E-HeaRT BPA: electronic health record telemetry BPA.

Area of Science:

• Healthcare quality improvement
• Clinical informatics
• Patient monitoring

Background:

• Continuous cardiac monitoring (telemetry) is often overutilized and costly in non-critical care settings.
• High rates of inappropriate telemetry use necessitate interventions to improve cost-effectiveness and care quality.
• An electronic best practice alert (BPA) system was developed to address persistent telemetry overuse.

Purpose of the Study:

• To evaluate the effectiveness of an electronic best practice alert (BPA) in reducing inappropriate continuous cardiac monitoring (telemetry) in a hospital setting.
• To assess the impact of BPAs on telemetry utilization and patient outcomes.

Main Methods:

• A randomized controlled trial was conducted involving non-critical care patients with telemetry orders at a 600-bed academic hospital.
• Patients were randomized into an intervention group receiving daily BPAs for active telemetry and a control group.
• Data on telemetry days, alert triggers, length of stay, and clinical outcomes were collected and analyzed.

Main Results:

• The intervention group, receiving BPAs, showed a trend toward fewer telemetry days (3.8 vs. 5.0 days).
• Telemetry was stopped more frequently in the intervention group (31.7% vs. 23.3% of alerted patient-days), indicating successful reduction.
• No significant differences were observed in length of stay, rapid responses, code blues, or mortality between the groups.

Conclusions:

• Electronic best practice alerts (BPAs) are effective in significantly reducing telemetry use in non-critical care settings.
• The implementation of BPAs did not negatively impact key patient safety outcomes.
• BPAs represent a valuable tool for promoting high-value use of cardiac telemetry.