Christopher Bennett - Academia.edu (original) (raw)

Papers by Christopher Bennett

Anesthesia & Analgesia, Feb 1, 2016

Operating rooms are identified as being one of the noisiest of clinical environments, and intraop... more Operating rooms are identified as being one of the noisiest of clinical environments, and intraoperative noise is associated with adverse effects on staff and patient safety. Simulation-based experiments would offer controllable and safe venues for investigating this noise problem. However, realistic simulation of the clinical auditory environment is rare in current simulators. Therefore, we retrofitted our operating room simulator to be able to produce immersive auditory simulations with the use of typical sound sources encountered during surgeries. Then, we tested the hypothesis that anesthesia residents would perceive greater task load and fatigue while being given simulated lunch breaks in noisy environments rather than in quiet ones. As a secondary objective, we proposed and tested the plausibility of a novel psychometric instrument for the assessment of stress. In this simulation-based, randomized, repeated-measures, crossover study, 2 validated psychometric survey instruments, the NASA Task Load Index (NASA-TLX), composed of 6 items, and the Swedish Occupational Fatigue Inventory (SOFI), composed of 5 items, were used to assess perceived task load and fatigue, respectively, in first-year anesthesia residents. Residents completed the psychometric instruments after being given lunch breaks in quiet and noisy intraoperative environments (soundscapes). The effects of soundscape grouping on the psychometric instruments and their comprising items were analyzed with a split-plot analysis. A model for a new psychometric instrument for measuring stress that combines the NASA-TLX and SOFI instruments was proposed, and a factor analysis was performed on the collected data to determine the model's plausibility. Twenty residents participated in this study. Multivariate analysis of variance showed an effect of soundscape grouping on the combined NASA-TLX and SOFI instrument items (P = 0.003) and the comparisons of univariate item reached significance for the NASA Temporal Demand item (P = 0.0004) and the SOFI Lack of Energy item (P = 0.001). Factor analysis extracted 4 factors, which were assigned the following construct names for model development: Psychological Task Load, Psychological Fatigue, Acute Physical Load, and Performance-Chronic Physical Load. Six of the 7 fit tests used in the partial confirmatory factor analysis were positive when we fitted the data to the proposed model, suggesting that further validation is warranted. This study provides evidence that noise during surgery can increase feelings of stress, as measured by perceived task load and fatigue levels, in anesthesiologists and adds to the growing literature pointing to an overall adverse impact of clinical noise on caregivers and patient safety. The psychometric model proposed in this study for assessing perceived stress is plausible based on factor analysis and will be useful for characterizing the impact of the clinical environment on subject stress levels in future investigations.

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Anesthesia & Analgesia, Jun 1, 2017

