Featured Publications
Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice
Wong AH, Ray JM, Eixenberger C, Crispino LJ, Parker JB, Rosenberg A, Robinson L, McVaney C, Iennaco JD, Bernstein SL, Yonkers KA, Pavlo AJ. Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice. BMJ Open 2022, 12: e059876. PMID: 35545394, PMCID: PMC9096567, DOI: 10.1136/bmjopen-2021-059876.Peer-Reviewed Original ResearchConceptsEmergency departmentAgitation eventsQualitative studyEmergency careQualitative studies of patients' experiencesPhysical restraintStudies of patients' experiencesAvoidance of physical restraintSystem of healthcare deliveryPhysical restraint useEmergency care networkCommunity-based teaching hospitalSystems-based practiceTertiary care academic centreInterviews of patientsVerbal de-escalationGrounded theory approachPatient-oriented strategiesExposure to psychological traumaExcessive psychomotor activityCare approachSocioeconomic inequalitiesPatient experienceRestraint useCare networkRacial and Ethnic Disparities in Physical Restraint Use for Pediatric Patients in the Emergency Department
Nash KA, Tolliver DG, Taylor RA, Calhoun AJ, Auerbach MA, Venkatesh AK, Wong AH. Racial and Ethnic Disparities in Physical Restraint Use for Pediatric Patients in the Emergency Department. JAMA Pediatrics 2021, 175: 1283-1285. PMID: 34515764, PMCID: PMC8438617, DOI: 10.1001/jamapediatrics.2021.3348.Peer-Reviewed Original ResearchDisparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department
Haimovich A, Taylor R, Chang-Sing E, Brashear T, Cramer L, Lopez K, Wong A. Disparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 100-107. PMID: 37269262, PMCID: PMC10689576, DOI: 10.1016/j.annemergmed.2023.04.004.Peer-Reviewed Original ResearchConceptsHealth care systemEmergency departmentPatient-level analysisCare systemED visitsLeft-without-being-seenNegative perceptions of patientsElectronic health record dataUnited States health care systemRegional health care systemStates health care systemDiscontinuity of careHealth record dataElectronic health recordsBlack non-Hispanic patientsPerceptions of patientsBlack non-HispanicRetrospective cross-sectional study of adult patientsAdult emergency departmentNon-Hispanic patientsCross-sectional study of adult patientsMixed-effects regression analysisStudy periodRetrospective cross-sectional studyCare deliveryRacial Inequities in Police Transport for Patients to the Emergency Department: A Multicenter Analysis
Gagliardi J, Smith C, Chang-Sing E, Cramer L, Robinson L, Shah D, Jivalagian P, Turner N, Wong A. Racial Inequities in Police Transport for Patients to the Emergency Department: A Multicenter Analysis. American Journal Of Preventive Medicine 2023, 66: 154-158. PMID: 37661074, PMCID: PMC10842350, DOI: 10.1016/j.amepre.2023.08.018.Peer-Reviewed Original ResearchConceptsEmergency medical careEmergency departmentPolice transportMedical careRacial inequalityElectronic health recordsAdult emergency department visitsRegional hospital systemBehavioral health diagnosesEmergency department visitsAssociated with increased oddsAdult emergency department (ED) visitsCross-sectional studyDrivers of inequalityInfluences clinical outcomeVisit characteristicsHealth recordsDifferent emergency departmentsDepartment visitsMultivariable mixed modelsSubstance use disordersHealth diagnosisHospital systemPatient transportMultivariate mixed models
2024
Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study
Fults E, Gerwin J, Boyce M, Joseph M, Wong A, Evans L. Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study. BMC Medical Education 2024, 24: 1055. PMID: 39334215, PMCID: PMC11429862, DOI: 10.1186/s12909-024-05972-4.Peer-Reviewed Original ResearchConceptsEmergency medicine resident physiciansResident physiciansQualitative studyEmergency departmentResident physicians' experiencesEmergency medicine facultyCOVID-19 pandemicResident physician trainingResidency program leadershipSocial support systemsBackgroundThe COVID-19 pandemicData saturationPhysician trainingCode teamFrontline physiciansPractice styleUrban academic institutionProgram leadershipPhysician experienceMedicine facultyResident experiencePersonal impactPhysiciansMoral injuryResident preparationRacial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department
