Tackling Telemetry: A Resident-Led Initiative to Reduce Unnecessary Telemetry Use

The overuse of telemetry without indication leads to alarm fatigue, unnecessary costs, and reduced patient satisfaction. Unnecessary telemetry use does not improve patient outcomes.

We hypothesized that a quality-improvement initiative could improve telemetry ordering practices at our hospital.

Telemetry orders on admission and at 48 hours were reviewed by 2 physicians. Educational sessions were conducted on the American Heart Association guidelines. Orders were reassessed post intervention to evaluate changes in appropriateness. The proportion of appropriate telemetry orders at admission significantly increased from 60.9% to 73.6%. No significant change was observed in appropriateness at 48 hours.

A low-cost, resident-led initiative was able to improve telemetry ordering practice. Further work should elucidate electronic medical record changes to further improve ordering practices at 48 hours and evaluate the frequency of initiatives needed to sustain response.