ArticleApplied clinical informatics2020
Reducing Interruptive Alert Burden Using Quality Improvement Methodology.
Article in Applied clinical informatics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 3 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Alert fatigue measurement in clinical decision support: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2026Pooled it
- Measuring Documentation Burden in Healthcare.Journal of general internal medicine · 2024Pooled it
- Optimizing clinical decision support alerts in electronic medical records: a systematic review of reported strategies adopted by hospitals.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- Enhancing Comorbidity Management in Patients With Hemorrhagic Stroke via an Electronic Health Record-Linked Best Practice Alert: A Pre/Post Study.Journal of the American Heart Association · 2025Trial
- Qualitative Study of Inpatient Hospital Medicine Interruptive Alerts and Clinical Decision Support.Applied clinical informatics · 2026Article
- Examining usability of RxFill: integrating health IT to support medication adherence.BMC medical informatics and decision making · 2026Article
- User-Centered Redesign of a Clinical Decision Support System for Pneumonia in the Emergency Department.Applied clinical informatics · 2026Article
- Management and governance of medication prescribing alerts among hospitals in Japan: a nationwide survey.BMJ open quality · 2025Article
- Implementation of Passive Deterioration Index Alerts in an Intermediate Care Unit: A Failed Early Warning System Strategy.Applied clinical informatics · 2025Article
- A Systematic Approach to Screen, Identify, and Correct Malfunctioning Interruptive Alerts.Applied clinical informatics · 2025Article
- Rethinking the Biohazardous Bodily Fluids Alert for Improved Workflow and Safety.Applied clinical informatics · 2025Article
- Right Idea, Wrong Time: Focusing on Alert Timing for Effective Decision Support.Applied clinical informatics · 2025Article
- Improving Discrete Documentation of Cancer Staging-An Alert-Free Approach.Applied clinical informatics · 2025Article
- Redesigning Clinical Decision Support for Retinopathy of Prematurity Screening After Alert Failure.Applied clinical informatics · 2025Article
- Sisyphus' Alert: The Uphill Struggle to Improve Venous Thromboembolism Prophylaxis Clinical Decision Support.Applied clinical informatics · 2025Article
- Electronic health record nudges to optimize guideline-directed medical therapy for heart failure.Heart failure reviews · 2025Review
- Article
- Clinical implementation of AI-based screening for risk for opioid use disorder in hospitalized adults.Nature medicine · 2025Observational
- Reduction in the Concomitant Ordering of Erythrocyte Sedimentation Rate and C-Reactive Protein Within a Large Academic Medical Center.Journal of general internal medicine · 2025Article
- Actionability of Clinician Feedback in a Multi-Specialty Group Practice for Clinical Decision Support Improvement: An Observational Study.Journal of general internal medicine · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreased adoption of electronic health records (EHR) with integrated clinical decision support (CDS) systems has reduced some sources of error but has led to unintended consequences including alert fatigue. The "pop-up" or interruptive alert is often employed as it requires providers to acknowledge receipt of an alert by taking an action despite the potential negative effects of workflow interruption. We noted a persistent upward trend of interruptive alerts at our institution and increasing requests for new interruptive alerts.
objectivesUsing Institute for Healthcare Improvement (IHI) quality improvement (QI) methodology, the primary objective was to reduce the total volume of interruptive alerts received by providers.
methodsWe created an interactive dashboard for baseline alert data and to monitor frequency and outcomes of alerts as well as to prioritize interventions. A key driver diagram was developed with a specific aim to decrease the number of interruptive alerts from a baseline of 7,250 to 4,700 per week (35%) over 6 months. Interventions focused on the following key drivers: appropriate alert display within workflow, clear alert content, alert governance and standardization, user feedback regarding overrides, and respect for user knowledge.
resultsA total of 25 unique alerts accounted for 90% of the total interruptive alert volume. By focusing on these 25 alerts, we reduced interruptive alerts from 7,250 to 4,400 per week.
conclusionSystematic and structured improvements to interruptive alerts can lead to overall reduced interruptive alert burden. Using QI methods to prioritize our interventions allowed us to maximize our impact. Further evaluation should be done on the effects of reduced interruptive alerts on patient care outcomes, usability heuristics on cognitive burden, and direct feedback mechanisms on alert utility.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.