Anaesthesia Providers’ Perspectives on the Redesigned Philips Acoustic Alarm System: A Qualitative Pre- and Post-Implementation Study (Preprint)

BACKGROUND Alarm fatigue caused by frequent or false alarms poses a persistent threat to patient safety. Despite technological progress, alarm acoustics remain largely unchanged and are often perceived as disruptive. To address this, Philips redesigned its patient monitoring alarm sounds using a user-centred approach aimed at improving priority differentiation and reducing emotional strain. OBJECTIVE This study provides insights into human–technology interaction by examining anaesthesia providers’ experiences with original and updated alarms, with a focus on emotional responses, usability, and guidance for the user-centred design of future clinical alarm systems. METHODS This single-centre qualitative study involved anaesthesia providers who completed an online questionnaire before and after implementation of the updated Philips alarms. Only those who completed the pre-phase participated in the post-phase. The questionnaire included four open-ended questions addressing perceptions of the current alarm sounds, suggestions for improvement, design expectations, and attitudes toward an alarm-free operating room. Responses were analysed using thematic analysis to identify key usability and emotional response themes, while quantitative data were summarised descriptively. RESULTS Ninety eligible providers participated in the pre- and 77 in the post-implementation phase. Positive emotional responses increased in the post-implementation phase, whereas concerns regarding alarm functionality also became more prominent. Prior to the introduction of the updated alarm sounds, participants predominantly called for softer alarm sounds. Following implementation, the most frequently expressed concern shifted to the need for clearer prioritisation of alarms. Across both phases, the primary expectation remained the alarms’ ability to effectively capture attention. The concept of an alarm-free operating room elicited concerns about increased workload and potential risks to patient safety. CONCLUSIONS The redesigned alarm sounds were better accepted emotionally; however, they did not improve the recognition of alarm priority. The modest acoustic changes did not address the broader issue of alarm overload. Suggestions such as visual-only alerts for low-priority alarms show potential but must be balanced with patient safety standards. Future alarm development should combine user feedback with expert-driven and evidence-based approaches to improve both usability and clinical effectiveness. CLINICALTRIAL Cantonal Ethics Committee Zurich (Req-2022-00689)