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JCOM Abstract


J Clin Outcomes Manage 
2008 Sep;15(9):435-440
Optimizing telemetry utilization in an academic medical center
Lee JC, Lamb P, Rand E, Ryan C, Rubal BJ

Abstract Objective: To evaluate the impact of a telemetry bed management policy on utilization and hospital closure patterns. Methods: Patients admitted to non–intensive care telemetry units in an academic tertiary care medical center were studied. Baseline telemetry utilization was prospectively assessed in 167 consecutive telemetry admissions using prespecified endpoints. After a new telemetry policy was implemented, utilization was assessed in the next 1025 consecutive telemetry admissions for quality of use, safety, and impact on hospital closure. Results: Following implementation of the new policy, there was a significant improvement in telemetry utilization as measured by proper order writing (78.4% vs. 90%; P < 0.001), proper indication (76% vs. 92%; P < 0.001), and appropriate duration of monitoring (67% vs. 81%; P < 0.001). There was an increase in the 50% hospital closure threshold from 16 intensive care unit/telemetry admissions per day to 18.5, a 16% increase in admission capacity. No deaths or adverse events related to lack of telemetry use occurred. Conclusion: A multispecialty telemetry policy with dedicated enforcement by a cardiologist/nurse team improved telemetry bed utilization and decreased hospital closures without increasing beds, personnel, or sacrificing patient care and safety.

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