What does this research mean for the field?

A multimodal quality improvement initiative combining workflow modifications and resident education significantly reduces non-ICU telemetry ordering. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate whether a multimodal quality improvement initiative decreases guideline-discordant continuous cardiac telemetry orders in hospitalized non-ICU patients.

September 19, 2026JACC Case ReportsOpen Access

Multimodal QI initiative reduces non-ICU telemetry orders via workflow modifications and resident education.

Q: What is the clinical evidence from this study?

Study design: Other. Population: Non-ICU telemetry overutilization. Intervention: Multimodal quality improvement initiative vs. Preintervention period. Primary outcome: Reduction in telemetry orders per resident.

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Why the study?

Continuous cardiac telemetry is frequently overutilized in hospitalized non-intensive care unit patients beyond guideline-supported indications, leading to alarm fatigue, resource strain, and increased costs.

Does a multimodal quality improvement initiative reduce non-ICU telemetry ordering by residents?

Population

Hospitalized non-intensive care unit patients at a community hospital

Comparison

16 weeks of preintervention data vs 16 weeks of postintervention data

Design

Quasi-experimental before-and-after study

Follow-up

16 weeks

Key result

A multimodal quality improvement initiative including workflow modifications and resident education significantly reduced non-intensive care unit telemetry ordering.

Authors

TJTaysir Al Janabi JAJack Anderson MAMoataz Ali

Discussion

Member takes

Overview

May support reduced low-value telemetry in non-ICU settings; leaves open generalizability and durability across institutions.

Key Points

To evaluate whether a multimodal quality improvement initiative decreases guideline-discordant continuous cardiac telemetry orders in hospitalized non-ICU patients.
Quasi-experimental before-and-after study at a community hospital comparing 16 weeks of preintervention data with 16 weeks of postintervention data.
Implemented four concurrent interventions: default order expiration at noon on hospital day 2, resident education on American Heart Association indications, an electronic medical record telemetry indicator, and pocket reference cards.
Assessed the primary outcome of telemetry orders per resident using the Wilcoxon signed-rank test.
The multimodal intervention produced a statistically significant reduction in continuous cardiac telemetry orders placed per resident physician.
Combining electronic order expiration defaults with targeted clinician education provided a low-cost, reproducible, and sustainable reduction in low-value cardiac monitoring.

Structured PICO

Does a multimodal quality improvement initiative reduce non-ICU telemetry ordering by residents?

Population

Hospitalized non-intensive care unit patients at a community hospital

Intervention

Multimodal quality improvement intervention including changing telemetry order expiration to noon on hospital day 2, targeted resident education regarding American Heart Association telemetry indications, implementation of a visible telemetry indicator within the electronic medical record, and distribution of pocket reference cards

Comparator

16 weeks of preintervention data (standard practice before the quality improvement initiative)

Outcome

Reduction in telemetry orders per resident

A multimodal quality improvement initiative including workflow modifications and resident education significantly reduces unnecessary non-ICU telemetry ordering.

Cite This Study

Janabi et al. (2026) studied Non-ICU telemetry overutilization. Multimodal quality improvement initiative vs. Preintervention period was evaluated on Reduction in telemetry orders per resident. A multimodal quality improvement initiative including workflow modifications and resident education significantly reduced non-intensive care unit telemetry ordering.

synapsesocial.com/papers/6aae47640c69660b71ecc649 https://doi.org/10.1016/j.jaccas.2026.109232

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September 19, 2026JACC Case ReportsOpen Access

Multimodal QI initiative reduces non-ICU telemetry orders via workflow modifications and resident education.

View Full Paper

Ask AI

Bookmark

Why the study?

Does a multimodal quality improvement initiative reduce non-ICU telemetry ordering by residents?

Population

Hospitalized non-intensive care unit patients at a community hospital

Comparison

16 weeks of preintervention data vs 16 weeks of postintervention data

Design

Quasi-experimental before-and-after study

Follow-up

16 weeks

Key result

A multimodal quality improvement initiative including workflow modifications and resident education significantly reduced non-intensive care unit telemetry ordering.

Authors

TJTaysir Al Janabi JAJack Anderson MAMoataz Ali

Discussion

Member takes

Overview

May support reduced low-value telemetry in non-ICU settings; leaves open generalizability and durability across institutions.

Key Points

To evaluate whether a multimodal quality improvement initiative decreases guideline-discordant continuous cardiac telemetry orders in hospitalized non-ICU patients.
Quasi-experimental before-and-after study at a community hospital comparing 16 weeks of preintervention data with 16 weeks of postintervention data.
Implemented four concurrent interventions: default order expiration at noon on hospital day 2, resident education on American Heart Association indications, an electronic medical record telemetry indicator, and pocket reference cards.
Assessed the primary outcome of telemetry orders per resident using the Wilcoxon signed-rank test.
The multimodal intervention produced a statistically significant reduction in continuous cardiac telemetry orders placed per resident physician.
Combining electronic order expiration defaults with targeted clinician education provided a low-cost, reproducible, and sustainable reduction in low-value cardiac monitoring.

Structured PICO

Does a multimodal quality improvement initiative reduce non-ICU telemetry ordering by residents?

Population

Hospitalized non-intensive care unit patients at a community hospital

Intervention

Comparator

16 weeks of preintervention data (standard practice before the quality improvement initiative)

Outcome

Reduction in telemetry orders per resident

A multimodal quality improvement initiative including workflow modifications and resident education significantly reduces unnecessary non-ICU telemetry ordering.

Cite This Study

synapsesocial.com/papers/6aae47640c69660b71ecc649 https://doi.org/10.1016/j.jaccas.2026.109232

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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