Systems used to continuously monitor vital signs in hospitals and home settings generate alarms intended to warn caregivers, clinicians in the hospital, or parents at home of conditions that warrant their immediate attention. However, less than 1% of these alarms are considered actionable or informative, which has led to clinical alarm fatigue being ranged as one of the Top 10 Health Technology Hazards. While there have been advances in human factors, operational factors, and technical factors independently, their interdependencies have yet to be collectively considered. Consequently, current alarm suppression systems aimed at addressing clinical alarm fatigue are generally not extensible, suffer from low adoption rates, and/or have poor performance in practice.<br/><br/>This proposal aims to develop foundations for the design of next generation smart alarms. Smart Alarms 2.0 will utilize caregiver-in-the-loop alarm suppression systems to reduce the frequency of non-informative alarms in-clinic and at home. Realizing an effective caregiver-in-the-loop alarm suppression system requires fundamental advances in robust alarm suppression design methodologies and caregiver-in-the-loop modeling and analysis. The potential impact of the proposed design and analysis techniques is evaluated in medical scenarios for alarm suppression applications, spanning pediatric wards and at-home monitoring of Bronchopulmonary dysplasia (BPD) patients. This project will lay the foundations for designing caregiver-in-the-loop alarm systems in which physicians, nurses, and parents monitor the right children, at the right times, using optimal alarm settings to maximize informativeness.<br/><br/>This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.