Reduction of Overuse of Non-ICU Cardiac Telemetry Feasible
(HealthDay News) — Efforts to reduce overuse of non-intensive care unit (ICU) cardiac telemetry correlate with reductions in telemetry use and considerable cost savings, according to a research letter published online September 22 in JAMA Internal Medicine.
Robert Dressler, MD, from the Christiana Care Health System in Newark, DE, and colleagues redesigned and standardized all cardiac telemetry orders within an electronic ordering system (EOS). American Heart Association guidelines were integrated into the EOS to increase appropriate use of non-ICU telemetry. The total direct and indirect costs were calculated for the delivery of non-ICU telemetry.
The researchers observed an immediate and sustained reduction in the mean weekly number of telemetry orders from 1,032.3 to 593.2 (43% reduction; P<0.001), with implementation of the revised telemetry order sets. In addition, the mean duration of telemetry decreased from 57.8 to 30.9 hours (47% reduction; P<0.001). There was a 70% reduction in the mean number of patients monitored with telemetry, from 357.5 to 109.1. Throughout the observation period, hospital census, code blue, mortality, and rapid response team activation rates were stable. There was a reduction in the mean daily cost for non-ICU telemetry from $18,971 to $5,772.
"Our project led to a sustained 70% reduction in telemetry use without adversely affecting patient safety," the authors write.