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 ResearchMeSH KeywordsAgedEmergency Service, HospitalHumansLearning Health SystemPatient DischargePotentially Inappropriate Medication ListQuality ImprovementConceptsMedication 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
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 confidenceBouncing 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 hospitalsHospitalEnhancing 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
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 ResearchMeSH KeywordsAgedAged, 80 and overDecision Support Systems, ClinicalDrug PrescriptionsEmergency Service, HospitalHospitals, VeteransHumansQuality ImprovementConceptsEmergency 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 processIncreased Identification of Emergency Department 72‐hour Returns Using Multihospital Health Information Exchange
Shy BD, Kim EY, Genes NG, Lowry T, Loo GT, Hwang U, Richardson LD, Shapiro JS. Increased Identification of Emergency Department 72‐hour Returns Using Multihospital Health Information Exchange. Academic Emergency Medicine 2016, 23: 645-649. PMID: 26932394, DOI: 10.1111/acem.12954.Peer-Reviewed Original ResearchConceptsEmergency departmentHealth information exchangeED returnIndex visitReturn visitsEarly ED returnsInitial ED dischargeCases of patientsReturn visit rateLarge health information exchangeIndividual emergency departmentsPatient safety effortsED dischargeED visitsEarly returnVisit ratesPatient encountersStudy periodPatient dataVisitsNew York metropolitan areaSafety effortsDepartmentHoursPatientsImpact 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 ResearchMeSH KeywordsAgedEmergency Service, HospitalHumansMedication ErrorsNorth CarolinaPharmacy Service, HospitalQuality ImprovementVeteransConceptsClinical 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 ResearchMeSH KeywordsAgedDrug PrescriptionsEmergency Service, HospitalHumansPatient DischargeQuality ImprovementVeterans HealthConceptsQuality 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
2013
Transforming Emergency Care For Older Adults
Hwang U, Shah MN, Han JH, Carpenter CR, Siu AL, Adams JG. Transforming Emergency Care For Older Adults. Health Affairs 2013, 32: 2116-2121. PMID: 24301394, PMCID: PMC4070367, DOI: 10.1377/hlthaff.2013.0670.Peer-Reviewed Original ResearchConceptsEmergency departmentEmergency careHealth care systemOlder adultsCare systemComprehensive discharge planningUS emergency departmentsPatient health outcomesGeriatric emergency careGeriatric Emergency DepartmentBroader health care systemED visitsInitial hospitalizationDischarge planningCare coordinationHealth outcomesObservation unitCareAdultsLengthy evaluationRehospitalizationHospitalizationPatientsVisits