Centralized Telemetry Monitoring Station William Beaumont Hospital Royal Oak, Michigan

2. Centralized Telemetry Monitoring StationWilliam Beaumont Hospital Royal Oak, Michigan

3. About Beaumont… • WBH is a 969 bed, Level 1 Trauma Center. • Located in suburban Detroit, Michigan. • Recently recognized by the AARP as a “Top 10” Hospital in a study of the nation’s 50 leading metropolitan hospitals. • Centralized TMS was started in 1991 in an effort to reduce ambulance diversions by increasing the number of cardiac monitored beds.

4. Growth of TMS

5. Technician Responsibilities • Rate and Rhythm assessments are done every 2 hours and entered on a “flow sheet” • 1 hour scanning is done on every shift • Document rhythm and significant changes every shift. • Communicate significant rhythms to the nursing unit via. Alpha display Pager.

6. ASO policyAutomatic Stop Order • The order for TMS will expire at exactly 48 hours. • The technician can remove the transmitter from the patient at that time.

7. ASO policyAutomatic Stop Order • Significant notice is given to physicians to re-order TMS • An ASO sticker is placed in the chart 24 hours in advance which reminds physician of ASO time and asks for signature to re-order. • A notice will appear to the physician on the computer. • Physicians can directly place orders into the hospital computer system which will appear in a work queue in TMS.

8. Early ASO Policy • When TMS is at Critical Monitor Status (100% channel utilization) an early ASO policy takes effect. • Cardiology Nurse Clinicians are notified and a list of patients is compiled who meet the following criteria: • They have been monitored for 24 hours. • They have not had any level 1 alarms. • Their physician is notified and gives an order to discontinue TMS.

9. ASO Exceptions • Patients who have had a level 1 alarm within 24 hours. • Cardiovascular surgery patients

10. Monitoring of Progressive Units • TMS provides back up cardiac monitoring to all Medical and Cardiac progressive care units. • TMS communicates with progressive units via Alpha pager any Level 1 or Level 2 alarms. • Equipment issues are also communicated via pager (leads off , poor signal, or low battery).

11. Progressive Unit (WMTS)

12. Remote Station • Remote Viewing Station located in the nursing station • Nurses or Physicians can look at any patient on TMS from any remote station.

13. Remote Station

14. Communication • Display pagers are worn by RN’s on each floor TMS monitors. • Pager displays: • Priority of the page • Reason for the page • Room number of patient • Call back extension

15. TMS Pod • We currently have 4 pods • Pods 1,2 and 4 have the capacity to monitor 64 patients and Pod 3 has up to 72 patients

16. Upgrade to WMTS • WBH TMS department will be transitioning into the WMTS band in early 2003. • Reasons for the upgrade: • Protected WMTS band, reduced RF interference • Bi-directional communication (between transceiver and computer) • Improved transceiver • Age of our current system (between 7-11 yrs) • Future implementation of PDA • Increased networking capabilities (VHF limited to 200 channels)

17. What’s new for TMS at WBH • TMS is online at WBH • Written orders or Direct orders are place in the Hospital computer system (Ulticare) • Orders are displayed in a work queue for the technicians

18. TMS Status Report

19. Patients Scheduled for TMS