2023
Correlations among common emergency medicine physician performance measures: Mixed messages or balancing forces?
Scofi J, Underriner E, Sangal R, Rothenberg C, Patel A, Pickens A, Sather J, Parwani V, Ulrich A, Venkatesh A. Correlations among common emergency medicine physician performance measures: Mixed messages or balancing forces? The American Journal Of Emergency Medicine 2023, 72: 58-63. PMID: 37481955, DOI: 10.1016/j.ajem.2023.07.021.Peer-Reviewed Original ResearchSociodemographic Disparities in Queue Jumping for Emergency Department Care
Sangal R, Su H, Khidir H, Parwani V, Liebhardt B, Pinker E, Meng L, Venkatesh A, Ulrich A. Sociodemographic Disparities in Queue Jumping for Emergency Department Care. JAMA Network Open 2023, 6: e2326338. PMID: 37505495, PMCID: PMC10383013, DOI: 10.1001/jamanetworkopen.2023.26338.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesEmergency Medical ServicesEmergency Service, HospitalFemaleHumansMaleMedicareMiddle AgedRetrospective StudiesUnited StatesConceptsCross-sectional studyHigh acuityPatient demographicsSame acuityLatino ethnicityNon-Hispanic raceEmergency department careBed placementTime of triageNon-Hispanic blacksNon-Hispanic whitesED visitsPrimary outcomeED arrivalED patientsMedicaid insuranceMean ageTriage acuityStudy visitAcuity patientsSociodemographic disparitiesED outcomesHigher oddsMAIN OUTCOMECare access
2022
Patient cost consciousness in the emergency department
Gaylor JM, Chan E, Parwani V, Ulrich A, Rothenberg C, Venkatesh A. Patient cost consciousness in the emergency department. The American Journal Of Emergency Medicine 2022, 61: 61-63. PMID: 36054987, DOI: 10.1016/j.ajem.2022.08.039.Peer-Reviewed Original ResearchMeSH KeywordsConsciousnessEmergency Service, HospitalFees and ChargesHumansMedically UninsuredMedicareUnited StatesConceptsEmergency departmentPocket costsED patientsLarge academic hospital systemAcademic hospital systemCertain patient demographicsEmergency department settingPerceptions of patientsCost of careMedicare/MedicaidPatient demographicsED careUnscheduled careUninsured patientsDepartment settingPatients' estimatesPatient's abilityEmergency careHigh school educationPatientsPrivate insuranceFinal analysisHospital systemCareConvenience sampleEMS Non-Transport of Low-Risk COVID-19 Patients
Couturier K, Nelson AR, Burns K, Cone DC, Rollins M, Venkatesh AK, Ulrich A, Shapiro M, Joseph D. EMS Non-Transport of Low-Risk COVID-19 Patients. Prehospital Emergency Care 2022, 27: 310-314. PMID: 35639643, DOI: 10.1080/10903127.2022.2083278.Peer-Reviewed Original ResearchMeSH KeywordsChildCOVID-19Emergency Medical ServicesEmergency Service, HospitalHumansRetrospective StudiesTriageConceptsEMS cliniciansLow-risk COVID-19 patientsSuburban EMS systemLow-risk patientsED visit ratesEMS systemCOVID-19 patientsCOVID-19 infectionCOVID-19ED visitsRetrospective reviewEmergency departmentCOVID-19 casesProtocol violationsCommon reasonConnecticut OfficeHospital resourcesPatientsSmall studyVisit ratesVital signsHealth systemSymptomsReasonable adherenceCliniciansImplementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines
Sangal RB, Liu RB, Cole KO, Rothenberg C, Ulrich A, Rhodes D, Venkatesh AK. Implementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines. American Journal Of Medical Quality 2022, 37: 335-341. PMID: 35026785, PMCID: PMC9241559, DOI: 10.1097/jmq.0000000000000036.Peer-Reviewed Original ResearchMeSH KeywordsAspirinCOVID-19 Drug TreatmentCritical PathwaysDexamethasoneElectronic Health RecordsEmergency Service, HospitalHospitalsHumansPandemicsConceptsClinical pathwaySecondary outcomesCOVID-19 treatment guidelinesEmergency department cliniciansIntegrated clinical pathwayCOVID-19Electronic health recordsPrimary outcomeTreatment guidelinesClinician adherenceED cliniciansED patientsCare guidelinesTreatment recommendationsMedication administrationPatient outcomesPatient carePatientsCliniciansHealth systemHealth recordsOutcomesAdherenceAspirinCOVID-19 pandemic
