Abstract 14830: Digital Central Monitoring Units Reduce Telemetry Alert Burden and Improve Clinician Alert Response Metrics

Abstract

Introduction: Cardiac electrocardiographic telemetry is guided by AHA Practice Standards and is associated with improved patient outcomes. Cardiac telemetry digital central monitoring units (dCMU) optimize telemetry performance by facilitating alert dispatches and providing processes for quality improvement. Hypothesis: Implementation of dCMU would result in a reduced number of alerts transmitted to bedside staff and improved alert management. Methods: From May 2022 to March 2023, alerts were collected and analyzed at 6 hospitals transitioned from standard telemetry practice to dCMU. Standard practice includes monitor technicians reviewing alerts and waveforms, ranking alerts and manually contacting clinicians. The dCMU platform organizes and ranks clinical alerts after which a CMU tech dispatches alerts to a mobile app. The bedside clinician receives the alert, patient data, and real time waveform for contextual analysis. The alert is marked “handled” when the provider accepts the message. If the message is not accepted, the alert enters an escalation pathway. The dCMU platform also contains performance analyzing software which guides process improvement. Results: Alert counts and characteristics were collected and analyzed during an 11-month period. Comparing a 30-day baseline period to the last 30-day post-implementation period, dispatched alerts to clinician devices decreased 35.5% - from 5,032 to 3,246 alerts per day and the rate of notifications handled by providers increased 88% - from 42% to 78.8% of all dispatched alerts (Figure 1). The total time that patients were in alert state decreased 32.4% - from 31,930 to 21,576 minutes per day. Conclusions: The introduction of dCMU structured and streamlined the telemetry dispatch process leading to reduced alert burden and improved bedside clinician alert handling. Further studies are necessary to determine the effects of dCMU dispatch control on patient outcomes compared to standard telemetry practice.