2024
End‐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 expenditures
2023
Unfilled in emergency medicine: An analysis of the 2022 and 2023 Match by program accreditation, ownership, and geography
Gettel C, Bennett C, Rothenberg C, Smith J, Goldflam K, Sun W, Venkatesh A. Unfilled in emergency medicine: An analysis of the 2022 and 2023 Match by program accreditation, ownership, and geography. AEM Education And Training 2023, 7: e10902. PMID: 37600854, PMCID: PMC10436034, DOI: 10.1002/aet2.10902.Peer-Reviewed Original ResearchEM residency programsClinical sitesResidency programsGreater riskCross-sectional observational studyPrimary outcomeObservational studyProfit ownershipResidency program characteristicsMedicaid ServicesEmergency medicineCore-based statistical areasGraduate Medical EducationHigher numberRiskAccreditation CouncilDurationMatch cycleProgram characteristicsYearsStatusAvailable dataResidency positionsEmergency medicine physician workforce attrition differences by age and gender
Gettel C, Courtney D, Agrawal P, Madsen T, Rothenberg C, Mills A, Lall M, Keim S, Kraus C, Ranney M, Venkatesh A. Emergency medicine physician workforce attrition differences by age and gender. Academic Emergency Medicine 2023, 30: 1092-1100. PMID: 37313983, PMCID: PMC10973949, DOI: 10.1111/acem.14764.Peer-Reviewed Original ResearchConceptsFemale emergency physiciansEmergency physiciansMedian ageMultivariate logistic regression modelMale emergency physiciansResidency graduationRepeated cross-sectional analysisCharacteristics of physiciansWorkforce attritionCross-sectional analysisLogistic regression modelsStudy time frameDate of birthPrimary outcomeFemale genderMale physiciansClinical practiceFemale physiciansClinical servicesPhysiciansEmergency medicineAgeNumber of yearsRecent dataWorkforce concernsReal-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications
Sangal R, Rothenberg C, Hawk K, D'Onofrio G, Hsiao A, Solad Y, Venkatesh A. Real-World Observational Evaluation of Common Interventions to Reduce Emergency Department Prescribing of Opioid Medications. The Joint Commission Journal On Quality And Patient Safety 2023, 49: 239-246. PMID: 36914528, DOI: 10.1016/j.jcjq.2023.01.013.Peer-Reviewed Original ResearchConceptsOpioid prescribingED visitsElectronic health recordsOpioid prescriptionsEmergency department opioid prescriptionsAnalgesia prescriptionOpioid stewardshipOpioid medicationsSecondary outcomesPrimary outcomePreintervention periodInterruptive alertsCommon interventionPrescribingAlert fatigueElectronic prescribingPrevious interventionsHospital systemObservational evaluationHealth recordsVisitsStewardship policiesInterventionOutcomesPrescription
2022
Implementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines
Sangal RB, Liu RB, Cole KO, Rothenberg C, Ulrich A, Rhodes D, Venkatesh AK. Implementation of an Electronic Health Record Integrated Clinical Pathway Improves Adherence to COVID-19 Hospital Care Guidelines. American Journal Of Medical Quality 2022, 37: 335-341. PMID: 35026785, PMCID: PMC9241559, DOI: 10.1097/jmq.0000000000000036.Peer-Reviewed Original ResearchConceptsClinical pathwaySecondary outcomesCOVID-19 treatment guidelinesEmergency department cliniciansIntegrated clinical pathwayCOVID-19Electronic health recordsPrimary outcomeTreatment guidelinesClinician adherenceED cliniciansED patientsCare guidelinesTreatment recommendationsMedication administrationPatient outcomesPatient carePatientsCliniciansHealth systemHealth recordsOutcomesAdherenceAspirinCOVID-19 pandemicPrehospital emergency department care activations during the initial COVID-19 pandemic surge.
Leff R, Fleming-Nouri A, Venkatesh AK, Parwani V, Rothenberg C, Sangal RB, Flood CT, Goldenberg M, Wira C. Prehospital emergency department care activations during the initial COVID-19 pandemic surge. American Journal Of Disaster Medicine 2022, 17: 23-39. PMID: 35913181, DOI: 10.5055/ajdm.2022.0417.Peer-Reviewed Original ResearchConceptsCOVID-19 hospital admissionsCOVID-19 pandemic surgeTotal ED volumeNumber of patientsCOVID-19 hospitalizationScatterplot smoothing curvesPublic health measuresCritical medical conditionPublic health emergencyPrehospital presentationStroke activationHospital admissionPrimary outcomeTrauma activationsUrban EDAcademic EDCOVID-19 casesPrehospital settingClinical indicationsType of presentationMedical conditionsED volumePandemic surgeAbsolute decreaseHealth measures
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 analysis
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
2018
An appraisal of emergency medicine clinical practice guidelines: Do we agree?
