Quality improvement to reduce telemetry overuse on general medicine floor

SESSION TITLE: Novel Education and Assessments of TraineesSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/17/2022 12:15 pm - 1:15 pmPURPOSE: Continuous Cardiac monitoring or telemetry is important in the clinical assessment of the patients in determining and detecting arrhythmias, ischemic changes in the heart, conduction defects. AHA developed a set of Practice Standards for the appropriate use of telemetry monitoring in 2004, which they updated in 2017. Unfortunately, the AHA Practice Standards have not been widely adopted. Inappropriate use can lead to increased health care costs without benefiting patients. Overuse of telemetry alarms are intended to alert the caregiver of potential patient problem, but if not managed they can compromise safety. This leads to wasted resources, increased bedside nursing time, provider time-calls from RNs, alarm fatigue, and increased supply costs. The cost of telemetry at our center is 251$ per day. Our goal was to educate the residents about AHA guidelines to decrease the inappropriate use of telemetry. This Quality Improvement Project was conducted at a community hospital in a rural setting. Our target was to decrease the number of telemetry by 1 day for each patient, which could save 25100$ per month for 100 patients.METHODS: The data was reviewed retrospectively for 1 month. Patients on the general medicine floor in Internal medicine and Family medicine resident-led teams were included. Fishbone analysis was used for analysis. Residents were educated about AHA telemetry guidelines through additional training. Post-intervention data were reviewed for 1 month.RESULTS: Pre-intervention retrospective data for one month showed that 45.5% of telemetry days were inappropriate according to AHA telemetry guidelines. Total telemetry days were 230 for 98 patients; 113 days were appropriate and 107 days were inappropriate. The average telemetry days per patient were 2.34. Post-intervention data showed there was a reduction in inappropriate use of telemetry to 36.78%. The total number of patients on telemetry was 87 and the total days were 174, 110 were determined to be appropriate and 64 remained inappropriate. Average telemetry days were reduced to 2 days post-intervention compared to 2.34 pre-intervention.CONCLUSIONS: Inappropriate use of telemetry was reduced by 8.72% by teaching residents about the guidelines. There was an overall reduction in inappropriate telemetry use among the resident-driven services by only teaching the residents about guidelines.CLINICAL IMPLICATIONS: We can reduce the number of telemetry days by using AHA telemetry guidelines in our daily practice. More work is required in this regard by teaching the health care providers regularly which would not only improve health care costs but also increase patient satisfaction by preventing false alarms.DISCLOSURES: No relevant relationships by Anam AqeelNo relevant relationships by Premjeet DhillonNo relevant relationships by Taimoor HaiderNo relevant relationships by John Pamula SESSION TITLE: Novel Education and Assessments of Trainees SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Continuous Cardiac monitoring or telemetry is important in the clinical assessment of the patients in determining and detecting arrhythmias, ischemic changes in the heart, conduction defects. AHA developed a set of Practice Standards for the appropriate use of telemetry monitoring in 2004, which they updated in 2017. Unfortunately, the AHA Practice Standards have not been widely adopted. Inappropriate use can lead to increased health care costs without benefiting patients. Overuse of telemetry alarms are intended to alert the caregiver of potential patient problem, but if not managed they can compromise safety. This leads to wasted resources, increased bedside nursing time, provider time-calls from RNs, alarm fatigue, and increased supply costs. The cost of telemetry at our center is 251$ per day. Our goal was to educate the residents about AHA guidelines to decrease the inappropriate use of telemetry. This Quality Improvement Project was conducted at a community hospital in a rural setting. Our target was to decrease the number of telemetry by 1 day for each patient, which could save 25100$ per month for 100 patients. METHODS: The data was reviewed retrospectively for 1 month. Patients on the general medicine floor in Internal medicine and Family medicine resident-led teams were included. Fishbone analysis was used for analysis. Residents were educated about AHA telemetry guidelines through additional training. Post-intervention data were reviewed for 1 month. RESULTS: Pre-intervention retrospective data for one month showed that 45.5% of telemetry days were inappropriate according to AHA telemetry guidelines. Total telemetry days were 230 for 98 patients; 113 days were appropriate and 107 days were inappropriate. The average telemetry days per patient were 2.34. Post-intervention data showed there was a reduction in inappropriate use of telemetry to 36.78%. The total number of patients on telemetry was 87 and the total days were 174, 110 were determined to be appropriate and 64 remained inappropriate. Average telemetry days were reduced to 2 days post-intervention compared to 2.34 pre-intervention. CONCLUSIONS: Inappropriate use of telemetry was reduced by 8.72% by teaching residents about the guidelines. There was an overall reduction in inappropriate telemetry use among the resident-driven services by only teaching the residents about guidelines. CLINICAL IMPLICATIONS: We can reduce the number of telemetry days by using AHA telemetry guidelines in our daily practice. More work is required in this regard by teaching the health care providers regularly which would not only improve health care costs but also increase patient satisfaction by preventing false alarms. DISCLOSURES: No relevant relationships by Anam Aqeel No relevant relationships by Premjeet Dhillon No relevant relationships by Taimoor Haider No relevant relationships by John Pamula