N oise levels in health care settings have steadily increased since 1960, 1 and noise is currentl... more N oise levels in health care settings have steadily increased since 1960, 1 and noise is currently a significant source of dissatisfaction among hospital staff and patients. 2,3 Sound sources such as beepers, alarms, and conversational speech disrupt patient sleep cycles 3-7 and induce physiological effects in critically ill patients, 8 and they have also been associated with increased infection rate. 9-11 Effects of noise on staff include increased stress, 12-14 which may impact performance and increase risk of committing medical error. 15 Collectively, many studies indicate that noise, also referred to as the "third pollution" after air and water pollution, likely has a detrimental impact on both caregiver health and patient safety. Operating rooms (ORs), environments in which effective communication and signaling of alarms are integral to patient care, are particularly noisy. 16 Data have been published that characterize the excessive sound levels present during surgeries-especially in orthopedic and neurological procedures. 17,18 Recently, an intervention program that used behavioral modification and a feedbackproviding noise device was able to decrease sound levels in a pediatric surgical suite. The decreased sound levels were associated with fewer postoperative surgical complications. 19 As part of the intervention, landline phone ringers were muted, cell phones and any personal conversations were banned during procedures, medical and equipment alarm volumes were decreased, and doors were kept closed with entry and exit activity prevented. Many of these draconian measures may not be practical in all surgical environments. INTRODUCTION: Noise in health care settings has increased since 1960 and represents a significant source of dissatisfaction among staff and patients and risk to patient safety. Operating rooms (ORs) in which effective communication is crucial are particularly noisy. Speech intelligibility is impacted by noise, room architecture, and acoustics. For example, sound reverberation time (RT 60) increases with room size, which can negatively impact intelligibility, while room objects are hypothesized to have the opposite effect. We explored these relationships by investigating room construction and acoustics of the surgical suites at our institution. METHODS: We studied our ORs during times of nonuse. Room dimensions were measured to calculate room volumes (V R). Room content was assessed by estimating size and assigning items into 5 volume categories to arrive at an adjusted room content volume (V C) metric. Psychoacoustic analyses were performed by playing sweep tones from a speaker and recording the impulse responses (ie, resulting sound fields) from 3 locations in each room. The recordings were used to calculate 6 psychoacoustic indices of intelligibility. Multiple linear regression was performed using V R and V C as predictor variables and each intelligibility index as an outcome variable. RESULTS: A total of 40 ORs were studied. The surgical suites were characterized by a large degree of construction and surface finish heterogeneity and varied in size from 71.2 to 196.4 m 3 (average V R = 131.1 [34.2] m 3). An insignificant correlation was observed between V R and V C (Pearson correlation = 0.223, P = .166). Multiple linear regression model fits and β coefficients for V R were highly significant for each of the intelligibility indices and were best for RT 60 (R 2 = 0.666, F(2, 37) = 39.9, P < .0001). For D max (maximum distance where there is <15% loss of consonant articulation), both V R and V C β coefficients were significant. For RT 60 and D max , after controlling for V C , partial correlations were 0.825 (P < .0001) and 0.718 (P < .0001), respectively, while after controlling for V R , partial correlations were −0.322 (P = .169) and 0.381 (P < .05), respectively. CONCLUSIONS: Our results suggest that the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents correlated with improved speech intelligibility. This study provides valuable descriptive data and a predictive method for identifying existing ORs that may benefit from acoustic modifiers (eg, sound absorption panels). Additionally, it suggests that room dimensions and projected clinical use should be considered during the design phase of OR suites to optimize acoustic performance.

Digital Audio Theory, 2020

Journal of The Audio Engineering Society, 2018

Digital Audio Theory, 2020

Perceptual and Motor Skills, 2020

Rhythmic entrainment occurs when an auditory rhythm drives an internal movement oscillator, thus ... more Rhythmic entrainment occurs when an auditory rhythm drives an internal movement oscillator, thus providing a continuous time reference that improves temporal and spatial movement parameters. Entrainment processes and outcomes are well known for adults, but research is lacking for infants who might benefit from diagnosis and treatment of irregular rhythms within biological, sensorimotor, cognitive, and social domains. The present study used a combination of inertial measurement units and custom-made software to determine the amount, tempo, and regularity of movement in 28 infants aged 6-10 months while they were exposed to silence, an irregular rhythmic cue, or a regular rhythmic cue with tempo changes. We also assessed changes in the infants’ movement parameters following a one-week rhythm training protocol. While results revealed no significant effect of auditory condition on amount or tempo of movement, infant movement was significantly more regular when infants were exposed to 12...

International Journal of Sports Physical Therapy, 2019

Introduction: Impairments in postural stability have been identified following sports-related con... more Introduction: Impairments in postural stability have been identified following sports-related concussion. CaneSense TM is a recently developed mobile lower limb motion capture system and mobile application for movement assessment which provides an objective measure of postural stability. One of the components within CaneSense TM is the Post-Concussive Excursion Index (PCEI), a measure of postural stability expressed as a percentage of symmetry between lower limbs. Purpose: The purpose of this case series is to examine pre-and post-concussion differences using two separate measures, Cane-Sense TM , and a known test, the Balance Error Scoring System (BESS), in Division I collegiate football players. Methods: A convenience sample of eight football players diagnosed with a concussion, were the subjects in this case series. All subjects underwent baseline testing prior to the start of pre-season camp consisting of the single limb stance (SLS) test with Cane-Sense TM and the BESS test. Twenty-four to 72 hours following their concussion, SLS with CaneSense TM test and the BESS test, were administered. Segmental excursions for the thigh and shank segments for each lower limb were combined into the Post-Concussion Excursion Profile (PCEP), which represents each segment's maximum excursion in the medial-lateral and anterior-posterior direction. The PCEI is a single metric generated to quantify differences within subjects by comparing the PCEP value between lower limbs during SLS where 100% suggests absolute symmetry. Results: The PCEI value decreased significantly post-concussion (41.43 ± 15.53% vs. 87.41 ± 6.05%, p < 0.001) demonstrating a 52.6% decrease in inter-limb symmetry when compared to baseline values. There was an unanticipated 36.36% improvement in composite BESS performance post-concussion (10.5 ± 4.87 errors vs. 16.5 ± 8.49 errors, p = 0.10). Conclusions: Differences in inter-limb postural stability were found in subjects post-concussion. By assessing postural stability in both lower limbs individually, using the PCEI, impairments were detected that otherwise would have likely gone undiagnosed using the BESS test alone.

