title: Communication strategies and timeliness of response to life critical telemetry alarms.
abstract: BACKGROUND
  A centralized electrocardiogram telemetry monitoring system (TMS) facilitates early identification of critical arrhythmias and acute medical decompensation. Timely intervention can only be performed if abnormalities are communicated rapidly to the direct caregiver. The study objectives were to measure effectiveness of bi-directional voice communication badges versus one-way alphanumeric pagers for telemetry alarm response and communication loop closure.
  
  
  METHODS
  A sequential observational pilot study of nursing response to TMS alarms compared communication technologies on four nursing units in a 1,061 bed tertiary care hospital with 264 TMS channels of telemetry over a 2-year period. Subsequently, the communication technologies were compared in a randomized fashion on a 68-bed progressive cardiac care unit. Caregivers were blinded to the protocol. All alarm responses were recorded during two periods using either pagers or voice communication devices. Alarm response time and closure of the communication loop were analyzed in a blinded fashion.
  
  
  RESULTS
  The direct communication functionality of the badge significantly shortened the time to first contact, time to completion, and rate of closure of the communication loop in both the pilot and study phases. Median time to first contact with the communication badge was 0.5  min, compared to 1.6  min with pager communication (p < 0.0003). Communication loop closure was achieved in 100% of clinical alarms using the badge versus 19% with the pager (p < 0.0001).
  
  
  CONCLUSIONS
  Communication badge technology reduced alarm time to first contact and completion as well as facilitated communication loop closures. Immediate two-way communication significantly impacted practice, alarm management, and resulted in faster bedside care.
authors: Department of Cardiovascular Medicine, Beaumont Hospital, OUWB School of Medicine, Royal Oak, Michigan 48073, USA.
authors: Kimberly A
authors: KA
authors: Bonzheim
authors: Rani I
authors: RI
authors: Gebara
authors: Bridget M
authors: BM
authors: O'Hare
authors: R Darin
authors: RD
authors: Ellis
authors: Monique A
authors: MA
authors: Brand
authors: Salil D
authors: SD
authors: Balar
authors: Rita
authors: R
authors: Stockman
authors: Annette M
authors: AM
authors: Sciberras
authors: David E
authors: DE
authors: Haines
mesh_terms: D056902:Clinical Alarms / Q000706:statistics & numerical data*; D003142:Communication; D003625:Data Collection; D004562:Electrocardiography; D006747:Hospital Communication Systems / Q000706:statistics & numerical data*; D006801:Humans; D010865:Pilot Projects; D011446:Prospective Studies; D012306:Risk; D018709:Statistics, Nonparametric; D017216:Telemedicine / Q000379:methods / Q000706:statistics & numerical data*; D013686:Telemetry / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D013997:Time Factors