Abstract
Large healthcare organizations are complex socio-technical systems in many senses. Understanding how such complex systems adapt to their internal and external environment may help us devise effective strategies in building robust, high reliability organizations. In this paper we report findings of an in-depth study of auditory alarms in acute care settings as an attempt to study complex organizations. Investigations into incidents with adverse outcomes often lead to blames of not responding to auditory alarms which in most cases sound at audible levels. We interviewed a number of clinicians and stakeholders to understand the reasons why in some circumstances alarms are not responded to. The findings illustrate a spectrum of reasons that predispose care providers in certain responding patterns, such as large numbers of alarms, confusion of alarms, temporary episodes of high workload, external economic pressures, and proactive interventions at unit and organizational levels at improving quality of care.
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