In my experience it's sometimes a result of mismatched incentives resulting in a prisoner's dilemma rather than a lack of awareness or engineering ability.
The designer responsible for an alarm wants to avoid being blamed for the operator missing that specific alarm so they're incentivized to make their alarm as prominent as they can get away with. Of course once most designers are doing that then they have to keep doing it or risk get drowned out.
One way to fix that is by having someone who is responsible for the entire experience who can dictate shared prioritization, requirements, alerting frameworks, rate limiters, etc. In cases where the operator uses multiple products from different companies (e.g. in a hospital) that's especially hard which is why there's a cacophony of noise even though everyone involved acknowledges that it's a problem.
> In cases where the operator uses multiple products from different companies (e.g. in a hospital) that's especially hard
Somehow this works just fine in telecom. I was handling equipment from DSC, Alcatel, Fujitsu, Marconi, Rockwell, Cerent, Nortel, Pirelli, CarrierAccess, Tellabs, Cisco, ADC, Lucent, and more. There are Telcordia and NEBS standards for alarm severity and wiring, and everything just works when you hook it up. Does the medical industry not have standards?
I've heard from colleagues in the (US) medical industry that there are guidelines from the likes of AAMI and ECRI but few real "requirements". My second-hand understanding is that it's largely dependent on how much leverage the end-users (doctors and nurses) have to dictate system requirements and how much leverage the hospital system has with respect to negotiating with suppliers.
The designer responsible for an alarm wants to avoid being blamed for the operator missing that specific alarm so they're incentivized to make their alarm as prominent as they can get away with. Of course once most designers are doing that then they have to keep doing it or risk get drowned out.
One way to fix that is by having someone who is responsible for the entire experience who can dictate shared prioritization, requirements, alerting frameworks, rate limiters, etc. In cases where the operator uses multiple products from different companies (e.g. in a hospital) that's especially hard which is why there's a cacophony of noise even though everyone involved acknowledges that it's a problem.