2024
Effects of opening a vertical care area on emergency medicine resident clinical experience
Tsyrulnik A, Rothenberg C, Sun W, Venkatesh A, Coughlin R, Goldflam K, Sangal R. Effects of opening a vertical care area on emergency medicine resident clinical experience. AEM Education And Training 2024, 8: e11040. PMID: 39574943, PMCID: PMC11576914, DOI: 10.1002/aet2.11040.Peer-Reviewed Original ResearchEmergency Severity IndexBehavioral health patientsEmergency departmentHealth patientsPostgraduate year (PGY)-1 residentsAcuity level of patientsCare unitPractice registered nursesResident educational outcomesESI 4PGY-3 residentsFast-track unitPGY-1 residentsResident clinical experiencePatient acuityCritical care patientsCare patientsCare areasClinical educationTriage physiciansAcuity levelsCritical careLevels of patientsPGY-2PGY-1Emergency Department Visits Among Patients With Dementia Before and After Diagnosis
Gettel C, Song Y, Rothenberg C, Kitchen C, Gilmore-Bykovskyi A, Fried T, Brody A, Nothelle S, Wolff J, Venkatesh A. Emergency Department Visits Among Patients With Dementia Before and After Diagnosis. JAMA Network Open 2024, 7: e2439421. PMID: 39401040, PMCID: PMC11581500, DOI: 10.1001/jamanetworkopen.2024.39421.Peer-Reviewed Original ResearchEnd‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study
Gettel C, Kitchen C, Rothenberg C, Song Y, Hastings S, Kennedy M, Ouchi K, Haimovich A, Hwang U, Venkatesh A. End‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study. Journal Of The American Geriatrics Society 2024 PMID: 39311623, DOI: 10.1111/jgs.19199.Peer-Reviewed Original ResearchEnd-of-lifeOut-of-pocket spendingED visitsTotal healthcare spendingMedicare beneficiariesHealthcare spendingEmergency departmentOlder adultsMedicare Current Beneficiary Survey dataAnalysis of Medicare beneficiariesPooled cross-sectional analysisEmergency department usePrimary outcomeDecreased likelihoodDiagnosis of dementiaOut-of-pocket costsNationally representative studyNationally representative sampleAdult decedentsHospice statusDepartment useED useED servicesHealth careHealthcare expendituresTotal and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage
Gettel C, Salah W, Rothenberg C, Liang Y, Schwartz H, Scott K, Hwang U, Hastings S, Venkatesh A. Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage. Annals Of Emergency Medicine 2024, 84: 285-294. PMID: 38864783, PMCID: PMC11343654, DOI: 10.1016/j.annemergmed.2024.04.023.Peer-Reviewed Original ResearchOut-of-pocketED visitsTraditional MedicareOlder adultsEmergency departmentMedicare AdvantageMedicare Advantage plan enrolleesMedicare Current Beneficiary SurveyEmergency department careTreat-and-releaseOut-of-pocket expensesOut-of-pocket health care spendingHealth care spendingCross-sectional analysisProportion of costsMedian totalEmergency careTreat-and-release emergency departmentBeneficiary SurveyMedian total costProportion of expensesCare spendingPlan enrolleesMedicareVisitsEstimating the size and scope of the academic emergency physician workforce
Gettel C, Camargo C, Bennett C, Courtney D, Kaji A, Fermann G, Gallahue F, Nelson L, Hebbard C, Rothenberg C, Raja A, Venkatesh A. Estimating the size and scope of the academic emergency physician workforce. Academic Emergency Medicine 2024, 31: 732-738. PMID: 38769602, DOI: 10.1111/acem.14931.Peer-Reviewed Original ResearchProportion of emergency physiciansAccreditation Council for Graduate Medical EducationClinical training sitesED visitsEM residency programsAcademic emergency departmentEmergency physiciansEmergency departmentEM workforceEmergency medicineACGME-accredited EM residency programsAcademic sitesProportion of emergency departmentCenters for Medicare & Medicaid ServicesEmergency physician workforceResidency programsProportion of ED visitsDepartment of Veterans AffairsAccredited EM residency programsTraining of resident physiciansAmerican Hospital AssociationTraining sitesNational proportionsAcademic Emergency MedicineGraduate Medical EducationImpact of the geriatric emergency medicine specialist intervention on final emergency department disposition
