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Reducing telemetry overuse by improving med-surg monitoring

May 28, 2019
Patient Monitors
From the May 2019 issue of HealthCare Business News magazine

Smart health technology offers the opportunity to renew clinical trust in Med-Surg. These devices can easily convert manually monitored beds to continuously monitored beds, allowing hospitals to provide telemetry-level care in med-surg. Smart monitors deliver AI-power and predictive insights, giving the clinical team the data needed to identify at-risk patients. Furthermore, unlike other monitoring systems, this technology can be rapidly deployed, requiring no large capital investments or infrastructure changes.

But all this poses a question: is the current system – with all its misfiling – really that bad? Yes, because telemetry overuse is not an isolated problem. In fact, it largely contributes to the cross-country epidemic of ED congestion and diversion. When telemetry is at-capacity, patients are forced to “board” in the ER – often staying in hallways for multiple hours before being transferred to inpatient units. Overcrowded ERs have reduced quality of care, and the resulting chaos (patient beds lining hallways, towering stacks of hospital-issued food, and too many worried family members) can take a toll on patient well-being. By improving physician trust in med-surg, smart monitors have the capacity to reduce telemetry overuse and ED-overcrowding, thus improving patient throughput.

The current model has a number of other side effects, including nurse burnout. Studies show that nearly 70 percent of nurses feel overworked, and another 50 percent have considered leaving their jobs. While it’s difficult to pinpoint a single cause of burnout, med-surg inefficiencies play into nurse stress. Currently, med-surg nurses are assigned to more patients than they can handle, and spend a large portion of their shifts spot-checking vitals. While draining their time, this manual monitoring provides little useful information – simply compounding nurse stress. AI-powered devices could alleviate this issue by generating real-time vitals data and critical trends. This, in turn, would reduce nurse burdens and alleviate widespread burnout, allowing them to refocus on patient care.

In addition to its steep clinical implications, telemetry overuse bears a hefty price tag. In an attempt to cut costs while maintaining care-quality, Delaware’s Christiana Care system hardwired the AHA’s guidelines into their tele-ordering service. This implementation was extremely successful, significantly reducing tele-overuse without compromising patient care. Post-hardwiring, telemetry’s mean daily cost plummeted, falling from $18,971 to $5,772. Christiana Care shows that reducing tele-overuse frees up capital, allowing hospitals to invest in better technology and improve staffing.

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