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London Health Sciences Centre and St. Joseph’s Health Care London

Canadian health system streamlines provider workflow in effort to reduce alert fatigue

Alert fatigue can negatively impact clinician wellness, as clinicians find themselves faced with unneeded alerts they are forced to ignore. In response, staff at London Health Sciences Centre and St. Joseph’s Health Care London in Ontario, began reducing unnecessary drug alerts for pharmacists across London and regional partner hospitals. The total number of drug alerts fell by 41.5%.1

To help determine which drug alerts didn’t need to fire, staff turned to Lights On Network®, which provides health organizations data to discover how clinicians utilize Cerner solutions.

“We used the data in Lights On to determine which alerts were firing for whom and how often,” said Carrie Milligan, performance measurement consultant. “We used it to optimize our alerts so our pharmacists and physicians using the system see more value-added alerts, in order to reduce alert fatigue.”

Staff responded by adding several filters to suppress unnecessary drug alerts that hampered workflows. Some of the suppressed alerts included ones that would fire multiple times when a physician would place multiple orders for the same drug at the same time. For example, when a physician ordered a medication with decreasing doses, the pharmacist previously would receive multiple alerts, not just one.

Staff also suppressed alerts for drugs ordered on a regular schedule as maintenance medications. Other changes included suppressing alerts when physicians would sign multiple orders at the same time.

“We had alerts firing that were nearly always overridden,” said Milligan. “They took that alert, brought it to our pharmacy team, and used that information to make decisions as to whether or not that alert should still be firing.”

With the number of drug alerts pharmacists saw dropping by 398,0001, pharmacists don’t need to override alerts as often, and the number of drug alerts they did override dropped 42%.2

Milligan and her team intend to continue looking at data from Lights On Network not only related to alerts, but electronic health record usage as well, to improve efficiency and the clinician experience.

“Our team is always looking for new ways to engage with clinicians and end-users to improve the system,” said Milligan. “I’m always surprised that every time I go into Lights On, there’s always something new. It’s not a stagnant solution; it’s always changing and improving.”

1 Comparing 959,383 drug alerts from November 2017 – January 2018 to 560,936 drug alerts from March – May 2019

2 Percent change figured using 937,638 drug alert overrides from November 2017 – January 2018 to 543,415 drug alert overrides from March – May 2019

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Client outcomes were achieved in respective settings and are not representative of benefits realized by all clients due to many variables, including solution scope, client capabilities and business and implementation models.