Military Medicine, 2021

Introduction Telehealth is an increasingly common approach to improve healthcare delivery, especi... more Introduction Telehealth is an increasingly common approach to improve healthcare delivery, especially within the Veterans Health Administration and Department of Defense (DoD). Telehealth has diminished many challenges to direct access for clinical follow-up; however, the use of mobile telehealth for specialty rehabilitative care is emerging and is referred to as telerehabilitation. As early adopters of telehealth, the Veterans Affairs and DoD have supported collaborated efforts for programs designed to increase the access and quality of rehabilitative care while improving the functional ability of our service members (SMs) and veterans with lower limb amputation (LLA). The DoD and Veterans Health Administration collaborated on a Mobile Device Outcomes-based Rehabilitation Program (MDORP) to help injured SMs and veterans with LLA. The MDORP project utilized a mobile health system called the Rehabilitative Lower Limb Orthopedic Accommodating Device (ReLOAD) to assess walking quality....

Anesthesiology, Jul 1, 2018

What This Article Tells Us That Is New • In a simulated intensive care unit using primarily anest... more What This Article Tells Us That Is New • In a simulated intensive care unit using primarily anesthesiology residents as test subjects, the ability to learn and identify standard and icon alarms was tested • In this setting, icon alarms were easier to learn and identify than standard alarms, while standard alarms were more likely to be perceived as having higher fatigue and task load

Military Medicine, 2020

Introduction The objective was to determine if the Mobile Device Outcomes-based Rehabilitation Pr... more Introduction The objective was to determine if the Mobile Device Outcomes-based Rehabilitation Program (MDORP) improved strength, mobility, and gait quality in service members (SMs) and Veterans with lower limb amputation (LLA). Methods Seven SMs and 10 Veterans with LLA enrolled and were trained to use a mobile sensor system, called Rehabilitative Lower Limb Orthopedic Analysis Device (ReLOAD). ReLOAD provided participants with real-time assessment of gait deviations, subsequent corrective audio feedback, and exercise prescription for normalizing gait at home and in the community. After baseline testing, prosthetic gait and exercise training, participants took ReLOAD home and completed an 8-week walking and home exercise program. Home visits were conducted every 2 weeks to review gait training and home exercises. Results Significant improvements in hip extensor strength, basic and high-level mobility, musculoskeletal endurance, and gait quality (P < 0.05) were found at the compl...

Accurate identi cation of medical alarm sounds can be life-saving, but current standard alarms ar... more Accurate identi cation of medical alarm sounds can be life-saving, but current standard alarms are di cult to learn. One issue is that these alarms, despite having different melodies, possess highly similar tonal qualities. This makes it hard to distinguish, for example, an alarm indicating an abnormal heart rate from one denoting abnormal oxygen saturation. To ease interpretation, researchers have developed new auditory icon alarms. These real-world sounds are associated with the processes they represent, such as the sound made by pills rattling in a bottle to indicate a drug administration issue or the sound of

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018

Many human factors and ergonomics problems are associated with clinical alarms, usaually referred... more Many human factors and ergonomics problems are associated with clinical alarms, usaually referred to as ‘alarm fatigue’. Among these problems is the nature of auditory signals used to attract attention, as these signals are often difficult to learn, easily confusable, and sometimes prone to masking. Symptomatic of this problem is the poor quality of the audible alarms associated with a global medical device safety standard, IEC 60601-1-8. A project aimed at improving and updating these sounds according to best practice is being carried out. This paper charts the progress of this venture and summarizes the results and the published papers which present those results.

