SHM Converge Scientific Abstract ePoster Gallery-Optimization of Appropriate Inpatient Telemetry Ordering Safely Reduced Telemetry Utilization

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This quality improvement project at Lehigh Valley Health Network aimed to reduce inappropriate inpatient telemetry use by revising telemetry ordering indications to match the 2017 American Heart Association scientific statement. Telemetry is valuable for patients at high risk of arrhythmia, but overuse in low-risk patients can increase costs, length of stay, false alarms, and nurse alarm fatigue.<br /><br />The team identified that “acute medical illness” accounted for about 70% of telemetry use in their system, even though it was not a recommended indication. Other order indications, such as “CHF,” were also not aligned with AHA guidance. The hospital updated both Daily 24-hour Telemetry and Continuous Telemetry orders, then educated emergency, hospital medicine, family medicine, surgery, internal medicine, and cardiology teams.<br /><br />The study compared three months before and after implementation (May–July 2023 vs. August–October 2023). Results showed a 12% reduction in Med/Surg telemetry bed requests despite a 2% increase in admissions. Daily Telemetry use dropped by 36%, largely due to fewer initial orders and fewer renewals. Although Continuous Telemetry orders increased, overall telemetry days still decreased significantly.<br /><br />Importantly, the intervention appeared safe: there was no increase in inpatient Code Blue events without pre-arrest telemetry orders (6 before vs. 3 after). The project concluded that revising telemetry indications based on AHA recommendations safely reduced unnecessary telemetry utilization without worsening patient safety outcomes.

Asset Subtitle

Shuisen Li

Meta Tag

Author List Bruce Feldman, Deborah Sundlof, Kathryn Zaffiri, Shadi Jarjous, Shuisen Li, Zhe Chen

Category Innovations

Concept Inpatient Telemetry

Concept Alarm Fatigue

Concept American Heart Association Scientific Statement

Concept Order Set

Concept Telemetry Utilization

Distinguished Non-Finalist

Presenter Organization Department of Emergency and Hospital Medicine, Lehigh Valley Health Network / USF Morsani College of Medicine

Presenting Author Shuisen Li

Track Quality Improvement

Keywords

telemetry

inpatient telemetry

quality improvement

American Heart Association

arrhythmia

telemetry overuse

hospital orders

patient safety

alarm fatigue

utilization reduction

Inpatient Telemetry

Alarm Fatigue

American Heart Association Scientific Statement

Order Set

Telemetry Utilization