Featured Publications
Adapting Emergency Care for Persons Living With Dementia: Results of the Geriatric Emergency Care Applied Research Network Scoping Review and Consensus Conference
Carpenter CR, Dresden SM, Shah MN, Hwang U. Adapting Emergency Care for Persons Living With Dementia: Results of the Geriatric Emergency Care Applied Research Network Scoping Review and Consensus Conference. Journal Of The American Medical Directors Association 2022, 23: 1286-1287. PMID: 35940679, DOI: 10.1016/j.jamda.2022.05.016.Peer-Reviewed Original ResearchThe Geriatric Emergency Care Applied Research (GEAR) network approach: a protocol to advance stakeholder consensus and research priorities in geriatrics and dementia care in the emergency department
Hwang U, Carpenter C, Dresden S, Dussetschleger J, Gifford A, Hoang L, Leggett J, Nowroozpoor A, Taylor Z, Shah M, Bellolio M, Biese K, Binkley C, Bott N, Brody A, Carpenter C, Clark S, Dresden S, Forester S, Gettel C, Goldberg E, Greenberg A, Hammouda N, Han J, Hastings N, Hogan T, Hung W, Hwang U, Kayser J, Kennedy M, Ko K, Lesser A, Linton E, Liu S, Malsch A, Melady C, Morrow-Howell N, Nassisi D, Nerbonne L, Nyamu S, Ohuabunwa U, Platts-Mills T, Ragsdale L, Richardson L, Ringer T, Rosen A, Rosenberg M, Shah M, Skains R, Skees S, Souffront K, Stabler L, Sullivan C, Suyama J, Vargas S, Vaughan E, Voils C, Wei D, Allore H, Aloysi A, Belleville M, Bellolio M, Betz M, Biese K, Brandt C, Carnahan R, Carr D, Chin-Hansen J, Daven M, Degesys N, Ellenbogen M, Escobedo M, Falvey J, Gill T, Gilmore-Bykovskyi A, Goldberg E, Han J, Hardy J, Hastings S, Hirshon J, Hogan T, Hung W, Isaacs E, Kelly K, Kennedy M, Kind A, Malicki C, Malone M, Marottoli R, Moccia M, Mor V, Morris J, Howell N, Nowroozpoor A, Ohuabunwa U, Oiyemhonlan B, Perry W, Raven M, Rising K, Sano M, Stabler L, Sullivan C, Suyama J, Swartzberg J, Tolia V, Vann A, Weintraub S, Zieman S, Dussetschleger J, Gifford A, Leggett J, Nowroozpoor A, Taylor Z. The Geriatric Emergency Care Applied Research (GEAR) network approach: a protocol to advance stakeholder consensus and research priorities in geriatrics and dementia care in the emergency department. BMJ Open 2022, 12: e060974. PMID: 35459682, PMCID: PMC9036447, DOI: 10.1136/bmjopen-2022-060974.Peer-Reviewed Original ResearchConceptsEmergency departmentOlder adultsEmergency careEmergency care needsGeriatric emergency carePriority topic areasPeer-reviewed journalsClinical gapsCare needsResearch prioritiesCare partnersConsensus workshopSystematic reviewHealthcare needsDementia careIntervention impactDissemination of findingsTrial evaluationCareImplementation scienceAdultsResearch NetworkReviewStandardised searchHuman subjects researchAssociation 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
Geriatric assessment in the emergency department reduces healthcare costs—So when will CMS pay for it?
Southerland L, Biese K, Hwang U. Geriatric assessment in the emergency department reduces healthcare costs—So when will CMS pay for it? Journal Of The American Geriatrics Society 2023, 71: 2698-2700. PMID: 37435831, DOI: 10.1111/jgs.18473.Peer-Reviewed Original ResearchAn Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments
Gettel C, Hwang U, Janke A, Rothenberg C, Tomasino D, Schneider S, Goyal P, Venkatesh A. An Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments. Annals Of Emergency Medicine 2023, 82: 681-689. PMID: 37389490, PMCID: PMC10756927, DOI: 10.1016/j.annemergmed.2023.05.013.Peer-Reviewed Original ResearchConceptsGeriatric EDDiagnosis rateED lengthEmergency departmentMedian discharge rateAmerican CollegeRevisit ratesOlder adultsUrinary tract infectionAge categoriesGeriatric Emergency DepartmentHigher diagnosis ratesED visitsTract infectionsMental statusObservational studyDelirium/Outcome comparisonsData registryED statusProcess outcomesED sitesStayAnalytic sampleAdultsCare transition outcome measures of importance after emergency care: Do emergency clinicians and older adults agree?