Anesthesia & Analgesia, Feb 1, 2016

Operating rooms are identified as being one of the noisiest of clinical environments, and intraop... more Operating rooms are identified as being one of the noisiest of clinical environments, and intraoperative noise is associated with adverse effects on staff and patient safety. Simulation-based experiments would offer controllable and safe venues for investigating this noise problem. However, realistic simulation of the clinical auditory environment is rare in current simulators. Therefore, we retrofitted our operating room simulator to be able to produce immersive auditory simulations with the use of typical sound sources encountered during surgeries. Then, we tested the hypothesis that anesthesia residents would perceive greater task load and fatigue while being given simulated lunch breaks in noisy environments rather than in quiet ones. As a secondary objective, we proposed and tested the plausibility of a novel psychometric instrument for the assessment of stress. In this simulation-based, randomized, repeated-measures, crossover study, 2 validated psychometric survey instruments, the NASA Task Load Index (NASA-TLX), composed of 6 items, and the Swedish Occupational Fatigue Inventory (SOFI), composed of 5 items, were used to assess perceived task load and fatigue, respectively, in first-year anesthesia residents. Residents completed the psychometric instruments after being given lunch breaks in quiet and noisy intraoperative environments (soundscapes). The effects of soundscape grouping on the psychometric instruments and their comprising items were analyzed with a split-plot analysis. A model for a new psychometric instrument for measuring stress that combines the NASA-TLX and SOFI instruments was proposed, and a factor analysis was performed on the collected data to determine the model&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s plausibility. Twenty residents participated in this study. Multivariate analysis of variance showed an effect of soundscape grouping on the combined NASA-TLX and SOFI instrument items (P = 0.003) and the comparisons of univariate item reached significance for the NASA Temporal Demand item (P = 0.0004) and the SOFI Lack of Energy item (P = 0.001). Factor analysis extracted 4 factors, which were assigned the following construct names for model development: Psychological Task Load, Psychological Fatigue, Acute Physical Load, and Performance-Chronic Physical Load. Six of the 7 fit tests used in the partial confirmatory factor analysis were positive when we fitted the data to the proposed model, suggesting that further validation is warranted. This study provides evidence that noise during surgery can increase feelings of stress, as measured by perceived task load and fatigue levels, in anesthesiologists and adds to the growing literature pointing to an overall adverse impact of clinical noise on caregivers and patient safety. The psychometric model proposed in this study for assessing perceived stress is plausible based on factor analysis and will be useful for characterizing the impact of the clinical environment on subject stress levels in future investigations.

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Focal Press eBooks, Dec 27, 2020

