Featured Publications
Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review
Nowroozpoor A, Dussetschleger J, Perry W, Sano M, Aloysi A, Belleville M, Brackett A, Hirshon JM, Hung W, Moccia JM, Ohuabunwa U, Shah MN, Hwang U, Network G, Aggarwal N, Bellolio M, Betz M, Biese K, Brandt C, Bruursema S, Carnahan R, Carpenter C, Carr D, Chin-Hansen J, Daven M, Degesys N, Dresden S, Ellenbogen M, Falvey J, Foster B, Gettel C, Gilmore-Bykovskyi A, Goldberg E, Han J, Hardy J, Hastings S, Hogan T, Isaacs E, Jaspal N, Johnson J, Kelly K, Kennedy M, Kind A, Malone M, Moreno M, Morrow-Howell N, Oiyemhonlan B, Resendez J, Rising K, Savage B, Suyama J, Swartzberg J, Tolia V, Vann A, Webb T, Weintraub S. Detecting Cognitive Impairment and Dementia in the Emergency Department: A Scoping Review. Journal Of The American Medical Directors Association 2022, 23: 1314-1315.e55. PMID: 35940682, PMCID: PMC10804640, DOI: 10.1016/j.jamda.2022.03.019.Peer-Reviewed Original ResearchConceptsSix-Item ScreenerEmergency departmentCognitive impairmentED settingConsensus conferenceScoping ReviewHigh negative predictive valueAdult ED patientsNegative predictive valueMedical research databasesOttawa 3DYSystematic scoping reviewED patientsResearch funding prioritiesClinical careResearch DatabasePredictive valueCare partnersResearch prioritiesDementiaImpairmentConsensus processPractice gapTask ForceFuture research prioritiesAdapting 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
Dementia risk analysis using temporal event modeling on a large real-world dataset
Taylor R, Gilson A, Chi L, Haimovich A, Crawford A, Brandt C, Magidson P, Lai J, Levin S, Mecca A, Hwang U. Dementia risk analysis using temporal event modeling on a large real-world dataset. Scientific Reports 2023, 13: 22618. PMID: 38114545, PMCID: PMC10730574, DOI: 10.1038/s41598-023-49330-8.Peer-Reviewed Original ResearchRecurrent emergency department visits among persons living with dementia: Bending the curve
Shah M, Hwang U. Recurrent emergency department visits among persons living with dementia: Bending the curve. Journal Of The American Geriatrics Society 2023, 71: 3676-3679. PMID: 37804125, PMCID: PMC10842408, DOI: 10.1111/jgs.18610.Peer-Reviewed Original ResearchGeriatric 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 ResearchResearch 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 interventionsDissemination 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 yearVariation in firearm screening and access by LGBT status
Goulet J, Warren A, Workman T, Skanderson M, Farmer M, Gordon K, Abel E, Akgün K, Bean‐Mayberry B, Zeng‐Treitler Q, Haderlein T, Haskell S, Bastian L, Womack J, Post L, Hwang U, Brandt C. Variation in firearm screening and access by LGBT status. Academic Emergency Medicine 2023, 30: 420-423. PMID: 36661348, DOI: 10.1111/acem.14664.Peer-Reviewed Original ResearchAutomatable 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
Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review
Carpenter CR, Leggett J, Bellolio F, Betz M, Carnahan RM, Carr D, Doering M, Hansen JC, Isaacs ED, Jobe D, Kelly K, Morrow-Howell N, Prusaczyk B, Savage B, Suyama J, Vann AS, Rising KL, Hwang U, Shah MN, Network G, Aggarwal N, Allore H, Aloysi 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, Oiyemhonlan 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. Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review. Journal Of The American Medical Directors Association 2022, 23: 1313.e15-1313.e46. PMID: 35940681, DOI: 10.1016/j.jamda.2022.02.024.Peer-Reviewed Original ResearchConceptsCare partnersOutcome measuresSpecific communication strategiesEmergency department communicationSystematic electronic searchValid outcome measuresScoping ReviewED communicationMedical research databasesBarriers/facilitatorsSystem-level factorsSystematic scoping reviewED careED settingPICO questionED teamConsensus conferenceElectronic searchResearch DatabaseResearch prioritiesOutcome questionsDementiaDementia researchersEffective communicationRelevant publicationsOptimal 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 environmentOutcomesPragmatic clinical trial design in emergency medicine: Study considerations and design types
Gettel CJ, Yiadom MYAB, Bernstein SL, Grudzen CR, Nath B, Li F, Hwang U, Hess EP, Melnick ER. Pragmatic clinical trial design in emergency medicine: Study considerations and design types. Academic Emergency Medicine 2022, 29: 1247-1257. PMID: 35475533, PMCID: PMC9790188, DOI: 10.1111/acem.14513.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsClinical trial designTrial designReal-world clinical practicePragmatic clinical trial designElectronic health recordsEmergency departmentClinical trialsStudy design typeClinical practiceStudy typeTrial componentsHealth recordsEmergency medicineEmergency medicine investigatorsHuman subjects concernsInvestigatorsStudy findingsStudy considerationsTrialistsTrialsEmergency 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 system