Abstract
In the absence of appropriate tools, efficient teamwork, and clinician skills, cardiac monitoring has no therapeutic value (New South Wales Agency for Clinical Innovation, 2022). This initially shocking notion speaks to vital aspects of cardiac monitoring—underlying clinical necessity, early recognition and intervention in response to clinical changes, and alarm mitigation to avoid alarm fatigue. As healthcare context and technology become increasingly complex, reliance on the skill of individual clinicians is inadequate and unreliable for maximizing patient safety and well-being and for achieving optimal outcomes (McLaney et al., 2022). This presentation describes how one hospital group leveraged teamwork excellence and cutting-edge technology to transform cardiac monitoring in clinical practice. Through processes identified as strengthening best practice and interprofessional collaboration (Sunnybrook Health Sciences Centre, n.d.), our interprofessional team developed a system for patient-centered cardiac care (Charosaei et al., 2021) that strengthened patient safety and aligned with national patient safety goals and standards.
Telemetry (Svec at al., 2015) and communication and escalation algorithms (Ruskin & Hueske-Kraus, 2015) are integral to patient safety. Ergonomics and undistracted monitoring are critical for involved teams. In planning, we selected core system components: avoidance of manual admission processes that might yield mismatches between patients and monitor data; readily available algorithm display for early intervention and appropriate patient support; and elimination of nonactionable alarms, a problem well-recognized to interfere with patient safety and with staff engagement (Engel et al., 2022). The system’s architectural design with its included alarm communications was planned in tandem with the architecture of the surrounding physical space. We even integrated stand-up desks that would support staff member attention to monitor displays. Our goal was implementing an integrated solution that supported patient safety, gained efficiencies, and sustained all of our bedside teams in delivering high quality patient care.
Interdisciplinary team members met weekly to update project status, determine appropriate measures and counter measures, and define a comprehensive to-do list. Recognizing the importance of leadership style to the overall quality of care (Sfantou et al., 2017), we incorporated front- line staff and top-level administrators in deliberations, working with external vendors to review to vet an appropriate ‘Solution Design.’ Simultaneously, through adherence to our high reliability model, we aligned best practice strategies to complement and advance our educational practices.
In response to real-time contextual demands and interprofessional mortality review data, we incorporated continuous pulse oximetry in response to oxygenation threats imposed by COVID. We shared our progress regularly through our daily patient safety action group. Through it all, we benchmarked our activities and our planned physical layout against those of other institutions and in light of published evidence to ensure that our work was optimal. The process took two-and-a-half-years.
Our centralized monitoring unit went live twenty-four hours a day, seven days a week in September 2023. By leveraging teamwork and technology, we have hardwired increased accountability, improved performance, and reliability of our system, all identified as components vital not only to excellence in cardiac care but to staff members’ sense of psychological safety as well.
Notes
Reference list included in attached slide deck.
Sigma Membership
Mu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Teamwork in the Workplace, Interprofessional Relations, Clinical Competence, Remote Patient Monitoring, Medical Technology, Cardiac Monitoring, Cardiac Care
Recommended Citation
Ash, Jenifer; Ficara, Cheryl; Montano, Anna-Rae; Bailey, Laura; and Dzurec, Laura, "Hardwiring Best Practice: Leveraging Teamwork and Technology for Clinical Transformation" (2026). Creating Healthy Work Environments (CHWE). 122.
https://www.sigmarepository.org/chwe/2024/presentations_2024/122
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-03-12
Hardwiring Best Practice: Leveraging Teamwork and Technology for Clinical Transformation
Washington, DC, USA
In the absence of appropriate tools, efficient teamwork, and clinician skills, cardiac monitoring has no therapeutic value (New South Wales Agency for Clinical Innovation, 2022). This initially shocking notion speaks to vital aspects of cardiac monitoring—underlying clinical necessity, early recognition and intervention in response to clinical changes, and alarm mitigation to avoid alarm fatigue. As healthcare context and technology become increasingly complex, reliance on the skill of individual clinicians is inadequate and unreliable for maximizing patient safety and well-being and for achieving optimal outcomes (McLaney et al., 2022). This presentation describes how one hospital group leveraged teamwork excellence and cutting-edge technology to transform cardiac monitoring in clinical practice. Through processes identified as strengthening best practice and interprofessional collaboration (Sunnybrook Health Sciences Centre, n.d.), our interprofessional team developed a system for patient-centered cardiac care (Charosaei et al., 2021) that strengthened patient safety and aligned with national patient safety goals and standards.
Telemetry (Svec at al., 2015) and communication and escalation algorithms (Ruskin & Hueske-Kraus, 2015) are integral to patient safety. Ergonomics and undistracted monitoring are critical for involved teams. In planning, we selected core system components: avoidance of manual admission processes that might yield mismatches between patients and monitor data; readily available algorithm display for early intervention and appropriate patient support; and elimination of nonactionable alarms, a problem well-recognized to interfere with patient safety and with staff engagement (Engel et al., 2022). The system’s architectural design with its included alarm communications was planned in tandem with the architecture of the surrounding physical space. We even integrated stand-up desks that would support staff member attention to monitor displays. Our goal was implementing an integrated solution that supported patient safety, gained efficiencies, and sustained all of our bedside teams in delivering high quality patient care.
Interdisciplinary team members met weekly to update project status, determine appropriate measures and counter measures, and define a comprehensive to-do list. Recognizing the importance of leadership style to the overall quality of care (Sfantou et al., 2017), we incorporated front- line staff and top-level administrators in deliberations, working with external vendors to review to vet an appropriate ‘Solution Design.’ Simultaneously, through adherence to our high reliability model, we aligned best practice strategies to complement and advance our educational practices.
In response to real-time contextual demands and interprofessional mortality review data, we incorporated continuous pulse oximetry in response to oxygenation threats imposed by COVID. We shared our progress regularly through our daily patient safety action group. Through it all, we benchmarked our activities and our planned physical layout against those of other institutions and in light of published evidence to ensure that our work was optimal. The process took two-and-a-half-years.
Our centralized monitoring unit went live twenty-four hours a day, seven days a week in September 2023. By leveraging teamwork and technology, we have hardwired increased accountability, improved performance, and reliability of our system, all identified as components vital not only to excellence in cardiac care but to staff members’ sense of psychological safety as well.
Description
By leveraging teamwork and technology, our interprofessional team hardwired increased accountability, improved performance, and reliability into our cardiac monitoring system. Through this two-and-a-half-year process, we promoted not only excellence in cardiac care but also staff members’ sense of psychological safety as we aligned best practice strategies.