Telemetry guidelines built into order system saved $4.8 million annually
FROM JAMA INTERNAL MEDICINE
Embedding the American Heart Association’s recommendations for addressing the use of nonintensive care unit cardiac telemetry in an electronic ordering system reduced telemetry use without affecting patient safety.
The hardwiring into the electronic ordering system of AHA’s guidelines were implemented in Christiana Healthcare System of Newark, Del., on March 18, 2013. An examination of cardiac telemetry orders and associated costs from Dec. 31, 2012, to Aug, 12, 2013, found a reduction in telemetry orders.
Following the implementation, there was an “immediate and sustained reduction in the mean weekly number of telemetry orders from 1,032.3 to 593.2 and the mean duration of telemetry fell from 57.8 to 30.9 hours (reductions of 43% and 47%, respectively).”
Reducing non-ICU telemetry use was a part of the March 2013 list of the Society of Hospital Medicine in the Choosing Wisely campaign.
Research results were published online Sept. 22 in JAMA Internal Medicine.
The estimated total daily cost to deliver telemetry was $53.44 per telemetry patient, the authors wrote. The mean daily cost for non-ICU cardiac telemetry decreased from $18,971 to $5,772. Hardwiring the guidelines into the electronic ordering system is estimated to save Christiana Healthcare System $4.8 million annually.
“Although overuse of cardiac telemetry in non-ICU settings is widely recognized, there is a paucity of literature outlining successful and safe strategies addressing this concern,” Dr. Robert Dressler of Christiana Healthcare and his colleagues wrote in JAMA Internal Medicine. “Our project led to a sustained 70% reduction in telemetry use without adversely affecting patient safety. In fact, patient safety may be enhanced by reducing the potential for alarm fatigue and provider workflow interruption.”
Researchers reported no conflicts of interest.