Cardiac Monitor Alarm Customization to Reduce Alarm Frequency and Improve Staff Response Time in an Urban Academic Emergency Department

Introduction: Cardiac monitor settings impact alarm frequency.Prior literature supports alarm parameter optimizations; however, this is not standardized in the emergency department (ED).This quality improvement (QI) initiative aimed to safely reduce alarm frequency and improve staff response times through cardiac monitor alarm optimizations.Methods: This pre/post QI study was conducted in a single urban academic ED (>70,000 annual visits).Due to perceptions of significant alarm overload, baseline data of low, medium, and high-level alarm frequencies were extracted in October 2023.ED leadership implemented parameter optimizations throughout 2024 with follow-up data extraction in January 2025.Adjustments included vital sign thresholds and arrhythmia settings to reduce false alarms.Post-adjustments, study staff conducted in-person observations (July-August 2025) to classify true vs false or non-actionable alarms and record staff response times as <90 seconds (yes/no).Data was analyzed using Microsoft Excel.Preliminary results are described.Results: High-level alarms decreased 69.9% from 186,546 to 56,086.Medium level alarms decreased by 77.2% (388,144 to 88,394) and low-level alarms by 47.8% (936 to 490).During 50.75 hours of observation, 616 high-level alarms were recorded of which 74.8% were false.61.4% of false alarms were non-actionable.Among true alarms, 90.3% (n = 140) received a staff response within 90 seconds. Conclusion:Parameter customizations reduced alarm frequency overall.Response times met the set goal for most true alarms.Despite optimization, false non-actionable alarms remained prevalent.Future efforts should focus on further reducing non-actionable alarms to enhance response and minimize alarm fatigue.Longer hours of obervation will be analyzed in our future work.