ArticleApplied clinical informatics2024
Addressing Alert Fatigue by Replacing a Burdensome Interruptive Alert with Passive Clinical Decision Support.
Article in Applied clinical informatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review and Meta-analysis of Externally Validated Epic Clinical Decision Support Tools.Journal of general internal medicine · 2026Pooled it
- Making Symptoms Visible: The Impact of Real-Time PROM Integration in Pediatric Oncology.Children (Basel, Switzerland) · 2026Article
- Designing a Clinical Decision Support Tool to Promote Timely Palliative Care in Heart Failure.medRxiv : the preprint server for health sciences · 2026Article
- Molecular insights into antimicrobial resistance in human bacterial pathogens: mechanisms, resistance genes, and translational diagnostic applications.Frontiers in microbiology · 2026Review
- Guided Inhalation via Electronic Monitoring in Children With Uncontrolled Asthma (the IMAGINE Study): Randomized Controlled Trial.JMIR pediatrics and parenting · 2025Article
- A Systematic Approach to Screen, Identify, and Correct Malfunctioning Interruptive Alerts.Applied clinical informatics · 2025Article
- Improving Discrete Documentation of Cancer Staging-An Alert-Free Approach.Applied clinical informatics · 2025Article
- Right Idea, Wrong Time: Focusing on Alert Timing for Effective Decision Support.Applied clinical informatics · 2025Article
- Sisyphus' Alert: The Uphill Struggle to Improve Venous Thromboembolism Prophylaxis Clinical Decision Support.Applied clinical informatics · 2025Article
- Evaluation of Diagnostic Recommendations Embedded in Medication Alerts: Prospective Single-Arm Interventional Study.Journal of medical Internet research · 2025Article
- A Case Study: Optimizing CDS for Pediatric Oncology Trials by Transitioning from Interruptive to Passive Alerts.Applied clinical informatics · 2025Article
- The Elements of Style for Interruptive Electronic Health Record Alerts.Applied clinical informatics · 2025Article
- Effect of Tiered Implementation of Clinical Decision Support System for Acute Kidney Injury and Nephrotoxin Exposure in Cardiac Surgery Patients.Applied clinical informatics · 2025Article
- Identifying Patients with Heart Failure Eligible for Guideline-Directed Medical Therapy.Population health management · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecognizing that alert fatigue poses risks to patient safety and clinician wellness, there is a growing emphasis on evaluation and governance of electronic health record clinical decision support (CDS). This is particularly critical for interruptive alerts to ensure that they achieve desired clinical outcomes while minimizing the burden on clinicians. This study describes an improvement effort to address a problematic interruptive alert intended to notify clinicians about patients needing coronavirus disease 2019 (COVID) precautions and how we collaborated with operational leaders to develop an alternative passive CDS system in acute care areas.
objectivesOur dual aim was to reduce the alert burden by redesigning the CDS to adhere to best practices for decision support while also improving the percent of admitted patients with symptoms of possible COVID who had appropriate and timely infection precautions orders.
methodsIterative changes to CDS design included adjustment to alert triggers and acknowledgment reasons and development of a noninterruptive rule-based order panel for acute care areas. Data on alert burden and appropriate precautions orders on symptomatic admitted patients were followed over time on run and attribute (
resultsAt baseline, the COVID alert fired on average 8,206 times per week with an alert per encounter rate of 0.36. After our interventions, the alerts per week decreased to 1,449 and alerts per encounter to 0.07 equating to an 80% reduction for both metrics. Concurrently, the percentage of symptomatic admitted patients with COVID precautions ordered increased from 23 to 61% with a reduction in the mean time between COVID test and precautions orders from 19.7 to -1.3 minutes.
conclusionCDS governance, partnering with operational stakeholders, and iterative design led to successful replacement of a frequently firing interruptive alert with less burdensome passive CDS that improved timely ordering of COVID precautions.
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Registered trials
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.