A Multimodal Quality Improvement Initiative to Reduce Non-ICU Telemetry Overutilization

Continuous cardiac telemetry is frequently overutilized in hospitalized non-intensive care unit patients beyond guideline-supported indications.

Excessive telemetry use contributes to alarm fatigue, resource strain, increased health care costs, and unnecessary patient monitoring.

A quasi-experimental before-and-after study was conducted at a community hospital. A multidisciplinary team implemented a multimodal intervention that included 1) changing telemetry order expiration to noon on hospital day 2, 2) conducting targeted resident education regarding American Heart Association telemetry indications, 3) implementation of a visible telemetry indicator within the electronic medical record, and 4) distribution of pocket reference cards outlining telemetry indications and discontinuation criteria. Sixteen weeks of preintervention data were compared with 16 weeks of postintervention data. The primary outcome was the reduction in telemetry orders per resident, analyzed using the Wilcoxon signed-rank test.

A simple workflow modification supported by focused resident education significantly reduced non-intensive care unit telemetry ordering. This intervention was low cost, sustainable, and easily reproducible.