A renowned leader in electrocardiogram (ECG) technology and innovation, David W. Mortara, PhD, has donated $25 million to the UCSF School of Nursing to reduce “alarm fatigue” in nurses and other clinicians, and improve patient care and safety.
The contribution is the largest to date for the school, which is a national leader in nursing science, and will enable nursing researchers to work directly with UCSF hospitals and industry to address the high error rate in hospital ECG equipment that leads to millions of unnecessary alarms each month in hospital units.
The new UCSF Center for Physiologic Research (CPR) will support research and the establishment of a large ECG database from hospital units to identify specific predictors of adverse patient outcomes, reduce false alarm rates and improve ECG monitoring systems. It also will provide opportunities to bring in scholars, recruit new faculty and students, and foster interdisciplinary research with UCSF Health, which comprises UCSF Medical Center, UCSF Benioff Children’s Hospitals and other affiliations.
“We are very grateful to David Mortara for his tremendous contribution in creating the innovative Center for Physiologic Research in the UCSF School of Nursing,” said UCSF Chancellor Sam Hawgood, MBBS. “The school is a national leader in the study of alarm fatigue and ECG monitoring, and this gift will significantly advance these efforts to further improve patient care, one of UCSF’s primary missions.”
Alarm fatigue occurs when clinicians become desensitized to the constant noise of alarms and either ignore them or turn them off. Among the numerous detrimental results are anxiety in hospital staff and patients, sleep deprivation among hospitalized patients, and missed life-threatening heart rhythm events. With the increased sensitivity of ECG equipment, they have become the most common culprit for false alarms.
“I’ve seen for too long that there is a vendor world of research and a separate medical world of research, and they don’t cross very well,” said Mortara, a long-time industry leader and an associate professor of nursing who already has contributed to the school with a professorship and fellowships. “The long-term vision of this center is to be a bridge, an innovative center that has resources and people eager to work together to resolve alarm fatigue. Our success will not be just in what we’re able to do as a center, but also in what we can get vendors to do.”
The long-term vision of [the UCSF Center for Physiologic Research] is to be a bridge, an innovative center that has resources and people eager to work together to resolve alarm fatigue.
Pioneer in Computerized Electrocardiography
A graduate of Purdue University with a PhD in physics from the University of Illinois, Mortara joined the emerging field of automated ECG interpretation in 1973 and two years later became the manager of research and development, and then vice president of engineering, at Marquette Electronics, a major U.S. developer of hardware and software for computerized ECG. Among his many contributions while at Marquette was the development of simultaneous 12-lead ECG acquisition and interpretation, the technological foundation of virtually all electrocardiograms in use today.
In 1982, Mortara founded Mortara Instrument, Inc., a Milwaukee-based manufacturer of non-invasive cardiology products and leader in ECG technology and innovation, which was acquired in February 2017 by Hill-Rom, Inc. Since then, Mortara has continued to refine digital electrocardiography and improve automated algorithms for ECG interpretation. He also has been involved in the establishment of numerous ECG standards and played a leadership role in various industry initiatives.
The American College of Cardiology inducted Mortara as an Honorary Fellow in 2011 in recognition of his contributions to the field.
“David has dedicated more than four decades to laying the foundation of modern cardiology diagnostics and refining the instruments we use,” said Catherine L. Gilliss, PhD, RN, FAAN, dean of the UCSF School of Nursing and associate vice chancellor for nursing affairs for UCSF Health. “Through this gift, he is helping to extend our ability to develop and test essential instrumentation to keep patients safe.”
School of Nursing a Leader in Alarm Fatigue Research
Alarm fatigue has many causes, including companies making monitoring devices more sensitive to every medical event and clinicians or hospital administrators selecting instruments primarily for their sensitivity and purpose, rather than prioritizing the alarm issue.
The issue has become so significant that The Joint Commission, a national organization that accredits hospitals, named it a National Patient Safety Goal. This goal required hospitals to establish alarm safety as a priority, identify the most important alarms and establish policies to manage alarms by early 2016.
At UCSF, the effort to reduce alarm fatigue has been led by internationally recognized cardiac monitoring expert Barbara Drew, PhD, RN, who is the retired David Mortara Distinguished Professor in Physiological Nursing. Indeed, Mortara is providing the gift through the UCSF School of Nursing based on the efforts of Drew, who first began her coronary care unit nursing career in 1969 and her academic research career at the UCSF School of Nursing in 1990.
“The nursing profession likes the opportunity to measure things in the body simply and inexpensively,” said Drew, founder of the ECG Monitoring Research Lab in the UCSF School of Nursing. “There’s a lot of information to glean from electrocardiograms that we’re not tapping into. They also need to be more accurate and clinically relevant.”
In an October 2014 study in PLOS ONE, Drew and her colleagues found that the five adult ICUs at UCSF Medical Center, which together have 77 beds, logged more than 2.5 million patient-monitoring alarms in just one month. As the first study to comprehensively define the detailed causes and potential solutions for the widespread issue of alarm fatigue in hospitals, a top recommendation was better computer algorithms.
The new center will be housed in the school’s Department of Physiological Nursing on the UCSF Parnassus campus. The director, who will oversee 4-5 faculty and a few fellows, is yet to be finalized.
UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.