What is a common cause of alert fatigue in clinical decision support, and what is a recommended mitigation?

• A. Overabundance of alerts leads to overrides; mitigate by prioritizing critical alerts, refining thresholds, and customizing user settings.
• B. Too few alerts cause missed warnings; mitigate by lowering thresholds to generate more alerts.
• C. Alerts are always accurate; mitigate by removing all alerting to reduce interruption.
• D. Alerts should be identical for all users; mitigate by standardizing to a single system-wide configuration.

Answer: (A)

Alert fatigue happens when clinicians are bombarded with too many alerts, causing them to override or ignore them because the volume and relevance feel overwhelming. The most effective way to mitigate this is to focus on making alerts meaningful rather than numerous: prioritize only the most critical warnings, fine-tune the thresholds and rules so that only clinically important events generate alerts, and allow customization of alerts to fit each user’s role, specialty, and workflow. This approach preserves safety signals while reducing interruptions that lead to desensitization. Lowering thresholds to produce more alerts would worsen fatigue, removing all alerting would undermine patient safety, and making alerts identical for all users ignores differing contexts and needs, reducing relevance.