Anesthesia & Analgesia, Jun 1, 2017

N oise levels in health care settings have steadily increased since 1960, 1 and noise is currentl... more N oise levels in health care settings have steadily increased since 1960, 1 and noise is currently a significant source of dissatisfaction among hospital staff and patients. 2,3 Sound sources such as beepers, alarms, and conversational speech disrupt patient sleep cycles 3-7 and induce physiological effects in critically ill patients, 8 and they have also been associated with increased infection rate. 9-11 Effects of noise on staff include increased stress, 12-14 which may impact performance and increase risk of committing medical error. 15 Collectively, many studies indicate that noise, also referred to as the "third pollution" after air and water pollution, likely has a detrimental impact on both caregiver health and patient safety. Operating rooms (ORs), environments in which effective communication and signaling of alarms are integral to patient care, are particularly noisy. 16 Data have been published that characterize the excessive sound levels present during surgeries-especially in orthopedic and neurological procedures. 17,18 Recently, an intervention program that used behavioral modification and a feedbackproviding noise device was able to decrease sound levels in a pediatric surgical suite. The decreased sound levels were associated with fewer postoperative surgical complications. 19 As part of the intervention, landline phone ringers were muted, cell phones and any personal conversations were banned during procedures, medical and equipment alarm volumes were decreased, and doors were kept closed with entry and exit activity prevented. Many of these draconian measures may not be practical in all surgical environments. INTRODUCTION: Noise in health care settings has increased since 1960 and represents a significant source of dissatisfaction among staff and patients and risk to patient safety. Operating rooms (ORs) in which effective communication is crucial are particularly noisy. Speech intelligibility is impacted by noise, room architecture, and acoustics. For example, sound reverberation time (RT 60) increases with room size, which can negatively impact intelligibility, while room objects are hypothesized to have the opposite effect. We explored these relationships by investigating room construction and acoustics of the surgical suites at our institution. METHODS: We studied our ORs during times of nonuse. Room dimensions were measured to calculate room volumes (V R). Room content was assessed by estimating size and assigning items into 5 volume categories to arrive at an adjusted room content volume (V C) metric. Psychoacoustic analyses were performed by playing sweep tones from a speaker and recording the impulse responses (ie, resulting sound fields) from 3 locations in each room. The recordings were used to calculate 6 psychoacoustic indices of intelligibility. Multiple linear regression was performed using V R and V C as predictor variables and each intelligibility index as an outcome variable. RESULTS: A total of 40 ORs were studied. The surgical suites were characterized by a large degree of construction and surface finish heterogeneity and varied in size from 71.2 to 196.4 m 3 (average V R = 131.1 [34.2] m 3). An insignificant correlation was observed between V R and V C (Pearson correlation = 0.223, P = .166). Multiple linear regression model fits and β coefficients for V R were highly significant for each of the intelligibility indices and were best for RT 60 (R 2 = 0.666, F(2, 37) = 39.9, P < .0001). For D max (maximum distance where there is <15% loss of consonant articulation), both V R and V C β coefficients were significant. For RT 60 and D max , after controlling for V C , partial correlations were 0.825 (P < .0001) and 0.718 (P < .0001), respectively, while after controlling for V R , partial correlations were −0.322 (P = .169) and 0.381 (P < .05), respectively. CONCLUSIONS: Our results suggest that the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents correlated with improved speech intelligibility. This study provides valuable descriptive data and a predictive method for identifying existing ORs that may benefit from acoustic modifiers (eg, sound absorption panels). Additionally, it suggests that room dimensions and projected clinical use should be considered during the design phase of OR suites to optimize acoustic performance.

Digital Audio Theory, 2020

Journal of The Audio Engineering Society, 2018

Digital Audio Theory, 2020

Perceptual and Motor Skills, 2020

Rhythmic entrainment occurs when an auditory rhythm drives an internal movement oscillator, thus ... more Rhythmic entrainment occurs when an auditory rhythm drives an internal movement oscillator, thus providing a continuous time reference that improves temporal and spatial movement parameters. Entrainment processes and outcomes are well known for adults, but research is lacking for infants who might benefit from diagnosis and treatment of irregular rhythms within biological, sensorimotor, cognitive, and social domains. The present study used a combination of inertial measurement units and custom-made software to determine the amount, tempo, and regularity of movement in 28 infants aged 6-10 months while they were exposed to silence, an irregular rhythmic cue, or a regular rhythmic cue with tempo changes. We also assessed changes in the infants’ movement parameters following a one-week rhythm training protocol. While results revealed no significant effect of auditory condition on amount or tempo of movement, infant movement was significantly more regular when infants were exposed to 12...

International Journal of Sports Physical Therapy, 2019

Introduction: Impairments in postural stability have been identified following sports-related con... more Introduction: Impairments in postural stability have been identified following sports-related concussion. CaneSense TM is a recently developed mobile lower limb motion capture system and mobile application for movement assessment which provides an objective measure of postural stability. One of the components within CaneSense TM is the Post-Concussive Excursion Index (PCEI), a measure of postural stability expressed as a percentage of symmetry between lower limbs. Purpose: The purpose of this case series is to examine pre-and post-concussion differences using two separate measures, Cane-Sense TM , and a known test, the Balance Error Scoring System (BESS), in Division I collegiate football players. Methods: A convenience sample of eight football players diagnosed with a concussion, were the subjects in this case series. All subjects underwent baseline testing prior to the start of pre-season camp consisting of the single limb stance (SLS) test with Cane-Sense TM and the BESS test. Twenty-four to 72 hours following their concussion, SLS with CaneSense TM test and the BESS test, were administered. Segmental excursions for the thigh and shank segments for each lower limb were combined into the Post-Concussion Excursion Profile (PCEP), which represents each segment's maximum excursion in the medial-lateral and anterior-posterior direction. The PCEI is a single metric generated to quantify differences within subjects by comparing the PCEP value between lower limbs during SLS where 100% suggests absolute symmetry. Results: The PCEI value decreased significantly post-concussion (41.43 ± 15.53% vs. 87.41 ± 6.05%, p < 0.001) demonstrating a 52.6% decrease in inter-limb symmetry when compared to baseline values. There was an unanticipated 36.36% improvement in composite BESS performance post-concussion (10.5 ± 4.87 errors vs. 16.5 ± 8.49 errors, p = 0.10). Conclusions: Differences in inter-limb postural stability were found in subjects post-concussion. By assessing postural stability in both lower limbs individually, using the PCEI, impairments were detected that otherwise would have likely gone undiagnosed using the BESS test alone.

