Featured Publications
Association of a Geriatric Emergency Department Innovation Program With Cost Outcomes Among Medicare Beneficiaries
Hwang U, Dresden SM, Vargas-Torres C, Kang R, Garrido MM, Loo G, Sze J, Cruz D, Richardson LD, Adams J, Aldeen A, Baumlin KM, Courtney DM, Gravenor S, Grudzen CR, Nimo G, Zhu CW, Abraham G, Amoko C, Genes N, Morano B, Nassisi D, Ortiz J, Rivera-Reyes L, Sanon M, Shapiro J, Winkel G, Malik S, Rosenberg M, Christensen M, Karounos M, Schultz R, Sumberg D. Association of a Geriatric Emergency Department Innovation Program With Cost Outcomes Among Medicare Beneficiaries. JAMA Network Open 2021, 4: e2037334. PMID: 33646311, PMCID: PMC7921898, DOI: 10.1001/jamanetworkopen.2020.37334.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCost SavingsCross-Sectional StudiesEmergency Medical ServicesEmergency Service, HospitalFee-for-Service PlansGeriatric AssessmentHealth Services for the AgedHospital CostsHospitalsHumansMedicarePatient CareReferral and ConsultationSocial WorkTransitional CareUnited StatesConceptsTransitional care nursesFirst ED visitIndex ED visitED visitsMAIN OUTCOMEMedicare feeMedicare beneficiariesService beneficiariesEmergency department programComparison groupCross-sectional studyUnique Medicare beneficiariesLower Medicare expendituresMost patientsMean ageCare nursesVisit encountersCare programGeriatric treatmentCost outcomesPatient careMedicare expendituresHealth systemMean savingsPatients
2023
Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Hwang U, Runels T, Han L, Gruber E, McQuown C, Ragsdale L, Jetter E, Rossomano N, Javier D. Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Academic Emergency Medicine 2023, 30: 270-277. PMID: 36653961, DOI: 10.1111/acem.14665.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overEmergency Service, HospitalFemaleHospitalsHumansMaleUnited StatesVeteransConceptsVA emergency departmentEmergency departmentOlder veteransED visitsVA Corporate Data WarehouseAge-friendly careIndex ED visitVeterans Affairs hospitalYears of ageCorporate Data WarehouseScreening prevalencePoor outcomeStandardization of practiceMean ageVisit encountersPotential confoundingEmergency careGreater oddsExtended careDemographic dataOlder adultsLevel 1Observational evaluationCarePandemic year
2021
A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community‐Living Older Persons
Gettel CJ, Venkatesh AK, Leo‐Summers L, Murphy TE, Gahbauer EA, Hwang U, Gill TM. A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community‐Living Older Persons. Journal Of Hospital Medicine 2021, 16: 469-475. PMID: 34328835, PMCID: PMC8340961, DOI: 10.12788/jhm.3669.Peer-Reviewed Original ResearchMeSH KeywordsAftercareAgedAged, 80 and overAmbulatory CareHospitalizationHumansNursing HomesPatient DischargeConceptsAmbulatory care sensitive conditionsTotal disability scoreDisability scoresFunctional recoveryOlder personsNH admissionFunctional disabilityAdverse patient-reported outcomesPatient-reported disability scoresCommunity-living older personsSensitive conditionsMean disability scoreCommunity-living personsMonths of dischargePatient-reported outcomesNursing home utilizationMonthly probabilityFunctional outcomeMean ageMonths 1HospitalizationHome utilizationAdmissionAnalytic sampleMonthsEmergency department visits for emergent conditions among older adults during the COVID‐19 pandemic
Janke AT, Jain S, Hwang U, Rosenberg M, Biese K, Schneider S, Goyal P, Venkatesh AK. Emergency department visits for emergent conditions among older adults during the COVID‐19 pandemic. Journal Of The American Geriatrics Society 2021, 69: 1713-1721. PMID: 33955546, PMCID: PMC8242842, DOI: 10.1111/jgs.17227.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionED visit countsOlder adultsHip fractureExcess mortalityEmergent conditionsED sitesVisit countsEmergency department visitsIncident rate ratiosNational clinical quality registryAge categoriesClinical quality registryEarly pandemic periodCOVID-19 pandemicPandemic periodPoisson regression modelsPre-pandemic periodED visitsYounger patientsDepartment visitsPoor outcomeEmergency departmentMyocardial infarctionED diagnosisGeriatric emergency department revisits after discharge with Potentially Inappropriate Medications: A retrospective cohort study
