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
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
2023
Automatable 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
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 systemA 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 environmentOutcomes
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 system
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 sitesAGS 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-19
2006
Geriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health System
Wilber S, Gerson L, Terrell K, Carpenter C, Shah M, Heard K, Hwang U. Geriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health System. Academic Emergency Medicine 2006, 13: 1345-1351. DOI: 10.1111/j.1553-2712.2006.tb00304.x.Peer-Reviewed Original ResearchGeriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health System
Wilber ST, Gerson LW, Terrell KM, Carpenter CR, Shah MN, Heard K, Hwang U. Geriatric Emergency Medicine and the 2006 Institute of Medicine Reports from the Committee on the Future of Emergency Care in the U.S. Health System. Academic Emergency Medicine 2006, 13: 1345-1351. PMID: 17071799, DOI: 10.1197/j.aem.2006.09.050.Peer-Reviewed Original Research