If you’ve spent any time in a hospital, you know just how anxiety-provoking the experience can be. Medical devices are constantly sounding off in long whines and staccato beeps, all competing for attention. Yet despite the distress these blaring alarms seem to convey, you’ll hardly ever see doctors and nurses running toward them.
That’s because up to 99 percent of these sounds in hospitals aren’t really “alarms” in the way you might think. They’re more like notifications, providing useful updates about everything from a patient’s blood pressure to how much liquid is left in an IV bag. It’s only the very rare sound that serves as an all-hands-on-deck alarm, indicating a serious event like cardiac arrest.
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Despite their innocuous intent, these beeps and sirens are far from harmless. In fact, they can cost lives when health care workers can’t distinguish between routine alerts and important alarms. My experience as a professor of music cognition and percussion leads me to think some simple changes to medical alarms could improve patient outcomes, reduce burnout among health care workers, and make the hospital environment better for everyone.
The problem is that with each patient generating hundreds of medical alerts per day at the average hospital, doctors and nurses become desensitized to the sounds. When life-and-death alarms do go off, doctors and nurses are slower to respond than they might be if their attention hadn’t been sapped by a flood of low-priority alerts that sound similar. Sometimes they are so harried and burned out they turn down the volume on life-sustaining machines. In one example, a surgeon turned off a patient’s ventilator in order to perform a brief, routine step during a medical procedure, triggering an unnecessary alarm that kept sounding. Since the alarm was so annoying, the surgeon silenced it to avoid further disruption. However, the surgeon forgot to restart the ventilator, and because the alarm didn’t sound when it was actually needed, the patient died.
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A survey conducted by the Food and Drug Administration found that ignored alarms were responsible for the deaths of 566 people from 2005 to 2008. Studies also show that incessant alarms disturb patients’ sleep and increase their blood pressure and heart rate, slowing their recovery.
Medical device manufacturers have good reasons for making their machines easy to hear, and they rarely think about how alerts from hundreds of different devices in a hospital coalesce into a “beeping hellscape,” as one nurse described it to me. Meanwhile, even with all these problems, doctors and nurses themselves are reluctant to change. These sounds have been ingrained into them. They know, for example, that a certain beep means that a patient’s heart rate is low and that another indicates an empty IV bag.
So how can hospitals and device manufacturers work together to provide high-quality auditory information without using sounds that distress doctors, nurses, and patients?
The answer may lie in music. Music is an incredibly effective form of communication. Musical sounds are complex, with many different tones that begin and end at different times and that peak at varying intensities. As listeners, we are highly sensitive to these distinctions.
In a recent study, my team and I at McMaster University, in Canada, tested what would happen if we replaced standard medical beeps with sounds that have some of the complexity of music. The new sounds mimic the tone patterns of medical device alerts, but they sound more like ringtones or doorbells than robotic beeps. We found that participants were able to clearly recognize an alert’s meaning regardless of whether it was presented as a beep or a more complex sound. Yet they overwhelmingly rated the music-inspired alerts as less annoying.
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These results suggest it’s possible to have medical devices convey information in a less unpleasant way. This wouldn’t make the ICU sound like the Boston Symphony Orchestra. There would still be awful-sounding tones, but they’d be reserved for life-and-death situations that need to be acted upon immediately.
This would require buy-in from medical device manufacturers, hospital administrators, doctors, nurses, and patients. But it also would be a relatively easy fix to an alarming medical problem.
Michael Schutz is a professor of music cognition and percussion at McMaster University in Hamilton, Ontario, and a professional musician.