Did You Feel That? Developing Novel Multimodal Alarms for High Consequence Clinical Environments

Additionally, loudness of the alarms can cause ”alarm fatigue”, which is a phenomenon of diminished response due to desensitization of the practitioners [3]. This problem is exacerbated by the fact that free-field audible alarms are not informative, nonlocalizable, and presented to everyone in the room. When the fatigue is severe, it can increase clinician error, potentially leading to adverse patient outcomes. To cope with these problems, we are interested in the possibility of leveraging multimodality to improve the information transfer capacity of alarms. Through this approach to alarm management, we anticipate a reduction in overall sound exposure level in the clinical environment and decreased distractions, as well as a possibility of implementing personalized alarms. An extensive volume of previous literature has described the effects of multisensory integration, in particular involving the auditory and visual modalities. These include evidence for both complementary and inhibitory effects of the combination [4]. However, visual attention is directional, and in the case of a clinical environment, one cannot assume that a visual signal would be attended to by the health-care provider. In contrast, haptic feedback can be provided anywhere, any time, irrespective of current activity, and offers the additional benefit that it can be delivered selectively to the clinician(s) for whom it is relevant. To investigate the possibility of leveraging the audio-haptic modality in this manner, we conducted an experiment to determine the degree to which haptic stimuli can complement audible alarms. To quantify the accuracy to such cues, we compared unisensory auditory and multisensory auditory-haptic stimuli. The results of our experiments did not demonstrate a facilitative effect as expected. However, analyzing them raised important questions regarding fatigue and habituation to vibrotactile stimuli, potential interference of sensory streams, potential benefits of speech over non-speech auditory stimuli, and if supra-threshold stimuli can still be weakly effective as a unisensory stream to contribute to multisensory gain.