Hammouda N, Vargas-Torres C, Doucette J, Hwang U. Geriatric emergency department revisits after discharge with Potentially Inappropriate Medications: A retrospective cohort study. The American Journal Of Emergency Medicine 2021, 44: 148-156. PMID: 33621716, DOI: 10.1016/j.ajem.2021.02.004.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity Index scoreComorbidity Index scoreED revisitsEmergency Severity Index scoreEmergency departmentAcademic emergency departmentInappropriate medicationsHospital admissionChief complaintIndex scoreBeers criteriaMedicaid statusRisk factorsMedicare beneficiaries 65 yearsDay ED visitsUpdated Beers CriteriaRetrospective cohort studyEmergency department revisitsRetrospective chart reviewSeverity Index scoreBeneficiaries 65 yearsCovariate risk factorsMedicare beneficiaries 65Multiple logistic regressionEmergency Severity Index
2020
Managing Older Adults with Presumed COVID‐19 in the Emergency Department: A Rational Approach to Rationing
Rosen T, Ferrante LE, Liu SW, Benton EA, Mulcare MR, Stern ME, Biese K, Hwang U, Sanon M. Managing Older Adults with Presumed COVID‐19 in the Emergency Department: A Rational Approach to Rationing. Journal Of The American Geriatrics Society 2020, 68: 1631-1635. PMID: 32574404, PMCID: PMC7361631, DOI: 10.1111/jgs.16651.Commentaries, Editorials and LettersAGS Position Statement: Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond
Farrell TW, Ferrante LE, Brown T, Francis L, Widera E, Rhodes R, Rosen T, Hwang U, Witt LJ, Thothala N, Liu SW, Vitale CA, Braun UK, Stephens C, Saliba D. AGS Position Statement: Resource Allocation Strategies and Age‐Related Considerations in the COVID‐19 Era and Beyond. Journal Of The American Geriatrics Society 2020, 68: 1136-1142. PMID: 32374440, PMCID: PMC7267615, DOI: 10.1111/jgs.16537.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAmerican Geriatrics SocietyOlder adultsAppropriate advance care planningShort-term outcomesRelevant clinical factorsCoronavirus disease 2019Advance care planningPotential short-term outcomeClinical factorsSevere illnessAdvanced ageDisease 2019Care planningMortality riskGeriatrics SocietySocial determinantsHealthcare professionalsHealth systemOlder peopleInterprofessional expertsEthics CommitteeCOVID-19 eraLife expectancyAgeCOVID-19Rationing Limited Healthcare Resources in the COVID‐19 Era and Beyond: Ethical Considerations Regarding Older Adults
Farrell TW, Francis L, Brown T, Ferrante LE, Widera E, Rhodes R, Rosen T, Hwang U, Witt LJ, Thothala N, Liu SW, Vitale CA, Braun UK, Stephens C, Saliba D. Rationing Limited Healthcare Resources in the COVID‐19 Era and Beyond: Ethical Considerations Regarding Older Adults. Journal Of The American Geriatrics Society 2020, 68: 1143-1149. PMID: 32374466, PMCID: PMC7267288, DOI: 10.1111/jgs.16539.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus Statements
2019
Geriatric Emergency Department Innovations: The Impact of Transitional Care Nurses on 30‐day Readmissions for Older Adults
Dresden SM, Hwang U, Garrido MM, Sze J, Kang R, Vargas‐Torres C, Courtney DM, Loo G, Rosenberg M, Richardson L. Geriatric Emergency Department Innovations: The Impact of Transitional Care Nurses on 30‐day Readmissions for Older Adults. Academic Emergency Medicine 2019, 27: 43-53. PMID: 31663245, DOI: 10.1111/acem.13880.Peer-Reviewed Original ResearchConceptsIndex ED visitMount Sinai Medical CenterSt. Joseph's Regional Medical CenterNorthwestern Memorial HospitalPrior hospital dischargeEmergency departmentED visitsRegional Medical CenterOlder adultsHospital dischargeGeriatric patientsNurse careMedical CenterTransitional care nursesRisk of admissionEmergency Severity IndexSinai Medical CenterDecreased hospitalizationsDecreased readmissionsPrior hospitalizationProspective cohortED patientsCare nursesMemorial HospitalInpatient dischargesConcepts in Practice: Geriatric Emergency Departments
Southerland LT, Lo AX, Biese K, Arendts G, Banerjee J, Hwang U, Dresden S, Argento V, Kennedy M, Shenvi CL, Carpenter CR. Concepts in Practice: Geriatric Emergency Departments. Annals Of Emergency Medicine 2019, 75: 162-170. PMID: 31732374, PMCID: PMC6980991, DOI: 10.1016/j.annemergmed.2019.08.430.Peer-Reviewed Original Research30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia