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 ResearchMeSH KeywordsEmergency Service, HospitalHumansInterrupted Time Series AnalysisPsychomotor AgitationQuality ImprovementRestraint, PhysicalConceptsResponse 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 Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians
Scofi J, Parwani V, Rothenberg C, Patel A, Ravi S, Sevilla M, D'Onofrio G, Ulrich A, Venkatesh AK. Improving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians. Journal For Healthcare Quality 2021, 44: 69-77. PMID: 34570029, DOI: 10.1097/jhq.0000000000000329.Peer-Reviewed Original ResearchConceptsAdmission ratesEmergency department throughputEmergency physiciansMean timeUrban academic EDEmergency department physiciansMean admission rateLower admission ratesFirst study periodED physiciansAcademic EDDepartment physiciansPatient visitsPractice variationAdmissionPeer comparisonPhysiciansPhysician performanceStudy periodPatientsAcademic emergency physiciansReportAuditMinutesHoursUniversal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay
Sangal RB, Peaper DR, Rothenberg C, Landry ML, Sussman LS, Martinello RA, Ulrich A, Venkatesh AK. Universal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay. Annals Of Emergency Medicine 2021, 79: 182-186. PMID: 34756452, PMCID: PMC8424016, DOI: 10.1016/j.annemergmed.2021.09.005.Peer-Reviewed Original ResearchMeSH KeywordsCOVID-19COVID-19 TestingEmergency Service, HospitalHumansLength of StayPandemicsSARS-CoV-2United StatesConceptsSARS-CoV-2 testingUniversal SARS-CoV-2 testingEmergency department lengthAdmission lengthED admissionPositivity rateSARS-CoV-2 testAcademic health systemCOVID-19 prevalenceSecondary outcomesED lengthPrevention needsED boardingPatientsStayPositive casesClinical costsHealth systemAdmissionTesting policiesContainment effortsTestingPrevalenceTesting changesPositivitySimulating approaches to emergency department pandemic physician staffing during COVID-19.
Sangal RB, Venkatesh AK, Kinsman J, Dashevsky M, Scofi JE, Ulrich A. Simulating approaches to emergency department pandemic physician staffing during COVID-19. American Journal Of Disaster Medicine 2021, 16: 85-93. PMID: 34392521, DOI: 10.5055/ajdm.2021.0391.Peer-Reviewed Original ResearchConceptsEmergency departmentInfection rateStaffing modelsPercent infection rateCohort modelHigher infection rateInfectious disease outbreaksEmergency physiciansED staffAvailable physiciansThree-teamWeek 5Health systemEM physiciansPhysiciansAdequate staffingImmunityPhysician attritionCOVID-19CohortDisease outbreaksPandemicPandemic disasterWeeksLeadership communication, stress, and burnout among frontline emergency department staff amid the COVID-19 pandemic: A mixed methods approach
Sangal RB, Bray A, Reid E, Ulrich A, Liebhardt B, Venkatesh AK, King M. Leadership communication, stress, and burnout among frontline emergency department staff amid the COVID-19 pandemic: A mixed methods approach. Healthcare 2021, 9: 100577. PMID: 34411923, PMCID: PMC8361146, DOI: 10.1016/j.hjdsi.2021.100577.Peer-Reviewed Original ResearchDisparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakersCan metrics give physicians insight?