Cohen I, Sangal R, Taylor R, Crawford A, Lai J, Martin P, Palleschi S, Rothenberg C, Tomasino D, Hwang U. Impact of the geriatric emergency medicine specialist intervention on final emergency department disposition. Journal Of The American Geriatrics Society 2024, 72: 2017-2026. PMID: 38667266, DOI: 10.1111/jgs.18908.Peer-Reviewed Original ResearchED length of stayED lengthLength of stayObservation admissionsED dispositionInpatient admissionsEmergency departmentOdds of inpatient admissionRate of hospital admissionsAdvanced practice providersGeriatric ED patientsEmergency medicine specialistsTarget trial emulation frameworkHospital admission ratesOdds of dischargeRegional healthcare systemEmergency department dispositionIncreased odds of dischargeCare planningPractice providersED sitesED visitsOlder adultsSpecialist interventionAdmission rates
2023
Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department
Hawk K, Weiner S, Rothenberg C, Bernstein E, D'Onofrio G, Herring A, Hoppe J, Ketcham E, LaPietra A, Nelson L, Perrone J, Ranney M, Samuels E, Strayer R, Sharma D, Goyal P, Schuur J, Venkatesh A. Leveraging a Learning Collaborative Model to Develop and Pilot Quality Measures to Improve Opioid Prescribing in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 225-234. PMID: 37831040, DOI: 10.1016/j.annemergmed.2023.08.490.Peer-Reviewed Original ResearchAtraumatic back painCommunity EDED visitsBack painOpioid prescribing practicesFirst-line treatmentEmergency department patientsOpioid use disorderQuality improvement projectEvidence-based resourcesOpioid administrationOpioid prescriptionsDental painSafe analgesiaDepartment patientsOpioid pillsPrescribing practicesEmergency departmentAmerican CollegeUse disordersMedication safety educationPainOpioidsImprovement projectVisitsAn 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 sampleAdultsManaging opioid waste, cost, and opportunity for drug diversion in the emergency department
Coleska A, Oh A, Rothenberg C, Dinh D, Parwani V, Venkatesh A. Managing opioid waste, cost, and opportunity for drug diversion in the emergency department. The American Journal Of Emergency Medicine 2023, 69: 195-199. PMID: 37172559, DOI: 10.1016/j.ajem.2023.05.001.Peer-Reviewed Original ResearchConceptsDrug diversionContext of opioidEmergency department visitsManagement of painSingle health systemLogistic regression modelsHealth care systemOpioid ordersIntravenous opioidsSevere painDepartment visitsOpioid diversionEmergency departmentIncorrect doseOpioid epidemicOpioidsPrimary analysisMorphineDose orderHealth systemDoseHydromorphoneCare systemDrug shortagesPainClinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage
Zachrison K, Goldstein J, Jauch E, Radecki R, Madsen T, Adeoye O, Oostema J, Feeser V, Ganti L, Lo B, Meurer W, Corral M, Rothenberg C, Chaturvedi A, Goyal P, Venkatesh A. Clinical Performance Measures for Emergency Department Care for Adults With Intracranial Hemorrhage. Annals Of Emergency Medicine 2023, 82: 258-269. PMID: 37074253, DOI: 10.1016/j.annemergmed.2023.03.015.Peer-Reviewed Original ResearchConceptsIntracranial hemorrhageAcute neurologic emergenciesEmergency department careNontraumatic intracranial hemorrhageCare of patientsClinical performance measuresCommunity EDNeurologic emergencySyndromic approachEmergency departmentEvidence-based targetsHyperacute phaseWarrants further developmentWorkgroup of expertsQuality improvement resourcesCare processesReview of dataQuality improvementHemorrhageInternal quality improvementCareNational sampleBroad implementationEDImprovement resources
