Date of Doctor of Nursing Practice Project Completion

2026

Faculty Advisor

Lisa Thomas, DNP

Abstract

Improving Remote Monitoring Compliance for Pediatric and Adult Congenital Electrophysiology Patients with Cardiac Implantable Electronic Devices (CIEDs)

Purpose

The purpose of this scholarly project was to implement a quality improvement (QI) project to improve patient safety by improving cardiac implantable electronic device remote monitoring (RM) which has traditionally failed to achieve published benchmarks.

 

Background

The project was implemented at a healthcare institution in Houston, Texas. The practice area includes pediatric and adult patients with cardiac implantable electronic devices (CIEDs) in an outpatient setting. Current compliance with 14-day post-implementation enrollment (44%) and ongoing compliance (60%) did not meet published benchmarks.

Methodology

This QI initiative used the Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) methodology to systematically identify workflow gaps, implement targeted interventions, and develop methods to sustain improvements in RM enrollment and compliance. This framework provided an approach to systematically improve practice. Interventions included increasing portal information, developing primary language templates, and auto-scheduling.

Results

Following implementation of the quality improvement intervention, enrollment in remote monitoring within 14 days after CIED implantation increased to 82%.

Overall adherence to remote monitoring also increased from 60% pre-implementation to 87% post-implementation on a caseload of 226 patients.

Implications

Significant gains were realized in both initial and ongoing CIED compliance through the implementation of standardized tools and processes.

Key interventions, including automated scheduling and patient portal document uploads, were particularly effective in improving compliance outcomes. Although sustaining these improvements can be challenging, continued clinician engagement and ongoing optimization of wireless monitoring technologies have proven effective.

Keywords

cardiac implantable electronic device, remote monitoring, congenital heart disease

Meliones blank_SIGNED_N7304_TMC_Abstract_Consent__Authorization_Form_for_Deposit_of_Student_QI_Project.pdf (297 kB)
Improving Remote Monitoring Compliance for Pediatric and Adult Congenital Electrophysiology Patients with Cardiac Implantable Electronic Devices (CIEDs)

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