Quality Improvement Initiative in Enhanced Provider Communication for Telemetry Optimization
Authors
Mirisola, Elisheva
Advisor
Date
Embargo until
Language
Book title
Publisher
Peer Reviewed
Type
Research Area
Jurisdiction
Collections
Other Titles
See at
Abstract
Problem: Despite the American Heart Association (AHA) guidelines for appropriate use of continuous cardiac telemetry monitoring (CTM), overutilization remains common. Excessive use of CTM contributes to alarm fatigue, undue testing, and undue expenses for patients and hospitals. In Fall 2023, 46% of patients at a tertiary care hospital had CTM orders, many of which no longer met the AHA-recommended guidelines. The main issue was the absence of an efficient mode of communicating discontinuable CTM orders. Purpose: This Quality Improvement (QI) project aimed to enhance notification of providers when patients become eligible for CTM discontinuation. Methods: The project took place on a telemetry unit and included adult patients who were eligible for CTM removal. One monitor technician (MT) per day, overseeing the target unit, used the “FirstProvider” feature of the electronic health record (EHR) to identify the primary provider for patients who met discontinuation criteria and used TigerConnect phones to alert providers with a pre-programmed message. Results: Education was delivered to 100% of participants. Compliance was high but data collection was inconsistent due to staff unavailability. An average 99% of patients on the unit remained on CTM, with a slight increase the first week and unchanging CTM saturation of the unit for the remaining duration, which may have been due to simultaneous changes in unit leadership’s priorities. Conclusions: Ultimately, the project produced no tangible impact on the unit’s CTM utilization. For successful future endeavors, the organization may need to consider establishing both regular pattern of audits and non-conflicting priorities before this intervention can assist in reducing overuse. Initially, this unit was selected due to its high CTM utilization, however the institutional context heavily suggested that other units may be more appropriate in the future.