2022
Patient cost consciousness in the emergency department
Gaylor JM, Chan E, Parwani V, Ulrich A, Rothenberg C, Venkatesh A. Patient cost consciousness in the emergency department. The American Journal Of Emergency Medicine 2022, 61: 61-63. PMID: 36054987, DOI: 10.1016/j.ajem.2022.08.039.Peer-Reviewed Original ResearchConceptsEmergency departmentPocket costsED patientsLarge academic hospital systemAcademic hospital systemCertain patient demographicsEmergency department settingPerceptions of patientsCost of careMedicare/MedicaidPatient demographicsED careUnscheduled careUninsured patientsDepartment settingPatients' estimatesPatient's abilityEmergency careHigh school educationPatientsPrivate insuranceFinal analysisHospital systemCareConvenience sampleEmergency department utilization for substance use disorders and mental health conditions during COVID-19
Venkatesh AK, Janke AT, Kinsman J, Rothenberg C, Goyal P, Malicki C, D’Onofrio G, Taylor A, Hawk K. Emergency department utilization for substance use disorders and mental health conditions during COVID-19. PLOS ONE 2022, 17: e0262136. PMID: 35025921, PMCID: PMC8757912, DOI: 10.1371/journal.pone.0262136.Peer-Reviewed Original ResearchConceptsOpioid use disorderOverall ED visitsED visitsEmergency departmentMental health conditionsAlcohol use disorderED visitationUse disordersED utilizationHospital-based emergency departmentsHealth conditionsEmergency department utilizationPublic health surveillance toolSite of careClinical quality registryEarly pandemic periodVisit countsSubstance use disordersCOVID-19COVID-19 pandemicED visit countsDiagnosis codesOutpatient treatmentMedicines RegistryQuality registry
2021
Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act
Sangal RB, Powers E, Rothenberg C, Ndumele C, Ulrich A, Hsiao A, Venkatesh AK. Disparities in Accessing and Reading Open Notes in the Emergency Department Upon Implementation of the 21st Century CURES Act. Annals Of Emergency Medicine 2021, 78: 593-598. PMID: 34353651, DOI: 10.1016/j.annemergmed.2021.06.014.Peer-Reviewed Original ResearchConceptsProportion of patientsPatient portal accessEmergency departmentOpen notesClinical notesPortal accessPublic insuranceUrgent care centersCentury Cures ActDifferent patient demographicsSingle health systemPatient demographicsPrimary outcomeCures ActPatient utilizationPatient visitsCare centerObservational studyPatientsDigital health toolsAge 18Health systemHealth toolsUnique barriersNon-English speakersNational trends in emergency department closures, mergers, and utilization, 2005-2015
Venkatesh AK, Janke A, Rothenberg C, Chan E, Becher RD. National trends in emergency department closures, mergers, and utilization, 2005-2015. PLOS ONE 2021, 16: e0251729. PMID: 34015007, PMCID: PMC8136839, DOI: 10.1371/journal.pone.0251729.Peer-Reviewed Original ResearchConceptsHospital-based EDsEmergency department closureED visitsHospital admissionHospital bedsED closureYearly ED visitsLarge health systemAmerican Hospital Association Annual SurveyInpatient bed capacityPrimary outcomeSecondary outcomesMore patientsEmergency departmentRelative increaseInpatient bedsPatient volumeRural areasHealth systemAdmissionVisitsNational trendsBed capacityEDObservational analysisDelays in antibiotic redosing: Association with inpatient mortality and risk factors for delay
Kemmler CB, Sangal RB, Rothenberg C, Li SX, Shofer FS, Abella BS, Venkatesh AK, Foster SD. Delays in antibiotic redosing: Association with inpatient mortality and risk factors for delay. The American Journal Of Emergency Medicine 2021, 46: 63-69. PMID: 33735698, DOI: 10.1016/j.ajem.2021.02.058.Peer-Reviewed Original ResearchConceptsSecond dose administrationEmergency departmentDose administrationRisk factorsEmergency Severity IndexHospital mortalityFirst doseSecond doseED boardingAntibiotic dosesEnd-stage renal diseaseExtremes of weightHigh acuity presentationsRetrospective cohort studyStage renal diseaseWorse clinical outcomesSerious bacterial infectionsOdds of delayEarly hospital courseSingle healthcare systemAntibiotic redosingDosing intervalHospital courseCohort studyInpatient mortality
