Abstract 391: Telemetry Talk: A Quality Improvement Initiative To Decrease Inappropriate Telemetry Use

Objectives: The purpose of this study was to identify the percentage of inappropriate telemetry and reduce inappropriate use via a multidisciplinary interventional approach.

Background: Nationally studies have demonstrated that up to 43% of telemetry orders are inappropriate and do not change patient outcomes or clinical decision making. Overuse may also lead to unnecessary diagnostic workup, hospital costs, clinical duties, and even hospital divert status.

Methods: Using the AHA guidelines and the TUH official policy, we created an updated table of appropriate telemetry indications (Table 1). We used the Epic telemetry column to identify active orders. Then, each patient’s chart was reviewed to determine whether the order was appropriate.”We reviewed all active telemetry orders on our medicine services over four days.

Results: Teaching services had 72/140 (51%) inappropriate orders while direct-care services had 4/19 (21%) inappropriate orders (Table 2). “Subspecialty teaching services had 10/15 (67%) inappropriate orders.

Discussion: Inappropriate telemetry use is a systems-based, multidisciplinary problem requiring interventions at multiple levels Our goal was to reduce overall inappropriate telemetry use from 49% to 35% At our center, interventions underway include: Posting the indications on workstations, Encouraging “Time out for Tele!” review on rounds, Educating hospital teams, Additional Epic modifications.

Conclusions: Inappropriate telemetry use on medicine services at our institution is higher than national averages. We increased physician awareness of orders and performed education on appropriate use. We plan to re-assess telemetry use at interval periods to assess for improvement.