Jivalagian P, Gettel C, Smith C, Robinson L, Brinker M, Shah D, Kumar A, Faustino I, Nath B, Chang-Sing E, Taylor R, Kennedy M, Hwang U, Wong A. Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department. American Journal Of Geriatric Psychiatry 2024 PMID: 39054237, DOI: 10.1016/j.jagp.2024.07.004.Peer-Reviewed Original ResearchPhysical restraint useRestraint useOlder adultsED visitsPhysical restraintEmergency departmentElectronic health record dataHealth record dataBlack non-HispanicPatient-level characteristicsAge-related disparitiesAssociated with increased useRegional hospital networkCross-sectional studyLogistic regression modelsChemical sedationRetrospective cross-sectional studyNon-Hispanic groupNon-HispanicAgitation managementHospital sitesHospital networkRecord dataWhite non-Hispanic groupPrimary outcomeFormative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physiciansRacial and Ethnic Disparities in Patient Restraint in Emergency Departments by Police Transport Status
Chang-Sing E, Smith C, Gagliardi J, Cramer L, Robinson L, Shah D, Brinker M, Jivalagian P, Hu Y, Turner N, Wong A. Racial and Ethnic Disparities in Patient Restraint in Emergency Departments by Police Transport Status. JAMA Network Open 2024, 7: e240098. PMID: 38381433, PMCID: PMC10882414, DOI: 10.1001/jamanetworkopen.2024.0098.Peer-Reviewed Original ResearchConceptsED visitsPolice transportCross-sectional studyEmergency departmentPhysical restraintBlack patientsBlack raceWhite patientsCross-sectional study of ED visitsIncreased oddsElectronic health record dataStudy of ED visitsHealth record dataEmergency carePoliceEthnic disparitiesVisit diagnosesMental healthMain OutcomesHigher oddsPatient restraintBehavioral crisesHispanic patientsBlack individualsRecord data
2023
A Qualitative Study of Racial, Ethnic, and Cultural Experiences of Minority Clinicians During Agitation Care in the Emergency Department
Agboola I, Rosenberg A, Robinson L, Brashear T, Eixenberger C, Shah D, Pavlo A, Im D, Ray J, Coupet E, Wong A. A Qualitative Study of Racial, Ethnic, and Cultural Experiences of Minority Clinicians During Agitation Care in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 108-119. PMID: 37855791, PMCID: PMC10843036, DOI: 10.1016/j.annemergmed.2023.09.014.Peer-Reviewed Original ResearchConceptsEmergency departmentPatients of colorED cliniciansQuaternary care medical centerSemistructured individual interviewsMarginalized patient populationsManagement of agitationEthnic minority groupsEmergency careMinority patientsHealth careAgitation managementIndividual interviewsThematic analysisPrimary themesQualitative studyKey themesClinical interactionsOpen codingGroup discussionsMoral injuryCareMedical CenterAgitated patientsMinority groupsCharacterizing Racial Disparities in Emergency Department Pediatric Physical Restraint by Sex and Age
Tolliver D, Markowitz M, Obiakor K, Wong A, Cramer L, Robinson L, Nash K. Characterizing Racial Disparities in Emergency Department Pediatric Physical Restraint by Sex and Age. JAMA Pediatrics 2023, 177: 972-975. PMID: 37459087, PMCID: PMC10352924, DOI: 10.1001/jamapediatrics.2023.2300.Peer-Reviewed Original Research
2022
A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department
Wong AH, Sabounchi NS, Roncallo HR, Ray JM, Heckmann R. A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Services Research 2022, 22: 75. PMID: 35033071, PMCID: PMC8760708, DOI: 10.1186/s12913-022-07472-x.Peer-Reviewed Original ResearchConceptsExperience of workplace violenceClinician burnoutWorkplace violenceIncreased perceptions of safetyPhysical restraintPerceptions of safetyClinician stressWorkplace assaultsAgitated patientsEmergency departmentEffects of workplace violenceUse of restraintsQualitative system dynamics methodsModel building sessionsSymptoms of burnoutIncreased perceptionInterprofessional panelClinician stakeholdersResultsThe final modelRisk of assaultImpact future decisionsPatient safetyEpisodes of agitationAgitation managementClinician experience