Kent T, Lesser A, Israni J, Hwang U, Carpenter C, Ko KJ. 30‐Day Emergency Department Revisit Rates among Older Adults with Documented Dementia. Journal Of The American Geriatrics Society 2019, 67: 2254-2259. PMID: 31403717, PMCID: PMC6899685, DOI: 10.1111/jgs.16114.Peer-Reviewed Original ResearchConceptsIndex ED visitED revisitsEmergency departmentED visitsDementia diagnosisIndex encounterOdds ratioOlder adultsMedicare beneficiariesEmergency department revisit rateRevisit ratesED revisit ratesHigh ED utilizationSignificant predictorsNational emergency departmentSkilled nursing facilitiesLogistic regression modelsDementia codesED utilizationMedicaid statusOutpatient claimsRepresentative sampleContinuous feeClaims dataDementia patientsPROMIS Physical Function 10-Item Short Form for Older Adults in an Emergency Setting
Fox GWC, Rodriguez S, Rivera-Reyes L, Loo G, Hazan A, Hwang U. PROMIS Physical Function 10-Item Short Form for Older Adults in an Emergency Setting. The Journals Of Gerontology Series A 2019, 75: 1418-1423. PMID: 31251798, DOI: 10.1093/gerona/glz163.Peer-Reviewed Original ResearchConceptsPROMIS Physical FunctionPhysical functionOlder adultsPROMIS PFFunctional statusDaily livingED patients 65 yearsMean PROMIS-PF scorePatient-reported outcome measurementsPatients 65 yearsOutcomes Measurement Information SystemPROMIS PF scoresGeneral functional statusQuality of lifeMeasurement Information SystemShort formOlder adult populationSeverity of impairmentAssessment of functionKatz IndexEmergency settingHospital useOutcome measurementsPF scoresAdult population
2017
Using music to reduce anxiety among older adults in the emergency department: a randomized pilot study
Belland L, Rivera-Reyes L, Hwang U. Using music to reduce anxiety among older adults in the emergency department: a randomized pilot study. Journal Of Integrative Medicine 2017, 15: 450-455. PMID: 29103414, DOI: 10.1016/s2095-4964(17)60341-8.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnxietyEmergency Service, HospitalFemaleHumansMaleMusicMusic TherapyPilot ProjectsStress, PsychologicalConceptsRandomized pilot studyState-Trait Anxiety InventoryOlder adultsRoutine careIntervention subjectsPilot studyAcademic tertiary medical centerOlder ED patientsEmergency department visitsTertiary medical centerEffects of musicAnxiety levelsGeriatric EDDepartment visitsPrimary outcomeED patientsEmergency departmentControl subjectsStudy protocolMedical CenterTreatment groupsControl groupSTAI scoresMin of musicAnxiety InventoryBouncing Back Elsewhere: Multilevel Analysis of Return Visits to the Same or a Different Hospital After Initial Emergency Department Presentation
Shy BD, Loo GT, Lowry T, Kim EY, Hwang U, Richardson LD, Shapiro JS. Bouncing Back Elsewhere: Multilevel Analysis of Return Visits to the Same or a Different Hospital After Initial Emergency Department Presentation. Annals Of Emergency Medicine 2017, 71: 555-563.e1. PMID: 28967514, DOI: 10.1016/j.annemergmed.2017.08.023.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolEmergency Service, HospitalFemaleHealth Information ExchangeHumansInfantInfant, NewbornMaleMiddle AgedMultilevel AnalysisOdds RatioPatient ReadmissionQuality Assurance, Health CareQuality ImprovementRetrospective StudiesTime FactorsYoung AdultConceptsED visitsSame hospitalReturn visitsOdds ratioHealth information exchangeInitial emergency department presentationEmergency department return visitsInitial ED visitED return visitsInitial ED presentationEmergency department presentationsConfidence intervalsHospital-level dataEarly revisitsED presentationsInitial visitMale sexSecond HospitalStudy EDPatient visitsAcademic hospitalHospital variablesHealth information exchange networkDifferent hospitalsHospital
2016
Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use
Vandenberg AE, Vaughan CP, Stevens M, Hastings SN, Powers J, Markland A, Hwang U, Hung W, Echt KV. Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use. International Journal For Quality In Health Care 2016, 29: 117-123. PMID: 27852639, DOI: 10.1093/intqhc/mzw129.Peer-Reviewed Original ResearchConceptsEmergency departmentQuality improvement initiativesClinical decision supportOrder setsMedical recordsOrder set useSettings of carePatients' medical recordsGeriatric prescribingPrescribing practicesAdoption of CDSOlder veteransProvider groupsOlder adultsPhone interviewsImprovement initiativesPrescribingSafety concernsOrder entry processProvider autonomyQualitative studyProvidersEntry processRegional Nerve Blocks Improve Pain and Functional Outcomes in Hip Fracture: A Randomized Controlled Trial
