Decrease in Inpatient Telemetry Utilization Through a System-Wide Electronic Health Record Change and a Multifaceted...

Area of Science:

• Healthcare Management
• Clinical Engineering
• Patient Safety

Background:

• Unnecessary telemetry monitoring is a significant contributor to healthcare waste.
• Reducing suboptimal utilization of medical technology is crucial for cost-efficiency.

Purpose of the Study:

• To evaluate the effectiveness of two interventions aimed at reducing telemetry utilization in non-intensive care unit (ICU) patients.
• To assess the impact of these interventions on patient outcomes.

Main Methods:

• A retrospective, observational study involving 35,871 non-ICU patients across two intervention periods.
• Implementation of a multifaceted intervention including education, process changes, feedback, and financial incentives, followed by a system-wide electronic ordering change.

Main Results:

• Telemetry utilization decreased by 69% on the hospitalist service with the multifaceted intervention, compared to a 22% reduction on other services.
• No significant increases in mortality, code event rates, or escalation of care were observed.
• A trend towards improved appropriateness of telemetry utilization was noted.

Conclusions:

• A multifaceted intervention can lead to substantial reductions in telemetry monitoring rates.
• Electronic ordering changes contribute to decreased telemetry use, but a comprehensive approach yields greater impact.
• Further research is needed to determine the long-term durability of these utilization changes.