2021
Design and Implementation of an Agitation Code Response Team in the Emergency Department
Wong AH, Ray JM, Cramer LD, Brashear TK, Eixenberger C, McVaney C, Haggan J, Sevilla M, Costa DS, Parwani V, Ulrich A, Dziura JD, Bernstein SL, Venkatesh AK. Design and Implementation of an Agitation Code Response Team in the Emergency Department. Annals Of Emergency Medicine 2021, 79: 453-464. PMID: 34863528, PMCID: PMC9038629, DOI: 10.1016/j.annemergmed.2021.10.013.Peer-Reviewed Original ResearchConceptsResponse team interventionPhysical restraint useInterrupted time series analysisRestraint useEmergency departmentTeam interventionRates of physical restraint useTeam-based interventionAdministrative supportQuality improvement studyResponse teamBehavioral health systemManagement of agitated patientsInterprofessional collaborationRestraint ordersExcessive psychomotor activityRestraint ratesHealth systemED visitsImprovement studyPhysical restraintCompare trendsPrimary outcomeTime series analysisAgitated patientsImproving Safety and Quality During Interhospital Transfer of Patients With Nontraumatic Intracranial Hemorrhage: A Simulation-Based Pilot Program
Ray JM, Wong AH, Finn EB, Sheth KN, Matouk CC, Sudikoff SN, Auerbach MA, Sather JE, Venkatesh AK. Improving Safety and Quality During Interhospital Transfer of Patients With Nontraumatic Intracranial Hemorrhage: A Simulation-Based Pilot Program. Journal Of Patient Safety 2021, 18: 77-87. PMID: 33852541, DOI: 10.1097/pts.0000000000000808.Peer-Reviewed Original ResearchConceptsInterhospital transferNontraumatic intracranial hemorrhageThematic analysisRates of interhospital transfersQuality improvement initiativesQuality improvement strategiesInterhospital transfer of patientsTransfer of patientsCare handoffsCenter staff membersData saturationComplex handoffsImprovement initiativesInterprofessional debriefingFocus groupsEmergency physiciansQualitative studyEmergency departmentQuality improvementIll populationStaff membersTertiary care centerCare centerCommunication ChecklistSpecialized neurocritical care
2020
Addressing Workplace Safety in the Emergency Department: A Multi-Institutional Qualitative Investigation of Health Worker Assault Experiences.
Vrablik MC, Lawrence M, Ray JM, Moore M, Wong AH. Addressing Workplace Safety in the Emergency Department: A Multi-Institutional Qualitative Investigation of Health Worker Assault Experiences. Journal Of Occupational And Environmental Medicine 2020, 62: 1019-1028. PMID: 32991380, DOI: 10.1097/jom.0000000000002031.Peer-Reviewed Original ResearchConceptsWorkplace violenceEmergency departmentGeographically distinct institutionsHealth workersPatient assaultsThematic analysisHealthcare systemPotential interventionsEmergency preparednessPhases of preparednessIdentified conceptsHealthQualitative investigationInterventionInterconnected influencesSustained impactWorkplace safetyWorkplacePreparednessAssault experiencesComprehensive approachIndividual workersDepartmentRecovery phaseWorkersAn Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation
Roncallo HR, Ray JM, Kulacz RC, Yang TJ, Chmura C, Evans LV, Wong AH. An Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation. The Joint Commission Journal On Quality And Patient Safety 2020, 46: 640-649. PMID: 32919910, PMCID: PMC7606488, DOI: 10.1016/j.jcjq.2020.08.005.Peer-Reviewed Original ResearchConceptsCritical care rolesCaring roleEmergency departmentNovice nursesOrientation programResident physiciansInterprofessional simulation programHealthcare (DASHInterprofessional education teamsHigh-functioning teamsQualitative evaluation dataGroups of resident physiciansNurse participantsED nursesInterprofessional simulationProgram's long-term impactDebriefing AssessmentHealth workersTeam trainingNurse learnersNursesPatient careParticipant feedbackEmergency physiciansOrientation session