Resident Led Tele-intervention Program: An Impactful Strategy to Reduce Inappropriate Use

Abstract

Multiple studies have documented an inappropriate and excessive use of telemetry during hospitalization. In this IRB approved study, we report the impact of a focused residents led intervention program on reducing inappropriate telemetry use. The study included two groups. The house-staff covered patients (the intervention group) received the intervention. The non-house-staff covered patients did not receive the intervention and served as the control group. The intervention included the implementation of American Heart Association cardiac monitoring guidelines, daily tele-census and indication evaluation, and discussion around telemetry status during multidisciplinary rounds. Data were collected from the pre-(90 day) and post intervention (90 day) periods for both groups. The intervention resulted in a 49% relative decrease in the average telemetry days in the intervention group (pre-intervention=5.7 days vs. post-intervention=2.9 days; p<0.001). The number of patients maintained on telemetry for >48 hours also decreased by 56% in the intervention group. Overall, there were 9 less tele patients/day during the post intervention phase occupying a high cost tele-bed in the intervention group ($8,141 saved/day) and there were 810 less tele patients for the duration of the study. A resident led intervention program reduced inappropriate use of telemetry and minimized costs without compromising patient safety.