2020
Unscheduled Care Access in the United States-A Tale of Two Emergency Departments
Venkatesh AK, Greenwood-Ericksen MB, Mei H, Rothenberg C, Lin Z, Krumholz HM. Unscheduled Care Access in the United States-A Tale of Two Emergency Departments. The American Journal Of Emergency Medicine 2020, 45: 374-377. PMID: 33143957, PMCID: PMC8076339, DOI: 10.1016/j.ajem.2020.08.095.Peer-Reviewed Original ResearchConceptsHospital referral regionsED visit ratesEmergency departmentCare ratesVisit ratesMedicare Chronic Conditions WarehouseHospital-based emergency departmentsRole of EDsChronic Conditions WarehouseProportion of beneficiariesDartmouth Atlas hospital referral regionHealthcare delivery systemED utilizationED visitsED useUnscheduled careReferral regionsUrban zip codesCare accessMedicare beneficiariesCare needsCare deliveryOffice settingCare capabilitiesDisproportionate barriersNational Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015
Pendyal A, Rothenberg C, Scofi JE, Krumholz HM, Safdar B, Dreyer RP, Venkatesh AK. National Trends in Emergency Department Care Processes for Acute Myocardial Infarction in the United States, 2005 to 2015. Journal Of The American Heart Association 2020, 9: e017208. PMID: 33047624, PMCID: PMC7763391, DOI: 10.1161/jaha.120.017208.Peer-Reviewed Original ResearchConceptsST-segment elevation myocardial infarctionAcute myocardial infarctionMedian ED lengthUS emergency departmentsEmergency departmentED visitsMyocardial infarctionED administrationED lengthAMI careNational Hospital Ambulatory Medical Care SurveyCare processesAmbulatory Medical Care SurveyEvidence-based medicationsNonaspirin antiplatelet agentsEarly invasive strategyAnnual ED visitsRegionalization of careED care processesReal-world trendsAntiplatelet therapyAnnual incidenceAntiplatelet agentsYearly incidenceCare SurveyWhere Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionCross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries
Venkatesh AK, Mei H, Shuling L, D’Onofrio G, Rothenberg C, Lin Z, Krumholz HM. Cross‐sectional Analysis of Emergency Department and Acute Care Utilization Among Medicare Beneficiaries. Academic Emergency Medicine 2020, 27: 570-579. PMID: 32302034, DOI: 10.1111/acem.13971.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsEmergency departmentUnscheduled careMedicare beneficiariesCross-sectional analysisVisit ratesCare servicesHighest ED visit ratesNumber of EDVulnerable subpopulationsSkilled nursing facility useAmbulatory office settingNon-ED settingsUnscheduled care servicesAcute care utilizationED visit ratesOffice-based visitsAcute care servicesClaims-based definitionNursing facility useMedicare beneficiaries age 65Dual-eligible beneficiariesOlder adult populationBeneficiaries age 65Care visits
2019
Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency
Coughlin RF, Peaper D, Rothenberg C, Golden M, Landry ML, Cotton J, Parwani V, Shapiro M, Ulrich A, Venkatesh AK. Electronic Health Record–Assisted Reflex Urine Culture Testing Improves Emergency Department Diagnostic Efficiency. American Journal Of Medical Quality 2019, 35: 252-257. PMID: 31296024, DOI: 10.1177/1062860619861947.Peer-Reviewed Original ResearchConceptsUrine culture ordersUrine culture testingED visitsUrine cultureEmergency departmentDiagnostic yieldCulture ordersCulture testingUrine culture utilizationClinical decision support toolElectronic health recordsSecondary outcomesPrimary outcomeTest utilizationHealth recordsSignificant decreaseDiagnostic efficiencyMean numberVisitsCulture utilizationOutcomesTesting algorithm