Improving Appropriate Telemetry Utilization: A Resident-Led Quality Improvement Initiative

Continuous cardiac telemetry is frequently overused in noncritical care settings, contributing to increased health care costs, alarm fatigue, and patient discomfort without clear evidence of improved outcomes. Despite the availability of the 2017 American Heart Association (AHA) evidence-based guidelines, adherence in clinical practice remains a persistent challenge.

At our institution, telemetry was perceived to be overused, particularly with regard to duration of monitoring. We hypothesized that a targeted, multifaceted educational intervention based on the AHA guidelines could reduce the average duration of telemetry use and improve physician knowledge.

A pre-post quality improvement study was conducted comparing telemetry use from January to March 2025 (preintervention) vs July to September 2025 (postintervention). The intervention included a didactic presentation and informational posters. The average duration of telemetry use per patient decreased by 20.08%, from 2.85 to 2.27 days. Physician knowledge improved significantly, with self-reported high guideline awareness increasing from 5.9% to 45.5% and correct clinical scenario responses rising from 38.2% to 75.8%.

A low-cost, multifaceted educational program based on the 2017 AHA guidelines significantly reduced telemetry duration and improved physician knowledge. Combining sustained education with electronic medical record safeguards may further optimize telemetry use and reduce avoidable resource expenditure.