2024
Scaling the EQUIPPED medication safety program: Traditional and hub‐and‐spoke implementation models
Vandenberg A, Hwang U, Das S, Genes N, Nyamu S, Richardson L, Ezenkwele U, Legome E, Richardson C, Belachew A, Leong T, Kegler M, Vaughan C. Scaling the EQUIPPED medication safety program: Traditional and hub‐and‐spoke implementation models. Journal Of The American Geriatrics Society 2024, 72: 2184-2194. PMID: 38259070, DOI: 10.1111/jgs.18746.Peer-Reviewed Original ResearchPotentially inappropriate medicationsHub-and-spoke modelEmergency departmentSpoke sitesReduce potentially inappropriate medicationMedication safety programQuality improvement initiativesElectronic medical recordsInappropriate medicationsHealth systemImprovement initiativesPrescribing dataHub-and-spokeDisproportionate barriersImplementation modelMedical recordsSite engagementInterview dataSafety programCOVID-19 pandemicProgramEQUIP programCOVID-19BarriersHealth
2022
Use of the consolidated framework for implementation research in a mixed methods evaluation of the EQUIPPED medication safety program in four academic health system emergency departments
Kegler M, Rana S, Vandenberg A, Hastings S, Hwang U, Eucker S, Vaughan C. Use of the consolidated framework for implementation research in a mixed methods evaluation of the EQUIPPED medication safety program in four academic health system emergency departments. Frontiers In Health Services 2022, 2: 1053489. PMID: 36925898, PMCID: PMC10012623, DOI: 10.3389/frhs.2022.1053489.Peer-Reviewed Original ResearchEmergency departmentConsolidated FrameworkVeterans Administration health care systemPrimary implementation outcomeImplementation researchMedication safety programAcademic health systemImplementation outcomesQuality Improvement ProgramFidelity of deliveryHealth care systemEvidence-based approachProviders' receiptInappropriate medicationsMixed-methods evaluationEvidence-informed programsED providersED settingPrescribing practicesAcademic detailingMedication safetyPatient needsEffective quality improvement programOrder setsHealth systemExamination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments
Santangelo I, Ahmad S, Liu S, Southerland L, Carpenter C, Hwang U, Lesser A, Tidwell N, Biese K, Kennedy M. Examination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments. Journal Of Geriatric Emergency Medicine 2022, 3 PMID: 36970655, PMCID: PMC10035774, DOI: 10.17294/2694-4715.1041.Peer-Reviewed Original ResearchGeriatric EDGeriatric fallsCare processesMedication reconciliationMedication-related adverse eventsOlder adultsGeriatric pain managementPain medication protocolUnique care needsEmergency department settingInappropriate medication administrationGeriatric Emergency DepartmentIndividual care processesDifferent screening toolsCross-sectional analysisAssessment of functionLevel 1Beers criteriaED administrationInappropriate medicationsAdverse eventsRenal functionMedication protocolsPain managementEmergency department
2021
Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme
Vaughan CP, Hwang U, Vandenberg AE, Leong T, Wu D, Stevens MB, Clevenger C, Eucker S, Genes N, Huang W, Ikpe-Ekpo E, Nassisi D, Previl L, Rodriguez S, Sanon M, Schlientz D, Vigliotti D, Hastings SN. Early prescribing outcomes after exporting the EQUIPPED medication safety improvement programme. BMJ Open Quality 2021, 10: e001369. PMID: 34750188, PMCID: PMC8576471, DOI: 10.1136/bmjoq-2021-001369.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationAcademic health systemElectronic medical recordsHealth systemMedical recordsPrescribing outcomesOlder adultsVA health systemMedication safety programMonthly proportionEpic electronic medical recordDifferent health systemsSignificant reductionBeers criteriaMonthly prescribingMonths preimplementationInappropriate medicationsBenzodiazepine prescriptionsPrescribing ratesEmergency departmentMonths postimplementationDrug classesHealth AdministrationOrder setsVA systemGeriatric 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
Sequential implementation of the EQUIPPED geriatric medication safety program as a learning health system
Vandenberg AE, Kegler M, Hastings SN, Hwang U, Wu D, Stevens MB, Clevenger C, Eucker S, Genes N, Huang W, Ikpe-Ekpo E, Nassisi D, Previll L, Rodriguez S, Sanon M, Schlientz D, Vigliotti D, Vaughan CP. Sequential implementation of the EQUIPPED geriatric medication safety program as a learning health system. International Journal For Quality In Health Care 2020, 32: 470-476. PMID: 32671390, DOI: 10.1093/intqhc/mzaa077.Peer-Reviewed Original ResearchConceptsMedication safety programHealth systems researchHealth systemLearning health systemTime of dischargeEffective Programs frameworkEmergency department providersAcademic emergency departmentQuality improvement projectCommunity-based settingsImplementation packageFocus groupsInappropriate medicationsClinical decision supportEmergency departmentMedication safetyMAIN OUTCOMESafety programImplementation team membersIntervention packageImprovement projectImplementation yearYearsLarge-scale disseminationMultiple sites
2019
SEQUENTIAL IMPLEMENTATION AS A LEARNING HEALTH ORGANIZATION: THE EQUIPPED GERIATRIC MEDICATION SAFETY MODEL
