Reducing Unnecessary Telemetry Monitoring: An SHM Choosing Wisely Quality Improvement Implementation Module

Sheryl Williams, MD, FACP, SFHM, MS-HQSM and Ian Jenkins, MD, SFHM

Overview

Mounting evidence shows that the American healthcare system costs too much for the results it achieves in terms of patient outcomes and access. Many different parts of this system need attention, and it can be difficult to know where to begin. However, the inpatient / hospital environment is a “high intensity” healthcare delivery setting, and the “Choosing Wisely” initiative of the American Board of Internal Medicine Foundation (ABIMF) offers a list of low value healthcare practices which make great targets for improvement efforts. In this module, we will tackle one of the top five practices chosen for Choosing Wisely by the Society of Hospital Medicine: continuous telemetry monitoring. 

Objectives

The goal of this module is to review the guideline recommendations and the literature supporting the harms, benefits, and proper utilization of telemetry monitoring. 

Key Points
  • Understand why Choosing Wisely recommends not ordering telemetry outside the ICU without using a protocol to govern continuation
  • Why successful projects like this must target not only physician ordering behavior, but also hospital processes and departments that influence the targeted measure
  • That physicians will choose wisely when you make it easy to do the right thing
  • Why a successful project must be a multidisciplinary effort
  • Telemetry is not a proxy for closely monitoring a patient
  • Inappropriate telemetry use can contribute to well recognized patient harms
  • Overuse of telemetry can increase costs, and length of stay and decrease patient satisfaction
  • Hospitalists are in a unique position to improve this quality of care issue
Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: November 9, 2020 & expiration date: November 9, 2023
Estimated time to complete: 1 hour

Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Additional Information

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PDF icon References.pdf121.73 KB
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-physician
Course opens: 
11/09/2020
Course expires: 
11/09/2023
Your cost:
$0.00
Rating: 
0

Sheryl Williams, MD, FACP, SFHM, MS-HQSM

Dr. Williams reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

Ian Jenkins, MD, SFHM

Dr. Jenkins reports having no relevant financial or advisory relationships with corporate organizations related to this activity

Additional planners and faculty for this activity have no relevant relationships to disclose.

Conflict Of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Non-physician

Price

Your cost:
$0.00
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The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections, and all sections must be completed to receive CME credit.

Click START to begin.