicle for new ideas on better
alarm design.  Artistic considerations aside, music offers a wonderful
“playground” for non-verbal auditory communication.  So acoustic
principles that are true in music are likely true in the design of
alarms as well.  And one thing we see in instruments all the world
over is that they make rich, complex sounds.  Essentially the opposite
of the simplistic beeps used in so many medical devices.

MedicalResearch.com: Is there anything else you would like to add?

Response: For more information and background leading to this study please see
my TEDx Talk “Death by Beep?” at www.maplelab.net/ted

 Citation:

Foley L, Schlesinger JJ, Schutz M. Improving detectability of auditory interfaces for medical alarms through temporal variation in amplitude envelope. Br J Anaesth. 2023 Jan 17:S0007-0912(22)00648-1. doi: 10.1016/j.bja.2022.10.045. Epub ahead of print. PMID: 36658020.

https://pubmed.ncbi.nlm.nih.gov/36658020/

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Last Updated on March 1, 2023 by Marie Benz