Bright E, Scofi J, Sangal RB, Rothenberg C, Kinsman J, Patel A, Parwani V, Sather J, Pickens A, Ulrich A, Venkatesh AK. Can metrics give physicians insight? The American Journal Of Emergency Medicine 2021, 55: 219-220. PMID: 34301446, DOI: 10.1016/j.ajem.2021.06.059.Peer-Reviewed Original ResearchBalancing quality and utilization: Emergency physician level correlation between 72 h returns, admission, and CT utilization rates
Parwani V, Thomas M, Rothenberg C, Ulrich A, Venkatesh A. Balancing quality and utilization: Emergency physician level correlation between 72 h returns, admission, and CT utilization rates. The American Journal Of Emergency Medicine 2021, 48: 365-366. PMID: 33597095, DOI: 10.1016/j.ajem.2021.01.078.Peer-Reviewed Original ResearchFailure Mode and Effect Analysis: Engineering Safer Neurocritical Care Transitions
Chilakamarri P, Finn EB, Sather J, Sheth KN, Matouk C, Parwani V, Ulrich A, Davis M, Pham L, Chaudhry SI, Venkatesh AK. Failure Mode and Effect Analysis: Engineering Safer Neurocritical Care Transitions. Neurocritical Care 2021, 35: 232-240. PMID: 33403581, PMCID: PMC8255326, DOI: 10.1007/s12028-020-01160-6.Peer-Reviewed Original ResearchMeSH KeywordsCommunicationEmergency Service, HospitalHumansPatient SafetyPatient TransferQuality ImprovementConceptsPatient safetyInter-hospital transferEmergency department throughputIntracerebral hemorrhageAcute careSubarachnoid hemorrhageNeurocritical careCare transitionsMulti-disciplinary teamPatient transferHemorrhageSignificant reductionInterventionCareHazard analysisOutcomesRiskSafetyMultiple providersSpecific use-case examplesEvidence of successPatientsStrokeMethodsWe
2020
The cost of waiting: Association of ED boarding with hospitalization costs
Baloescu C, Kinsman J, Ravi S, Parwani V, Sangal RB, Ulrich A, Venkatesh AK. The cost of waiting: Association of ED boarding with hospitalization costs. The American Journal Of Emergency Medicine 2020, 40: 169-172. PMID: 33272871, DOI: 10.1016/j.ajem.2020.10.058.Peer-Reviewed Original ResearchMeSH KeywordsAgedCross-Sectional StudiesEmergency Service, HospitalFemaleHospitalizationHumansLength of StayMaleMedicareUnited StatesWaiting ListsConceptsED boardingHospitalization costsED crowdingHospital spendingHospital care accessMultivariate linear regression analysisED patient volumeCost of careQuality of careEmergency department boardingCross-sectional analysisPublic health crisisED lengthEffective careCare accessHospital levelInpatient bedsED characteristicsLinear regression analysisPatient volumeCareMedicare spendingMultivariate regressionPatientsRegression analysisA Multimodal Intervention to Improve the Quality and Safety of Interhospital Care Transitions for Nontraumatic Intracerebral and Subarachnoid Hemorrhage
Sather J, Littauer R, Finn E, Matouk C, Sheth K, Parwani V, Pham L, Ulrich A, Rothenberg C, Venkatesh AK. A Multimodal Intervention to Improve the Quality and Safety of Interhospital Care Transitions for Nontraumatic Intracerebral and Subarachnoid Hemorrhage. The Joint Commission Journal On Quality And Patient Safety 2020, 47: 99-106. PMID: 33358659, DOI: 10.1016/j.jcjq.2020.10.003.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalHospitalizationHumansPatient TransferQuality ImprovementSubarachnoid HemorrhageConceptsInterhospital transferQuality improvement interventionsIntracerebral hemorrhageMultimodal interventionImprovement interventionsClinical practice guideline disseminationEmergency department timeNeurocritical care cliniciansMultimodal quality improvement interventionNontraumatic intracerebral hemorrhageTimeliness of careED boarding timeRegionalization of careChi-square testIHT processED lengthPostintervention outcomesCare cliniciansSubarachnoid hemorrhageCare transitionsAdmission ordersDepartment timeGuideline disseminationOutcome measuresStudy populationAssociation between patient-physician gender concordance and patient experience scores. Is there gender bias?
