Telemetry: appropriateness of initial assignment and duration in nonintensive setting

Area of Science:

• Healthcare quality improvement
• Clinical informatics
• Patient safety

Background:

• Inappropriate use of telemetry monitoring contributes to alarm fatigue, increased healthcare costs, and potential patient harm.
• Current guidelines exist for the appropriate initial assignment and duration of telemetry monitoring.

Purpose of the Study:

• To assess adherence to guidelines for the initial assignment of telemetry monitoring.
• To evaluate adherence to guidelines for the duration of telemetry monitoring.

Main Methods:

• Retrospective study of 695 adult patients admitted to general medical floors over 3 months.
• Data collected from electronic health records (EHRs).
• Exclusion of patients on surgical services or transferred from critical care.

Main Results:

• 22.3% of patients were inappropriately assigned telemetry initially.
• 56.3% of appropriately assigned patients exceeded recommended monitoring duration (median 3 extra days).
• Annualized additional cost due to inefficient telemetry utilization exceeded $500,000.

Conclusions:

• Findings highlight the need for frequent reassessment of telemetry indications.
• Electronic health record (EHR)-based automated monitoring can facilitate improved telemetry utilization.