Gettel C, Hwang U, Rising K, Goldberg E, Feder S, Uzamere I, Venkatesh A. Care transition outcome measures of importance after emergency care: Do emergency clinicians and older adults agree? Academic Emergency Medicine 2023, 30: 1061-1064. PMID: 37014286, PMCID: PMC10548356, DOI: 10.1111/acem.14732.Peer-Reviewed Original ResearchDissemination 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 ResearchConceptsVA 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 yearResearch and policy recommendations from the SOTA XVI: State of the Art Conference on VA Emergency Medicine
Ward M, Hwang U, Hastings S, Timko C, Chen J, Vashi A, Mattocks K, Abel E, Bravata D. Research and policy recommendations from the SOTA XVI: State of the Art Conference on VA Emergency Medicine. Academic Emergency Medicine 2023, 30: 240-251. PMID: 36775279, PMCID: PMC11166248, DOI: 10.1111/acem.14679.Peer-Reviewed Original ResearchConceptsMental health needsEmergency careOlder veteransHealth needsEmergency Department Care TransitionsCommunity settingsVeterans Affairs Health Services ResearchFollow-up needsGeriatric assessment toolsEmergency medicineCommunity care settingsCare Improvement (BPCI) initiativeNon-VA sourcesSuicide prevention interventionsSubstance use disordersUse of telehealthHealth services researchEvaluation of interventionsEmergency cliniciansCare transitionsCare coordinationPatient outcomesArt ConferenceCare settingsPrevention interventionsAutomatable end‐of‐life screening for older adults in the emergency department using electronic health records
Haimovich A, Xu W, Wei A, Schonberg M, Hwang U, Taylor R. Automatable end‐of‐life screening for older adults in the emergency department using electronic health records. Journal Of The American Geriatrics Society 2023, 71: 1829-1839. PMID: 36744550, PMCID: PMC10258151, DOI: 10.1111/jgs.18262.Peer-Reviewed Original ResearchConceptsAdvance care planningDecision curve analysisLife screeningComorbidity indexCode statusPrognostic modelHealth systemOlder adultsCurve analysisOlder ED patientsPalliative care interventionsObservational cohort studyEmergency department visitsPalliative care servicesElixhauser Comorbidity IndexReceiver-operating characteristic curveIdentification of patientsMultivariable logistic regressionLarge regional health systemLife-limiting illnessRisk older adultsCode status ordersLife Screening ToolMortality predictive modelsElectronic health records
2022
Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review
Dresden SM, Taylor Z, Serina P, Kennedy M, Wescott AB, Hogan T, Shah MN, Hwang U, Aggarawal N, Allore H, Aloysi A, Belleville M, Bellolio F, Betz M, Biese K, Brandt C, Bruursema S, Carnahan R, Carpenter C, Carr D, Chin-Hansen J, Daven M, Degesys N, Dresden S, Dussetschleger J, Ellenbogen M, Falvey J, Foster B, Gettel C, Gifford A, Gilmore-Bykovskyi A, Goldberg E, Han J, Hardy J, Hastings S, Hirshon J, Hoang L, Hogan T, Hung W, Hwang U, Isaacs E, Jaspal N, Jobe D, Johnson J, Kelly K, Kennedy M, Kind A, Leggett J, Malone M, Moccia M, Moreno M, Morrow-Howell N, Nowroozpoor A, Ohuabunwa U, Oiyemhonian B, Perry W, Prusaczyk B, Resendez J, Rising K, Sano M, Savage B, Shah M, Suyama J, Swartzberg J, Taylor Z, Tolia V, Vann A, Webb T, Weintraub S. Optimal Emergency Department Care Practices for Persons Living With Dementia: A Scoping Review. Journal Of The American Medical Directors Association 2022, 23: 1314.e1-1314.e29. PMID: 35940683, DOI: 10.1016/j.jamda.2022.05.024.Peer-Reviewed Original ResearchConceptsED careCare practicesCare needsHealth care use outcomesEmergency care needsComprehensive geriatric assessmentManagement of painEmergency department carePatient-centered outcomesED care processesHome hospital programScoping ReviewSingle-site studyResearch prioritiesPRISMA-ScR guidelinesGeriatric assessmentSystematic scoping reviewDementia care networksEmergency departmentCare considerationsCare competenciesHospital programED environmentCare processesPsychological symptomsEmergency department‐to‐community care transition barriers: A qualitative study of older adults
