An Article from Nancy Hiney, Cardiac Physiologist in Portlaoise Regional Hospital
How we worked around the Pandemic – Holter Monitor Service
As a smaller Regional Hospital, our workload as a department centres around non-invasive
diagnostic testing, our Holter monitoring service is a busy integral part of that provision.
With the restrictions imposed on reducing footfall into the hospital, we looked to novel
approaches to surmount this. Having heard of a ‘drive by monitoring’ service being initiated
in the UK, we decided to test it out for ourselves, to try and curb at least one growing waiting
We began by targeting patients under 70 (who were not cocooning), and who were requiring
Holter monitors only. A detailed but concise instruction sheet was accompanied by
illustrations and these were tested by some of our non-physiologist colleagues, to ensure they made sense. Finally, a video demonstration was recorded and made available from a generic departmental email, if required.
We rang the patients that were suitable, briefly explained the process, that they would drive
up to the front entrance of the hospital (which is conveniently where our department is
located) and call from their car at their appointed time. A package would then be brought out
to them by our HCA wearing appropriate PPE, the package contained the initialised Holter,
pre activated 10 minutes before hand, electrodes with some extras in case they were needed, a symptom diary to record time fitted and alcohol swaps for skin prep, along with a return envelope.
We had emphasised on the phone when booking the patient in, that it was essential the
monitor was returned at the same time the next day, by a using a drop box at the entrance or
calling from their car as they had done the previous day. We also checked the patients details before handing the package over to ensure it was the correct patient. The 3 day and 5 day monitors we found it more convenient to fit on a Friday.
Two months later, the initiative has been extremely successful. The turnaround time for
handing the monitors over is about two minutes. We have no issues with unreturned or late
returns (no later than a couple of hours anyway). Most importantly, out of over 85 monitors
fitted this way, only one recording was artefact.
The feedback has been wonderful, patients appreciate the limited exposure to hospital
environments and the speediness of the interaction with easy return and no car park fees or
Going forward, this might be one initiative we maintain, for some of our suitable patients.
Written by Nancy Hiney on behalf of Cardiac Diagnostics Department at the Regional Hospital Portlaoise