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-1Quality improvement interventions to reduce coagulation testing overuse in the emergency department
Venkatesh A, Duke J, Wong S, Shah A, Rothenberg C, Patel A, Sun W, Shapiro M, Ulrich A, Parwani V. Quality improvement interventions to reduce coagulation testing overuse in the emergency department. The American Journal Of Emergency Medicine 2024 PMID: 39490322, DOI: 10.1016/j.ajem.2024.10.037.Peer-Reviewed Original Research8 Market Share of Emergency Department Annual Visits by Physician Employer Group Ownership Type
Cai A, Jarou Z, Janke A, Gettel C, Rothenberg C, Adelman L, Simpson M, Fisher J, Venkatesh A. 8 Market Share of Emergency Department Annual Visits by Physician Employer Group Ownership Type. Annals Of Emergency Medicine 2024, 84: s4. DOI: 10.1016/j.annemergmed.2024.08.017.Peer-Reviewed Original ResearchEmergency 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 projectVisitsUnfilled 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 positionsCorrelations among common emergency medicine physician performance measures: Mixed messages or balancing forces?
Scofi J, Underriner E, Sangal R, Rothenberg C, Patel A, Pickens A, Sather J, Parwani V, Ulrich A, Venkatesh A. Correlations among common emergency medicine physician performance measures: Mixed messages or balancing forces? The American Journal Of Emergency Medicine 2023, 72: 58-63. PMID: 37481955, DOI: 10.1016/j.ajem.2023.07.021.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 sampleAdultsEmergency 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 concernsManaging 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 resourcesEstimated reimbursement impact of COVID‐19 on emergency physicians
Venkatesh A, Janke A, Koski‐Vacirca R, Rothenberg C, Parwani V, Granovsky M, Burke L, Li S, Pines J. Estimated reimbursement impact of COVID‐19 on emergency physicians. Academic Emergency Medicine 2023, 30: 636-643. PMID: 36820470, DOI: 10.1111/acem.14700.Peer-Reviewed Original ResearchConceptsNationwide Emergency Department SampleED visitsEmergency physiciansSecondary analysisCOVID-19Acute care utilizationEmergency Department SampleEmergency Department registryCOVID-19 pandemicHealth care servicesEmergency department sitesReimbursement impactCare utilizationBilling codesInsurance payerDepartment registryPrimary analysisCare servicesPhysiciansReimbursement lossHealth careStudy sampleVisitsPandemic-related lossReimbursementReal-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
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 sampleImproving Sepsis Management Through the Emergency Quality Network Sepsis Initiative
Rodos A, Aaronson E, Rothenberg C, Goyal P, Sharma D, Slesinger T, Schuur J, Venkatesh A. Improving Sepsis Management Through the Emergency Quality Network Sepsis Initiative. The Joint Commission Journal On Quality And Patient Safety 2022, 48: 572-580. PMID: 36137885, DOI: 10.1016/j.jcjq.2022.08.002.Peer-Reviewed Original ResearchConceptsSepsis casesQI activitiesSEP-1 performanceEmergency department patientsQI effortsTime-sensitive conditionsSignificant correlationCross-sectional analysisSepsis careDepartment patientsSepsis managementAmerican CollegeED sitesScoresPublic reportingReal-time quality improvementHospital performanceEDQuality improvementImplementation dataOverall hospital performanceQI dataPatientsInpatientsED performanceThe 2013 to 2019 Emergency Medicine Workforce: Clinician Entry and Attrition Across the US Geography
Gettel CJ, Courtney DM, Janke AT, Rothenberg C, Mills AM, Sun W, Venkatesh AK. The 2013 to 2019 Emergency Medicine Workforce: Clinician Entry and Attrition Across the US Geography. Annals Of Emergency Medicine 2022, 80: 260-271. PMID: 35717274, PMCID: PMC9398978, DOI: 10.1016/j.annemergmed.2022.04.031.Peer-Reviewed Original ResearchConceptsAdvanced practice providersEmergency physiciansPractice providersNonemergency physiciansEmergency cliniciansRural designationUrban emergency physiciansRepeated cross-sectional analysisEmergency medicine workforceCross-sectional analysisUnique cliniciansMedicare Part BStudy yearsCliniciansPhysiciansProvider UtilizationPhysician attritionSubstantial state-level variationResidency trainingLongitudinal trendsManagement servicesAttrition ratesState-level changesState-level variationTotal proportion