Morrison RS, Dickman E, Hwang U, Akhtar S, Ferguson T, Huang J, Jeng CL, Nelson BP, Rosenblatt MA, Silverstein JH, Strayer RJ, Torrillo TM, Todd KH. Regional Nerve Blocks Improve Pain and Functional Outcomes in Hip Fracture: A Randomized Controlled Trial. Journal Of The American Geriatrics Society 2016, 64: 2433-2439. PMID: 27787895, PMCID: PMC5173407, DOI: 10.1111/jgs.14386.Peer-Reviewed Original ResearchConceptsContinuous fascia iliaca blockFascia iliaca blockOpioid side effectsFemoral nerve blockNerve blockRegional nerve blocksHip fractureIntervention participantsPOD 3Emergency physiciansSide effectsMorphine sulfate equivalentsPostoperative day 3Emergency department admissionsNew York HospitalStair climbing abilityConventional analgesicsPain scoresED presentationsStandard analgesicsControlled TrialsDepartment admissionsFunctional outcomeIntervention groupYork HospitalFeasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients
Tucker PW, Evans DD, Clevenger CK, Ardisson M, Hwang U. Feasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients. Geriatric Nursing 2016, 37: 453-457. PMID: 27477084, DOI: 10.1016/j.gerinurse.2016.06.015.Peer-Reviewed Original ResearchConceptsGait speedCommunity-dwelling adults 65 yearsDescriptive pilot projectED screening toolsED social workersFeasibility of nursesGait speed assessmentRoutine nursing assessmentRoutine nursing practiceEmergency department patientsAdults 65 yearsAdverse eventsDepartment patientsNursing assessmentUnfavorable outcomeED treatmentDisposition planningPatientsNursing practiceScreening toolNursesIndividualized resourcesObjective measuresSpeed assessmentSocial workersThe musculoskeletal diagnosis cohort
Goulet JL, Kerns RD, Bair M, Becker W, Brennan P, Burgess DJ, Carroll CM, Dobscha S, Driscoll M, Fenton BT, Fraenkel L, Haskell S, Heapy A, Higgins D, Hoff RA, Hwang U, Justice AC, Piette JD, Sinnott P, Wandner L, Womack J, Brandt CA. The musculoskeletal diagnosis cohort. Pain 2016, 157: 1696-1703. PMID: 27023420, PMCID: PMC4949131, DOI: 10.1097/j.pain.0000000000000567.Peer-Reviewed Original ResearchConceptsMSD diagnosisMusculoskeletal disordersMSD cohortIndex dateVeterans Health Administration (VHA) careNumeric rating scale scoreICD-9-CM codesCohort inclusion criteriaNontraumatic joint disordersPain-related treatmentsMore outpatient visitsVeterans Health AdministrationMental health diagnosesRating Scale scoresHigher NRS scoresHealth services researchElectronic health recordsDiagnosis cohortSevere painInpatient visitsNRS scoresOutpatient visitsNeck disordersFirst diagnosisMean age
2015
Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures
Dickman E, Pushkar I, Likourezos A, Todd K, Hwang U, Akhter S, Morrison S. Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures. The American Journal Of Emergency Medicine 2015, 34: 586-589. PMID: 26809928, PMCID: PMC4799725, DOI: 10.1016/j.ajem.2015.12.016.Peer-Reviewed Original ResearchConceptsUltrasound-guided femoral nerve blockExtracapsular hip fracturesMean pain scoreFemoral nerve blockHip fracturePain scoresNerve blockPain reliefExtracapsular groupIntracapsular groupEmergency departmentUltrasound-guided nerve blocksSubgroup analysisClinical trialsExtracapsular hipAcademic hospitalPatientsSimilar reductionPainScoresReliefHoursFracturesGroupNew York CityRedesigned Geriatric Emergency Care May Have Helped Reduce Admissions Of Older Adults To Intensive Care Units
Grudzen C, Richardson LD, Baumlin KM, Winkel G, Davila C, Ng K, Hwang U, investigators T. Redesigned Geriatric Emergency Care May Have Helped Reduce Admissions Of Older Adults To Intensive Care Units. Health Affairs 2015, 34: 788-795. PMID: 25941280, DOI: 10.1377/hlthaff.2014.0790.Peer-Reviewed Original ResearchConceptsGeriatric emergency careMount Sinai Medical CenterPalliative care principlesIntensive care unitEmergency careCare unitEmergency departmentCare principlesHigh-risk patientsED triage nursesSinai Medical CenterWise programED nurse practitionersED visitorsED revisitsED admissionHospital readmissionMedical CenterNurse practitionersTriage nursesHigh riskHospice careAdmissionOlder adultsStudy period