Frequent and interruptive telemetry decision support alerts (OPAs) caused confusion and workflow disruption. In 2024, 16 telemetry OPAs were modified to reduce alert frequency; however, five showed increased interruptions. Bed assignment delays were also observed due to mismatches between ED bed requests and ADT Level of Care orders. A telemetry subcommittee was established to review telemetry requirements and Level of Care selections. Key improvements included: Simplifying and standardizing Level of Care categories across bed placement and ADT workflows. Aligning ED bed placement orders with telemetry needs for accurate patient placement. Pairing telemetry orders with Admission/Transfer ADT orders to resolve disconnects between Level of Care, patient location, and telemetry status. These actions streamlined workflows, reduced unnecessary alerts, and improved coordination between ED, bed placement, and inpatient teams.