Lean Six Sigma to Reduce Off-site Patient Telemetry Monitoring Hours by 45% in a Tertiary Medical Center

Operational and physician leaders identified an opportunity to decrease the use of off-site telemetry monitors. Evidence indicated that decreasing use would reduce cost, increase the number of available beds and decrease alarm fatigue. The issue was further prioritized by the problems caused when emergency department or intensive care unit patients could not be moved due to lack of a telemetry unit. The team identified two critical factors: lack of standardized indications paired with the telemetry order and lack of a reliable mechanism for physicians to know their patients were still on telemetry.

Through both physician review of literature and active physician participation, improvements were made that resulted in a significant decrease in the number of hours patients remained on off-site telemetry, as well as a decrease in the total number of telemetry orders. The project's annualized expected savings exceeds $600,000 per year.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable.