Better Decisions. Better Health for Kids.

Clinical Decision Support Stewardship – Best Practices and Techniques to Monitor and Improve Interruptive Alerts

Interruptive clinical decision support systems, both within and outside of electronic health
records, are a resource that should be used sparingly and monitored closely. Excessive use of
interruptive alerting can quickly lead to alert fatigue and decreased effectiveness and ignoring of
alerts. In this review, we discuss the evidence for effective alert stewardship as well as practices
and methods we have found useful to assess interruptive alert burden, reduce excessive firings,
optimize alert effectiveness, and establish quality governance at our institutions. We also discuss
the importance of a holistic view of the alerting ecosystem beyond the electronic health record.