Gettel CJ, Serina PT, Uzamere I, Hernandez‐Bigos K, Venkatesh AK, Rising KL, Goldberg EM, Feder SL, Cohen AB, Hwang U. Emergency department‐to‐community care transition barriers: A qualitative study of older adults. Journal Of The American Geriatrics Society 2022, 70: 3152-3162. PMID: 35779278, PMCID: PMC9669106, DOI: 10.1111/jgs.17950.Peer-Reviewed Original ResearchConceptsCare transitionsOlder adultsClinical careImmediate post-discharge periodED discharge processEmergency clinical careEmergency department visitsPost-discharge periodAdverse health outcomesOutpatient clinical careDepartment visitsIntact patientsEmergency departmentHealth outcomesOlder adults' willingnessU.S. healthcare systemBaseline activityEffective interventionsIntervention developmentHealthcare systemAdultsCareAdults' willingnessSymptom explanationsEDA Qualitative Study of “What Matters” to Older Adults in the Emergency Department
Gettel CJ, Venkatesh AK, Dowd H, Hwang U, Ferrigno RF, Reid EA, Tinetti ME. A Qualitative Study of “What Matters” to Older Adults in the Emergency Department. Western Journal Of Emergency Medicine 2022, 23: 579-588. PMID: 35980413, PMCID: PMC9391017, DOI: 10.5811/westjem.2022.4.56115.Peer-Reviewed Original ResearchConceptsOlder adult patientsAdult patientsEmergency departmentOlder adultsED careAge-Friendly Health SystemIntact older adultsSymptom resolutionED cliniciansED settingPatient 1Clinician recommendationsPatient concernsPatient prioritiesDyadic semi-structured interviewsSymptom reductionClinical practicePatientsCliniciansHealth systemConversation guideHealthcare systemAdultsHome environmentOutcomesEmergency Department Care Transitions for Patients With Cognitive Impairment: A Scoping Review
Gettel CJ, Falvey JR, Gifford A, Hoang L, Christensen LA, Hwang U, Shah MN, Network T, Aggarawal N, Allore H, Amy A, Belleville M, Bellolio M, Betz M, Biese K, Brandt C, Bruursema S, Carnahan R, Carpenter C, Carr D, Chin-Hansen J, Daven M, Degesys N, Dresden M, Dussetschleger J, Ellenbogen M, Falvey J, Foster B, Gettel C, Gifford A, Gilmore-Bykovskyi A, Goldberg E, Han J, Hardy J, Hastings S, Hirshon J, Hoang L, Hogan T, Hung W, Hwang U, Isaacs E, Jaspal N, Jobe D, Johnson J, Kelly K, Kennedy M, Kind A, Leggett J, Malone M, Moccia M, Moreno M, Morrow-Howell N, Nowroozpoor A, Ohuabunwa U, Oiyemhonian B, Perry W, Prusaczk B, Resendez J, Rising K, Sano M, Savage B, Shah M, Suyama J, Swartzberg J, Taylor Z, Vaishal T, Vann A, Webb T, Weintraub S. Emergency Department Care Transitions for Patients With Cognitive Impairment: A Scoping Review. Journal Of The American Medical Directors Association 2022, 23: 1313.e1-1313.e13. PMID: 35247358, PMCID: PMC9378565, DOI: 10.1016/j.jamda.2022.01.076.Peer-Reviewed Original ResearchConceptsCare transition interventionsRelevant patient-centered outcomesPatient-centered outcomesCognitive impairmentCare partnersTransition interventionsCare transitionsOlder adultsEmergency Department Care TransitionsED revisit ratesSystematic electronic searchFull-text reviewScoping ReviewMedical research databasesGeriatric assessmentSecondary outcomesSystematic scoping reviewED careED patientsED settingPhysical functionFuture investigationsCare coordinationOutpatient careEligible studies
