Abstract 261: Best Practice Advisories Effects On Telemetry Ordering Habits

Abstract

Background: Inpatient Telemetry detects dysrhythmias. However, data from telemetry influences management on < 1% of patients, and telemetry is often used in cases with no benefit. We are conducting a multi-center study to evaluate the impact of an EMR-based best practice advisory (BPA) on telemetry ordering practice Methods: To assess the effectiveness of a BPA encouraging cessation of telemetry, we performed an analysis of time on telemetry and the number of BPA alerts before and after October 2019 [Figure 1]. We redesigned the telemetry BPA to restrict firing to the hours of (8 AM to 6 PM) and to restrict notifications to the first call and Attending provider. We used Epic-generated data from 88, 832 unique patient telemetry orders and 121, 621 BPA responses from 3 hospitals. The data was normalized for variation in patients hospitalized over time using admission contact serial numbers (CSN) and inpatient admission orders for non-ICU medicine floors. Results: We analyzed data from 243,280 BPA alerts. Pre-BPA implementation mean alerts were 150.01 std 43.07 and post BPA implementation mean alerts were 76.33 std 33.461 p-value 0.00. Mean time on telemetry pre BPA 4481.262 mins std 6531.82 post BPA 4311.14 mins std 6011.18 mins p value 0.001 Conclusion: Despite practice standards, telemetry use outside of the ICU varies widely amongst providers. Reduction in the number of telemetry minutes can lead to a decrease in clinician telemetry review time and offer improvement in patient satisfaction and comfort by not being connected to the device.