J Clin Outcomes Manage
Specialty care improves short-term survival for hospitalized heart failure patients
Abstract Objective: To create a set of indications for the use of telemetry on a general medical floor and to assess the effect of the guideline on reducing inappropriate utilization and costs. Methods: A literature review identified several position papers containing recommendations for the use of telemetry. These were translated into a handout for third-year medicine residents that was presented during orientation and posted in the resident area. The indications were reviewed at multidisciplinary rounds 3 times per week. Data regarding patient diagnosis and number of patients on telemetry were obtained from the telemetry log book. Cost analysis was provided by the department of planning, network development, and managed care. Data were collected prior to intervention from July to December 2003, with the intervention encompassing the resident blocks of January and February 2004. Results: The percentage of patients on telemetry for guideline-based indications was 49.7% before the intervention and 52.5% after the intervention. Total cost for telemetry per month as well as the percentage of total charges increased. The average number of patients on telemetry per month increased from 33.8 to 39.5, and the telemetry charges per person decreased. Conclusion: Our telemetry guideline intervention led to more appropriate utilization through improvement in indications for telemetry and increased the number of patients on telemetry a month while decreasing the cost per person of telemetry.
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