Multitasking and the technical quality of the electrocardiogram

Abstract

Background: The electrocardiogram (ECG) is a powerful clinical tool for diagnosing cardiac abnormalities. Proper ECG data acquisition is essential because it allows physicians to interpret ECG results accurately and efficiently. This is especially important for patients with acute myocardial infarction, so that they can receive early treatment. As a result of multitasking, ECGs are acquired by two groups of personnel at the University of Alberta Hospital, Edmonton - ECG technologists and non-ECG technologists.

Objective: To evaluate the effectiveness and quality of ECG acquisition at the University of Alberta Hospital site.

Methods: All adult ECGs acquired at the University of Alberta Hospital site from January 1 to June 30, 2000 were assessed. An ECG was classified as unacceptable if it lacked demographics identifying the patient, and/or it was of such poor technical quality that the interpretation was compromised.

Results: Of 25,509 ECGs acquired during this period, 13,849 (54%) and 11,660 (46%) ECGs were acquired by ECG technologists and non-ECG technologists, respectively. Eleven ECGs (0.08%) acquired by the ECG technologists and 3683 ECGs (32%) acquired by the non-ECG technologists were of unacceptable quality. The technical cost spent on these unacceptable ECGs is approximately $100,000 a year at this institution.

Conclusions: Multitasking has resulted in a high rate of unacceptable ECGs. There is a significant difference in the effectiveness and quality of ECG acquisition performed by ECG technologists and non-ECG technologists. Poorly acquired ECGs impede proper diagnosis for patients, subject the institution to potential medical legal consequences and add an unnecessary burden to the health care budget.