Military Medicine, 2021

Introduction Telehealth is an increasingly common approach to improve healthcare delivery, especi... more Introduction Telehealth is an increasingly common approach to improve healthcare delivery, especially within the Veterans Health Administration and Department of Defense (DoD). Telehealth has diminished many challenges to direct access for clinical follow-up; however, the use of mobile telehealth for specialty rehabilitative care is emerging and is referred to as telerehabilitation. As early adopters of telehealth, the Veterans Affairs and DoD have supported collaborated efforts for programs designed to increase the access and quality of rehabilitative care while improving the functional ability of our service members (SMs) and veterans with lower limb amputation (LLA). The DoD and Veterans Health Administration collaborated on a Mobile Device Outcomes-based Rehabilitation Program (MDORP) to help injured SMs and veterans with LLA. The MDORP project utilized a mobile health system called the Rehabilitative Lower Limb Orthopedic Accommodating Device (ReLOAD) to assess walking quality....

Anesthesiology, Jul 1, 2018

What This Article Tells Us That Is New • In a simulated intensive care unit using primarily anest... more What This Article Tells Us That Is New • In a simulated intensive care unit using primarily anesthesiology residents as test subjects, the ability to learn and identify standard and icon alarms was tested • In this setting, icon alarms were easier to learn and identify than standard alarms, while standard alarms were more likely to be perceived as having higher fatigue and task load

Military Medicine, 2020

Introduction The objective was to determine if the Mobile Device Outcomes-based Rehabilitation Pr... more Introduction The objective was to determine if the Mobile Device Outcomes-based Rehabilitation Program (MDORP) improved strength, mobility, and gait quality in service members (SMs) and Veterans with lower limb amputation (LLA). Methods Seven SMs and 10 Veterans with LLA enrolled and were trained to use a mobile sensor system, called Rehabilitative Lower Limb Orthopedic Analysis Device (ReLOAD). ReLOAD provided participants with real-time assessment of gait deviations, subsequent corrective audio feedback, and exercise prescription for normalizing gait at home and in the community. After baseline testing, prosthetic gait and exercise training, participants took ReLOAD home and completed an 8-week walking and home exercise program. Home visits were conducted every 2 weeks to review gait training and home exercises. Results Significant improvements in hip extensor strength, basic and high-level mobility, musculoskeletal endurance, and gait quality (P < 0.05) were found at the compl...

Accurate identi cation of medical alarm sounds can be life-saving, but current standard alarms ar... more Accurate identi cation of medical alarm sounds can be life-saving, but current standard alarms are di cult to learn. One issue is that these alarms, despite having different melodies, possess highly similar tonal qualities. This makes it hard to distinguish, for example, an alarm indicating an abnormal heart rate from one denoting abnormal oxygen saturation. To ease interpretation, researchers have developed new auditory icon alarms. These real-world sounds are associated with the processes they represent, such as the sound made by pills rattling in a bottle to indicate a drug administration issue or the sound of

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care, 2018

Many human factors and ergonomics problems are associated with clinical alarms, usaually referred... more Many human factors and ergonomics problems are associated with clinical alarms, usaually referred to as ‘alarm fatigue’. Among these problems is the nature of auditory signals used to attract attention, as these signals are often difficult to learn, easily confusable, and sometimes prone to masking. Symptomatic of this problem is the poor quality of the audible alarms associated with a global medical device safety standard, IEC 60601-1-8. A project aimed at improving and updating these sounds according to best practice is being carried out. This paper charts the progress of this venture and summarizes the results and the published papers which present those results.