Vandenberg A, Kegler M, Hastings S, Hwang U, Vaughan C. SEQUENTIAL IMPLEMENTATION AS A LEARNING HEALTH ORGANIZATION: THE EQUIPPED GERIATRIC MEDICATION SAFETY MODEL. Innovation In Aging 2019, 3: s945-s945. PMCID: PMC6846564, DOI: 10.1093/geroni/igz038.3434.Peer-Reviewed Original ResearchEmergency departmentOlder adultsHealth OrganizationImportant public health issueSame electronic health recordEffective Programs frameworkHospital emergency departmentPublic health issueEvidence-based interventionsElectronic health recordsResearch NetworkInappropriate medicationsAdverse eventsClinical decision supportIntervention sitesHealth issuesHealth recordsIntervention packageProcess evaluationCollaborative research networksHealthcare practiceWidespread disseminationAdultsFocus groupsSafety program1 Risk of Emergency Department Revisit or Hospitalization in Older Adults Discharged With Potentially Inappropriate Medications: A Retrospective Cohort Study
Hammouda N, Hwang U. 1 Risk of Emergency Department Revisit or Hospitalization in Older Adults Discharged With Potentially Inappropriate Medications: A Retrospective Cohort Study. Annals Of Emergency Medicine 2019, 74: s1. DOI: 10.1016/j.annemergmed.2019.08.004.Peer-Reviewed Original Research
2017
An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department
Moss JM, Bryan WE, Wilkerson LM, King HA, Jackson GL, Owenby RK, Van Houtven CH, Stevens MB, Powers J, Vaughan CP, Hung WW, Hwang U, Markland AD, Sloane R, Knaack W, Hastings SN. An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department. Journal Of Pharmacy Practice 2017, 32: 167-174. PMID: 29277130, PMCID: PMC6533068, DOI: 10.1177/0897190017747424.Peer-Reviewed Original ResearchMeSH KeywordsAgedClinical CompetenceDrug PrescriptionsEducation, MedicalEmergency MedicineEmergency Service, HospitalHealth Services for the AgedHumansInappropriate PrescribingInternship and ResidencyInterprofessional RelationsPhysiciansPotentially Inappropriate Medication ListQuality ImprovementSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsQuality improvement projectAcademic detailingEmergency departmentOlder adultsPIM ratesBeers criteriaPhysician residentsResident cohortVeterans Affairs emergency departmentInappropriate medication prescribingAcademic detailing interventionDrug-disease interactionsImprovement projectSelf-perceived barriersInappropriate medicationsMedication prescribingED populationAppropriate medicationOlder veteransSelf-reported confidenceCohortEducational interventionRate ratioSignificant decreaseSelf-rated confidenceEnhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUiPPED)
Stevens M, Hastings SN, Markland AD, Hwang U, Hung W, Vandenberg AE, Bryan W, Cross D, Powers J, McGwin G, Fattouh N, Ho W, Clevenger C, Vaughan CP. Enhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUiPPED). Journal Of The American Geriatrics Society 2017, 65: 1609-1614. PMID: 28388818, DOI: 10.1111/jgs.14890.Peer-Reviewed Original ResearchConceptsOlder adultsAmerican Geriatrics Society 2012 Beers CriteriaMulticomponent quality improvement initiativeEmergency department dischargeNumber of PIMsUse of PIMsElectronic clinical decision supportQuality improvement initiativesPost-intervention comparisonBeers criteriaPIM prescriptionInappropriate medicationsClinical decision supportEmergency departmentSafe prescribingCenter EDMedication safetyProvider practicesOlder veteransSustained reductionMulticomponent programPoisson regressionED sitesImprovement initiativesIndividual providers
2016
Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.
Vandenberg AE, Stevens M, Echt KV, Hastings SN, Powers J, Markland A, Hwang U, Hung W, Belbis S, Vaughan CP. Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments. Federal Practitioner 2016, 33: 29-33. PMID: 27773986, PMCID: PMC5070380.Peer-Reviewed Original ResearchImpact of Clinical Pharmacy Specialists on the Design and Implementation of a Quality Improvement Initiative to Decrease Inappropriate Medications in a Veterans Affairs Emergency Department
Moss JM, Bryan WE, Wilkerson LM, Jackson GL, Owenby RK, Van Houtven C, Stevens MB, Powers JS, Vaughan CP, Hung WW, Hwang U, Markland AD, McGwin G, Hastings SN. Impact of Clinical Pharmacy Specialists on the Design and Implementation of a Quality Improvement Initiative to Decrease Inappropriate Medications in a Veterans Affairs Emergency Department. Journal Of Managed Care & Specialty Pharmacy 2016, 22: 10.18553/jmcp.2016.22.1.74. PMID: 27015054, PMCID: PMC10397930, DOI: 10.18553/jmcp.2016.22.1.74.Peer-Reviewed Original ResearchConceptsClinical pharmacy specialistsVeterans Affairs emergency departmentPIM prescribingEmergency departmentQuality improvement initiativesPIM ratesAcademic detailingED providersPharmacy specialistsRate of PIMInappropriate medication useQI projectOlder adult patientsImprovement initiativesVA Medical CenterComputerized patient record systemHealth care systemBeers criteriaPIM prescriptionInappropriate medicationsAdult patientsMedication usePrescribing practicesProvider educationMedical Center
2015
Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative
Stevens MB, Hastings SN, Powers J, Vandenberg AE, Echt KV, Bryan WE, Peggs K, Markland AD, Hwang U, Hung WW, Schmidt AJ, McGwin G, Ikpe-Ekpo E, Clevenger C, Johnson TM, Vaughan CP. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative. Journal Of The American Geriatrics Society 2015, 63: 1025-1029. PMID: 25945692, DOI: 10.1111/jgs.13404.Peer-Reviewed Original ResearchConceptsQuality improvement initiativesOlder veteransPrescribing practicesStaff providersEmergency departmentProvider educationEmergency department studyNumber of PIMsUse of PIMsImprovement initiativesAverage monthly proportionBeers criteriaED dischargeInappropriate medicationsClinical decision supportAcademic detailingSustained reductionHealth outcomesPoisson regressionSuboptimal medicationOrder setsDepartment studyOlder adultsMonthly proportionVeterans