• J Natl Med Assoc · Jul 2010

    Evaluation of telemetry utilization, policy, and outcomes in an inner-city academic medical center.

    • Chinedu Ivonye, Chima Ohuabunwo, Marshaleen Henriques-Forsythe, Jamched Uma, Lois Kemilembe Kamuguisha, Kelechi Olejeme, and Anekwe Onwuanyi.
    • Department of Medicine, Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310, USA. civonye@msm.edu
    • J Natl Med Assoc. 2010 Jul 1; 102 (7): 598-604.

    ObjectiveTo evaluate the appropriateness and intermediate outcomes of telemetry admissions.MethodsWe abstracted demographic and clinical data from records of all new telemetry admissions during a 2-month period. To determine appropriateness, 2 authors classified patients using the American College of Cardiology (ACC) guidelines and our telemetry policy. Other utilization and outcome measures were assessed. Agreement between both guidelines was computed (kappa coefficient). Categorical group covariates were compared using chi2 test. Variations in telemetry length of stay (LOS) were compared using Mann-Whitney and Kruskal-Wallis tests. LOS predictors were ascertained by multiple regression analysis.ResultsOf the 120 patients, appropriate admission was 81.6% (ACC criteria) and 83% by our criteria. Guidelines interrater reliability was .89 (kappa). Telemetry events incidence was 33.3%, with 5.8% major and 27.5% minor. LOS was longer among major than minor events group(7.8 vs. 3.4 days, p = .01). Type of telemetry event was a predictor of LOS (p = .0001). The occurrence of a major telemetry event was associated with cardiology consultation (p = .03).ConclusionsAppropriate telemetry admission was observed in more than 80% of cases. Our telemetry policy had very good agreement with standard guideline. However, the low rate of major telemetry events in all patient groups suggests current guidelines might have considerable limitations.

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