Beware of alarm fatigue

Over the winter, I spent a good deal of time visiting a relative in a hospital and later in a rehab facility. It wasn’t particularly enjoyable for a whole host of obvious reasons, but one thing that struck me was just how noisy these places are.

As soon as you step inside, everything is beeping. Garbled voices call out names and codes on the PA. Paired with the noise is an uncountable number of lights and screens, papers and whiteboards.

When I was sitting in the hospital room, one of these machines started making sounds. Was this a bad beep or a normal beep? It sounded like all the other ones... but were the other ones bad?

I got the nurse. Turned out the battery on some monitor needed to be recharged. That was a benign beep.

The cacophony in that hospital room is one of the causes of alarm fatigue, and we’re all susceptible to it – regardless if we’ve ever worn scrubs to work.

According to safety research, somewhere between 72% and 99% of clinical alarms are false. Almost all of those beeps are just that, noise – clutter which then makes the signal so hard to find.

Alarm fatigue pops up everywhere. It happens on construction sites. It happened at the infamous Three Mile Island nuclear power plant, and it helped lead to the Deepwater Horizon oil spill. It happens when you leave your check engine light on too long and when the New York Times app sends you far too many push notifications.

Wherever a boy is crying wolf one too many times, we start to ignore warnings, alerts, and alarms.

If there is no quiet, there can be no loud. In each moment, we’re incentivized to send that push alert or to engineer another flashing light, but each instance of these mini-hijackings of our attention chips away at our interest in paying attention to any of them. Our individual incentives push one way, but that collectively makes us worse off.

We need our messages, auditory and otherwise, to be salient. They must rise to our attention to be of any use, which is only achieved through contrast. Fortunately, this is a solvable problem.

Design podcast 99% Invisible recently did a great episode about California’s massively prevalent Proposition 65 warnings, which is worth listening to for lots of reasons. But be sure to stick around to the end, where the show revisits work being done by Professor Judy Edworthy in designing “auditory icons” to replace our standard set of bells and sirens. For instance, a patient needing medication might trigger an alarm that sounds like a shaking pill bottle.

If we don’t design alarms smartly and choose what to alarm wisely, we might as well not have them. (And that’s exactly what the MTA did here in New York with the subway emergency exit doors in 2015.)