CHANGE IS HARD for everyone, but it may be particularly difficult for many physicians.
In our cover story, we look at the use—or overuse—of telemetry in inpatients. Reducing unnecessary telemetry has been a goal of several organizations for some time; the Society of Hospital Medicine identified it five years ago as a Choosing Wisely goal. But physicians continue to have a hard time quitting.
Why is telemetry so overused? For one, it can be really easy to order. And some physicians continue to think that patients are somehow better cared for with telemetry because they’re being closely monitored. The reality, though, is that telemetry patients may actually receive less monitoring for things like basic vital signs and respiratory measures.
Our coverage looks at how hospitalists are trying to wean their colleagues from inappropriate telemetry services, but there may a bigger issue with trying to change physician behavior. After all, the Choosing Wisely Web site lists close to 600 treatments, tests and procedures that clinicians really shouldn’t use, but apparently continue to.
Perhaps part of the problem is that evidence for high-profile recommendations seems to change all the time. That may erode physicians’ confidence in all recommendations, including those to reduce the use of telemetry services.
At the same time, doctors are turning to local data to help their colleagues become more comfortable with less telemetry. They’re tracking the impact of interventions being put in place to make sure more patients don’t need rapid responses or transfers to the ICU.
The good news: The hospitalists we talked to are having some success. But they still face the daunting task of overcoming physician attitudes.
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