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 systemEvaluation and disposition of older adults presenting to the emergency department with abdominal pain
Friedman AB, Chen AT, Wu R, Coe NB, Halpern SD, Hwang U, Kelz RR, Cappola AR. Evaluation and disposition of older adults presenting to the emergency department with abdominal pain. Journal Of The American Geriatrics Society 2021, 70: 501-511. PMID: 34628638, PMCID: PMC10078825, DOI: 10.1111/jgs.17503.Peer-Reviewed Original ResearchConceptsNational Hospital Ambulatory Medical Care SurveyAbdominal painUS emergency departmentsEmergency departmentED visitsOlder adultsOlder patientsChief complaintAmbulatory Medical Care SurveyRepresentative emergency departmentsCommon chief complaintSurvey-weighted analysisDischarge homeIncident disabilityED encountersCare SurveyPatient outcomesCritical careSerious conditionSyndromic presentationHigh riskPainDiagnostic testingPatientsCT imagingInclusion of older adults in emergency department clinical research: Strategies to achieve a critical goal
Hunold KM, Goldberg EM, Caterino JM, Hwang U, Platts‐Mills T, Shah MN, Rosen T, Medicine F. Inclusion of older adults in emergency department clinical research: Strategies to achieve a critical goal. Academic Emergency Medicine 2021, 29: 376-383. PMID: 34582613, PMCID: PMC8958170, DOI: 10.1111/acem.14386.Peer-Reviewed Original ResearchCare transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement
Gettel CJ, Voils CI, Bristol AA, Richardson LD, Hogan TM, Brody AA, Gladney MN, Suyama J, Ragsdale LC, Binkley CL, Morano CL, Seidenfeld J, Hammouda N, Ko KJ, Hwang U, Hastings SN. Care transitions and social needs: A Geriatric Emergency care Applied Research (GEAR) Network scoping review and consensus statement. Academic Emergency Medicine 2021, 28: 1430-1439. PMID: 34328674, PMCID: PMC8725618, DOI: 10.1111/acem.14360.Peer-Reviewed Original ResearchConceptsCare transition interventionsOlder adult populationTransition interventionsIntervention studiesAdult populationCare transitionsOlder adultsEmergency Department Care TransitionsHealth care utilization outcomesSubsequent health care utilizationComprehensive geriatric assessmentHealth care utilizationPatient-centered outcomesOptimal outcome measuresResearch NetworkGeriatric assessmentCare utilizationUtilization outcomesDischarge planningPatient outcomesConsensus statementOutcome measuresClinical questionsConsensus conferenceElectronic databasesReach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States
Kennedy M, Lesser A, Israni J, Liu SW, Santangelo I, Tidwell N, Southerland LT, Carpenter CR, Biese K, Ahmad S, Hwang U. Reach and Adoption of a Geriatric Emergency Department Accreditation Program in the United States. Annals Of Emergency Medicine 2021, 79: 367-373. PMID: 34389196, PMCID: PMC10015385, DOI: 10.1016/j.annemergmed.2021.06.013.Peer-Reviewed Original ResearchConceptsGeriatric Emergency DepartmentEmergency departmentCare processesUrinary catheter useUS emergency departmentsHealth care utilizationPatient-oriented outcomesAccreditation programCatheter useCare utilizationEmergency physiciansAmerican CollegeRural designationStudy periodInterquartile rangeSignificant heterogeneityPotential needContinuous dataLow levelsLevel 1Level 2CohortPhysiciansPreventionA 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 ResearchConceptsAmbulatory 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 diagnosis