Step-down units and telemetry monitoring: optimizing utilization.

In this article, we address the issue of patient-flow problems in the hospital, which often occur because of improper utilization of step-down (intermediate care) unit resources. Utilization is often adversely affected by the inappropriate use of telemetry monitoring (traditionally offered in step-down units) as a rationale for placing patients in step-down areas, even when they would benefit from other types of monitoring or just the proper level of nursing care. We also discuss the other types of patient monitoring available, as well as other monitoring issues (see "Communicating Alarm Event").