Chekijian S, Kinsman J, Taylor RA, Ravi S, Parwani V, Ulrich A, Venkatesh A, Agrawal P. Association between patient-physician gender concordance and patient experience scores. Is there gender bias? The American Journal Of Emergency Medicine 2020, 45: 476-482. PMID: 33069544, DOI: 10.1016/j.ajem.2020.09.090.Peer-Reviewed Original ResearchConceptsPatient satisfaction surveyFemale patientsProvider scoresOverall assessment scoreEmergency departmentPatient satisfactionPhysician genderPatient-physician gender concordanceFemale physiciansAssessment scoresGender concordancePatient satisfaction survey dataSatisfaction surveyEffect of patientFemale emergency physiciansPatient experience scoresLogistic regression modelsCross-sectional analysisElectronic health recordsPatients' oddsAdult patientsPatient genderEmergency physiciansLower oddsEmergency careClinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate
Peaper DR, Branson B, Parwani V, Ulrich A, Shapiro MJ, Clemons C, Campbell M, Owen M, Martinello RA, Landry ML. Clinical impact of rapid influenza PCR in the adult emergency department on patient management, ED length of stay, and nosocomial infection rate. Influenza And Other Respiratory Viruses 2020, 15: 254-261. PMID: 32851793, PMCID: PMC7902247, DOI: 10.1111/irv.12800.Peer-Reviewed Original ResearchMeSH KeywordsAdultCross InfectionEmergency Service, HospitalHumansInfluenza, HumanLength of StayPolymerase Chain ReactionConceptsEmergency departmentInfluenza PCRPatient managementClinical redesignED lengthInfluenza seasonED workflowPCR testingBed transfersAnti-influenza medicationsDiverse emergency departmentsHospital-acquired influenzaInfluenza-positive patientsHA influenzaNosocomial infection ratesDiagnosis of influenzaAdult emergency departmentAnti-viral therapyCommon presenting concernPost-intervention periodPre-post studyED LOSED patientsSignificant morbidityTherapeutic guidelinesAssociation between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system?
Lord K, Rothenberg C, Parwani V, Finn E, Khan A, Sather J, Ulrich A, Chaudhry S, Venkatesh A. Association between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system? The American Journal Of Emergency Medicine 2020, 45: 548-550. PMID: 32839053, DOI: 10.1016/j.ajem.2020.07.040.Peer-Reviewed Original ResearchStudy protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department
Wong AH, Ray JM, Auerbach MA, Venkatesh AK, McVaney C, Burness D, Chmura C, Saxa T, Sevilla M, Flood CT, Patel A, Whitfill T, Dziura JD, Yonkers KA, Ulrich A, Bernstein SL. Study protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department. BMJ Open 2020, 10: e036982. PMID: 32606062, PMCID: PMC7328814, DOI: 10.1136/bmjopen-2020-036982.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalEvaluation Studies as TopicFeasibility StudiesHealth Plan ImplementationHumansPatient Care TeamPilot ProjectsConceptsEmergency departmentRestraint useCode teamControlled interrupted time series designResponse interventionsRate of restraint useInterrupted time series designAcute care settingDe-escalation techniquesTime series designPeer-reviewed publicationsED staffIdentified teamworkPilot interventionCare settingsHealth systemPatient encountersAgitation managementHuman Investigation CommitteeWorkplace violenceEthical approvalStaff safetyPatient agitationReduce harmSeries design