Background: Telemetry is overused in hospitals and continues to be a source of health system waste. Although there have been studies on the cause as well as efforts to reduce telemetry overuse, the extent to which physicians are aware that their patients are on telemetry has not been studied. Unawareness of telemetry status has both healthcare waste and patient safety implications. We aimed to study how often inpatient clinicians were aware (or unaware) of the telemetry status of their patients.
Methods: We conducted a two-hospital (single healthcare system), cross-sectional observational study of internal medicine physicians caring for hospitalized patients on general medicine units (non-ICU) at academic medical centers. We surveyed physicians once weekly before their interdisciplinary rounds on whether their patients were on telemetry or not. Telemetry status was determined by electronic health record review (Ronald Reagan Hospital) or telemetry technician logs (Santa Monica Hospital).
Results: We surveyed resident physicians, attending physicians, and direct-care hospitalists over a 10-week period, obtaining a total of 1379 clinician assessments on 962 patients. About half of all patients were on telemetry (53%). Twenty-eight percent of the time (208/745), clinicians erroneously thought patients were not on telemetry when in fact they were. Similarly, 25% of the time, clinicians erroneously marked that patients were on telemetry when they were not. Overall, clinicians were incorrect 26% of the time (365/1379). Direct-care hospitalists were more accurate than attending physicians (81% vs. 72%, p < 0.05).
Conclusions: Clinicians are often unaware of the telemetry status of their hospitalized patients. Interventions to increase awareness of a patient’s telemetry status may help reduce telemetry overuse and increase patient safety.