Zupon A, Rothenberg C, Couturier K, Tan T, Siddiqui G, James M, Savage D, Melnick ER, Venkatesh AK. An appraisal of emergency medicine clinical practice guidelines: Do we agree? International Journal Of Clinical Practice 2018, 73: e13289. PMID: 30372798, PMCID: PMC6351191, DOI: 10.1111/ijcp.13289.Peer-Reviewed Original ResearchConceptsACEP clinical policyClinical practice guidelinesStrength of recommendationsClinical policyPractice guidelinesEvidence-based emergency careAGREE II instrumentAppraisal of GuidelinesRigor of developmentAGREE II criteriaOverall qualityPrimary outcomeOverall assessmentEmergency physiciansAmerican CollegeEmergency carePublication dateClarity of presentationSecondary analysisAppraisal instrumentsMean scorePositive associationGuidelinesAppraisal itemsScoresEmergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service
Lord K, Parwani V, Ulrich A, Finn EB, Rothenberg C, Emerson B, Rosenberg A, Venkatesh AK. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service. The American Journal Of Emergency Medicine 2018, 36: 1246-1248. PMID: 29605480, DOI: 10.1016/j.ajem.2018.03.043.Peer-Reviewed Original ResearchConceptsAdverse hospitalization outcomesRapid response team activationGeneral medical servicesHospitalization outcomesEmergency departmentED boardingComposite outcomeCare escalationPrimary outcomeAdverse outcomesRRT activationPatient encountersConsecutive patient encountersGeneral medicine serviceInpatient hospital stayMedical servicesEmergency department boardingED departureHospital mortalityHospital deathHospital stayED admissionPatient demographicsHospital admissionIntensive careOpening of Psychiatric Observation Unit Eases Boarding Crisis
Parwani V, Tinloy B, Ulrich A, D'Onofrio G, Goldenberg M, Rothenberg C, Patel A, Venkatesh A. Opening of Psychiatric Observation Unit Eases Boarding Crisis. Academic Emergency Medicine 2018, 25: 456-460. PMID: 29266537, DOI: 10.1111/acem.13369.Peer-Reviewed Original ResearchConceptsED LOSLength of stayMedian ED LOSTotal LOSPsychiatric admission ratesCrisis intervention unitSecondary outcomesPrimary outcomeObservation unitAdmission ratesPrimary analysisTertiary care academic medical centerPsychiatric chief complaintsBehavioral health staffInpatient psychiatric bedsAcute psychiatric careAcademic medical centerHours of careEmergency department boardingAdult EDAdult patientsPreintervention periodChief complaintPediatric hospitalInpatient admissions
2017
Preliminary Performance on the New CMS Sepsis-1 National Quality Measure: Early Insights From the Emergency Quality Network (E-QUAL)
Venkatesh AK, Slesinger T, Whittle J, Osborn T, Aaronson E, Rothenberg C, Tarrant N, Goyal P, Yealy DM, Schuur JD. Preliminary Performance on the New CMS Sepsis-1 National Quality Measure: Early Insights From the Emergency Quality Network (E-QUAL). Annals Of Emergency Medicine 2017, 71: 10-15.e1. PMID: 28789803, DOI: 10.1016/j.annemergmed.2017.06.032.Peer-Reviewed Original ResearchConceptsBundle complianceBundle elementsSEP-1 performanceSeptic shock casesIntravenous fluid resuscitationHospital-level variationChart review dataHospital-based EDsNational quality measuresQuality improvement dataBest practice implementationHospital-level performanceMedicaid Services definitionsSevere sepsisSecondary outcomesFluid resuscitationPrimary outcomeAcademic centersED implementationBundle componentsPractice implementationPreliminary dataImprovement dataFiscal year 2016Modest improvementSystematic review of emergency medicine clinical practice guidelines: Implications for research and policy
Venkatesh AK, Savage D, Sandefur B, Bernard KR, Rothenberg C, Schuur JD. Systematic review of emergency medicine clinical practice guidelines: Implications for research and policy. PLOS ONE 2017, 12: e0178456. PMID: 28628660, PMCID: PMC5476239, DOI: 10.1371/journal.pone.0178456.Peer-Reviewed Original ResearchConceptsCurrent clinical policyClinical practice guidelinesPractice guidelinesClinical policyEmergency medicineSystematic reviewClinical practice guideline recommendationsACEP clinical policyPractice guideline recommendationsLow-level evidenceLarge evidence baseLevel of recommendationPrimary outcomeGuideline recommendationsEmergency physiciansAmerican CollegeMajority of recommendationsExpert opinionClass of evidencePrimary analysisEvidence gapsSecondary analysisClass IIEvidence baseClass IReducing Unnecessary Blood Chemistry Testing in the Emergency Department: Implementation of Choosing Wisely
Venkatesh AK, Hajdasz D, Rothenberg C, Dashevsky M, Parwani V, Sevilla M, Shapiro M, Schwartz I. Reducing Unnecessary Blood Chemistry Testing in the Emergency Department: Implementation of Choosing Wisely. American Journal Of Medical Quality 2017, 33: 81-85. PMID: 28693330, DOI: 10.1177/1062860617691842.Peer-Reviewed Original ResearchConceptsBlood chemistry testingMultimodal interventionChemistry testingFormal laboratory testingMultimodal quality improvement interventionQuality improvement interventionsChemistry testsCare laboratory testingEmergency department throughputPre-post analysisAutoregressive integrated moving-average modelsED visitsPrimary outcomeUrban EDEmergency departmentProvider educationLaboratory testingImprovement interventionsVisitsInterventionDaily numberEDTesting