Detecting Abnormalities on Displays of Patient
Information
Sydney Fleishman
1(B )
, Alexis Hess
2
, Larry Sloan
2
, Joseph J. Schlesinger
3
,
and Joshua Shive
2
1
Vanderbilt University, Nashville, TN 37235, USA
sydney.a.fleishman@vanderbilt.edu
2
Tennessee State University, Nashville, TN 37209, USA
jshive@tnstate.edu
3
Vanderbilt University Medical Center, Nashville, TN 37209, USA
joseph.j.schlesinger@vanderbilt.edu
Abstract. This project tested a new physiological information display that aims to
improve a clinician’s ability to detect vital sign abnormalities before those abnor-
malities trigger an alarm. The configural display integrates information about
heart rate, blood pressure, and blood oxygen saturation into a visual represen-
tation of the patient’s current state relative to alarm and “pre-alarm” thresholds.
Eight participants were asked to monitor patient displays for six different types
of emergency events under three display configurations (numerical, configural,
and both) and two levels of cognitive load. The numerical display showed color-
coded numerical values of each of the three patient parameters. Emergency events
involved abnormal values of heart rate, blood pressure, and blood oxygen sat-
uration that occurred approximately every thirty seconds during six ten-minute
patient monitoring blocks. Cognitive load was manipulated using an N-back task
with two levels (N = 1 and N = 2). Emergency event detection was faster when
both the configural display and numerical display were present than when only
the numerical display was present. Furthermore, a combined display showing both
the numerical and configural information required the fewest number of alarms
to facilitate correct detection of emergency events. In addition, reaction times to
emergency events were slower in the high cognitive load condition than in the low
cognitive load condition. These results suggest that the combination of numerical
and configural displays has the potential to reduce the number of threshold alarms
and reduce the time it takes clinicians to respond to emergency events.
Keywords: Configural display · Hospital alarms · Visual displays · Pre-alarm
space · Cognitive load
1 Introduction
Intensive Care Units (ICU), operating rooms (OR), and emergency rooms (ER) in hospi-
tals are busy, hectic environments. In the ICU, alarms have the important task of alerting
clinicians of emergency events and keeping them informed of patients with deteriorating
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2021
N. L. Black et al. (Eds.): IEA 2021, LNNS 222, pp. 287–300, 2021.
https://doi.org/10.1007/978-3-030-74611-7_40