A recent report in JAMA Internal Medicine found that hospitals are using various approaches to reducing unnecessary telemetry for cardiac monitoring, but not enough are using the American Heart Association (AHA) guidelines.
“Unfortunately, the AHA Practice Standards have not been widely adopted — with as many as 43% of monitored patients lacking a recommended indication for monitoring. Thus, we created an overview discussing the safety and efficacy of incorporating the AHA Practice Standards and a review of studies highlighting their successful incorporation within patient care workflow,” the authors wrote. “We conclude by outlining an ‘implementation blueprint’ for health system professionals and administrators seeking to change their institution’s culture of telemetry use.”
The researchers looked at eight previous studies and assessed how the hospitals involved were using the AHA guidelines and addressing overuse of telemetry.
They found these approaches:
- using email reminders, rounding, and presentations to encourage physicians to become more familiar with the AHA standards;
- having physicians justify the indications for telemetry and renew orders before monitoring is continued;
- reducing the monitoring period;
- financial incentives for compliance with guidelines on telemetry use;
- automatic discontinuation of telemetry after a specified time, requiring a new physician order to resume monitoring.
Some of the hospitals reported a reduction in telemetry orders and monitoring duration, but not all.
An abstract of the report is available online at: https://bit.ly/2ORJAbv.