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CC BY 4.0 · Appl Clin Inform 2025; 16(04): 863-871
DOI: 10.1055/a-2646-6297
Research Article

A Systematic Approach to Screen, Identify, and Correct Malfunctioning Interruptive Alerts

EzzAddin Al Wahsh
1   AL Clinic, Minneapolis, Minnesota, United States
,
Justin Juskewitch
2   Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, United States
,
Carol Eichenlaub
3   Department of Information Technology, Mayo Clinic, Rochester, Minnesota, United States
,
Courtney Holbrook
3   Department of Information Technology, Mayo Clinic, Rochester, Minnesota, United States
,
Pedro J. Caraballo
4   Department of Medicine, Mayo Clinic, Rochester, Minnesota, United States
5   Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, United States
› Institutsangaben
Funding None.
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Abstract

Background

Interruptive alerts can negatively impact clinical workflows and contribute to alert fatigue, provider frustration, and burnout. Given that interruptive alert overriding is a heterogeneous and recurring phenomenon, occurring across different organizational contexts with varying characteristics and circumstances, we hypothesize a pragmatic approach with multimodal interventions to address malfunctioning alert populations and maintain those contributing to better patient care.

Objective

This study aimed to develop a systematic approach to screen, identify, and correct malfunctioning interruptive alerts within a tertiary healthcare system.

Methods

We performed screening by assessing the alert population, exploring available resources, and defining alert population inclusion and exclusion criteria. We identified interruptive alerts and then conducted an exploratory analysis. We shared insights from discussions with our expert panel to validate our findings and find gaps in current alert monitoring. We then performed focus groups and interviews as part of a root cause analysis. To address the findings of these investigations, we prioritized which alerts to improve, evaluated solutions, and recommended steps to improve our governance structure.

Results

We developed an approach to assess around 1,500 unique alerts in a tertiary center from January to June 2023. We introduced two approaches to visually analyze alert populations: alert-focused analysis and people- and systems-focused analysis. We utilized an expert panel to further enhance the power and speed of alert evaluation and then investigated one emerging alert with focus groups, identifying root causes for its malfunction. This alert demonstrated how enterprise practice changes, coupled with design and cultural issues, can trigger significant alert malfunctions.

Conclusion

A multi-modal intervention approach is needed to evaluate interruptive alerts and act quickly on findings. Utilizing both analytical and nonanalytical methods can work in synergy to facilitate this framework. Such approaches may reduce time and be valuable tools for optimally allocating resources to tackle institutional alert challenges.

Keywords

decision support systems - clinical - alert fatigue - clinical alerts - alert malfunctions - interruptive alerts

Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects.




Publikationsverlauf

Eingereicht: 17. Oktober 2024

Angenommen: 11. Juni 2025

Artikel online veröffentlicht:
20. August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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