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. 2015:2015:697149.
doi: 10.1155/2015/697149. Epub 2015 Sep 14.

Improving ECG Services at a Children's Hospital: Implementation of a Digital ECG System

Frank A Osei  1 , Gregory J Gates  1 , Steven J Choi  1 , Daphne T Hsu  1 , Robert H Pass  1 , Scott R Ceresnak  2
Affiliations

Improving ECG Services at a Children's Hospital: Implementation of a Digital ECG System

Frank A Osei et al. Int J Pediatr. 2015.

Abstract

Background. The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children's hospital. Methods. As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children's Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared via t-tests. Results. The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p < 0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p < 0.001). Conclusion. Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported.

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Figures

Figure 1
Figure 1
ECG workflow in the predigital versus digital eras.
Figure 2
Figure 2
A copy of a faxed ECG.
Figure 3
Figure 3
A copy of ECG acquired during the digital era.
Figure 4
Figure 4
Total number of ECGs read over the study period. This quality control chart demonstrates the marked increase in the volume of ECGs that were interpreted with the implementation of digital ECG services in June 2012 (x—number of ECGs, x-bar—mean, LCL—lower control limit, and UCL—upper control limit).
Figure 5
Figure 5
Hospital inpatient and outpatient volumes during the study period. These figures demonstrate that while the total number of ECGs interpreted after the introduction of the digital ECG system markedly increased, there was no significant increase in total hospital admissions (a), total ambulatory visits (b), or inpatient pediatric cardiology volume (c) that could have accounted for that increase.
Figure 6
Figure 6
Fishbone diagram of factors affecting ECG workflow.
Figure 7
Figure 7
A photograph of a smartphone demonstrating a digital ECG.
See this image and copyright information in PMC

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