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Training Course Saved Knoxville Hospital $196,668

Across the spectrum of health care settings, the electrocardiogram (EKG) daily serves as an indispensable tool for the identification and diagnosis of many cardiac problems. Doctors and nurses also use 12 Lead EKGs to establish baseline cardiac data for patients without known problems.

For many years, precordial (chest) lead placement standards were ignored. Thus, information on the electrocardiogram was inaccurate. The following excerpt from the AHA’s “Recommendations for the Standardization and interpretation of the electrocardiogram” confirms this reality: “Variations in chest electrode placement in the 12 Lead electrocardiogram are a MAJOR CONCERN in interpretation of serial EKG changes.”

As an RN and educator in a 325-bed acute care medical facility, I was aware of several problems associated with 12 Lead EKGs. In January of 2006, I spearheaded a facility-wide study of 12 Lead EKGs. My goal over the two years that followed was to improve staff expertise and performance. If we wanted to cut down costs resulting from inaccurate lead placement, then we needed to improve our staff’s accuracy, artifact, EKG lead placement and lead reversal. 

After establishing baseline data, I developed goals, objectives and a four-hour course to educate staff.  Every month, all 12 leads done by staff were audited using the guidelines established for the study. At the end of two years, I had reviewed all the data collected from over 12,000 EKGs. The results were remarkable: from 2005 to 2007, my course and subsequent audits had saved the hospital $196,668.

Estimated lost revenue in 2007 was $51,984, as compared to $248,652 in 2005.

In 2008, I was honored with a Performance Excellence award “In Recognition of Improving the Care of Our Patients” for “Improving Electrocardiograms Facility Wide.”