Featured Publications
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
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 research
2024
System-level Variability in Trauma Center Utilization for Seriously Injured Older Adults
Ordoobadi A, Castillo-Angeles M, Tabata-Kelly M, Jenkins P, Hwang U, Cooper Z, Jarman M. System-level Variability in Trauma Center Utilization for Seriously Injured Older Adults. Journal Of Surgical Research 2024, 305: 10-18. PMID: 39616785, DOI: 10.1016/j.jss.2024.10.047.Peer-Reviewed Original ResearchInjured older adultsTrauma service areasSystem-level factorsOlder adultsMultivariable hierarchical logistic regressionHierarchical logistic regressionTrauma centerLogistic regressionRate of undertriageLevel IRetrospective cross-sectional studyCross-sectional studyUnited States countiesHospital destinationInjury characteristicsTrauma center utilizationMedicare dataSystem-level variablesPatient demographicsRandom interceptStates countiesUndertriagePrimary outcomeRural regionsCenter utilizationScreening for cognitive impairment in the emergency department: agreement between older adult patient- and informant-completed Ascertain Dementia 8 tool.
Galske J, Sather A, Chera T, Hwang U, Carpenter C, Babcock M, Gettel C. Screening for cognitive impairment in the emergency department: agreement between older adult patient- and informant-completed Ascertain Dementia 8 tool. Dementia And Geriatric Cognitive Disorders 2024, 1-13. PMID: 39616991, DOI: 10.1159/000542895.Peer-Reviewed Original ResearchAscertain Dementia 8Intraclass correlation coefficientEmergency departmentCognitive impairmentTrained research assistantsDiagnosis of dementiaClinicians providing careModerate agreementSuspected CIEmergency careOlder adultsAnalytic sampleResearch assistantsED patientsCareScreening protocolSelf-identifyEarly interventionDementiaScoresCorrelation coefficientDepartmentDyadsPatientsImpairmentEnd‐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 expendituresRacial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department
Jivalagian P, Gettel C, Smith C, Robinson L, Brinker M, Shah D, Kumar A, Faustino I, Nath B, Chang-Sing E, Taylor R, Kennedy M, Hwang U, Wong A. Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department. American Journal Of Geriatric Psychiatry 2024 PMID: 39054237, DOI: 10.1016/j.jagp.2024.07.004.Peer-Reviewed Original ResearchPhysical restraint useRestraint useOlder adultsED visitsPhysical restraintEmergency departmentElectronic health record dataHealth record dataBlack non-HispanicPatient-level characteristicsAge-related disparitiesAssociated with increased useRegional hospital networkCross-sectional studyLogistic regression modelsChemical sedationRetrospective cross-sectional studyNon-Hispanic groupNon-HispanicAgitation managementHospital sitesHospital networkRecord dataWhite non-Hispanic groupPrimary outcomeTotal 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 enrolleesMedicareVisitsGeriatric Emergency Departments
Hwang U, Dresden S, Southerland L, Meldon S. Geriatric Emergency Departments. 2024, 231-237. DOI: 10.1007/978-3-031-56204-4_24.Peer-Reviewed Original ResearchImpact 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 ratesPatient‐reported outcome measure use among older adults after emergency department care: A systematic review
Gettel C, Galske J, Sather A, Haidous A, Hwang U, Brackett A, Venkatesh A, Rising K, Goldberg E, van Oppen J, Conroy S, Carpenter C. Patient‐reported outcome measure use among older adults after emergency department care: A systematic review. Academic Emergency Medicine 2024, 31: 273-287. PMID: 38366698, DOI: 10.1111/acem.14850.Peer-Reviewed Original ResearchPatient-reported outcome measuresActivities of daily livingED visitsOlder adultsPhysical functionPatient-reported outcome measure useInstrumental activities of daily livingKatz activities of daily livingOlder adult ED patientsPatient-reported outcome measure assessmentSystematic reviewOutcome measure useEmergency department carePatient symptom burdenFull-text screeningAdult ED patientsRisk of biasQuality of lifeStudy inclusion criteriaWeb of Science-Core CollectionKatz ActivitiesEmergency careDaily livingPROM assessmentBarthel Index
2023
Automating risk stratification for geriatric syndromes in the emergency department
Haimovich A, Shah M, Southerland L, Hwang U, Patterson B. Automating risk stratification for geriatric syndromes in the emergency department. Journal Of The American Geriatrics Society 2023, 72: 258-267. PMID: 37811698, PMCID: PMC10866303, DOI: 10.1111/jgs.18594.Peer-Reviewed Original ResearchRisk stratificationGeriatric syndromesCognitive impairmentGeriatric Emergency Department GuidelinesHigh-risk patientsRisk stratification approachHigh-risk populationED patient volumeEmergency Department GuidelinesGeriatric emergency careElectronic health recordsOlder patientsRisk patientsPalliative careEmergency departmentProvider burdenImproved careLife careEmergency carePatient volumeDepartment guidelinesOlder adultsHealth recordsCareEHR dataAn 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 ResearchDissemination 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 yearAutomatable 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
263 Emergency Department Care Transition Barriers: A Qualitative Study of Care Partners of Older Adults With Cognitive Impairment
Gettel C, Serina P, Uzamere I, Hernandez-Bigos K, Cohen A, Venkatesh A, Monin J, Feder S, Fried T, Hwang U. 263 Emergency Department Care Transition Barriers: A Qualitative Study of Care Partners of Older Adults With Cognitive Impairment. Annals Of Emergency Medicine 2022, 80: s115. DOI: 10.1016/j.annemergmed.2022.08.290.Peer-Reviewed Original Research136 Ambulatory Follow-up After Emergency Department Discharge and Association With Outcomes Among Older Adults With Alzheimer’s Disease and Related Dementia
Lin M, Burke R, Goldberg E, Hwang U, Burke L. 136 Ambulatory Follow-up After Emergency Department Discharge and Association With Outcomes Among Older Adults With Alzheimer’s Disease and Related Dementia. Annals Of Emergency Medicine 2022, 80: s63-s64. DOI: 10.1016/j.annemergmed.2022.08.160.Peer-Reviewed Original ResearchEmergency 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 environmentOutcomesEmergency 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 studiesExamination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments
Santangelo I, Ahmad S, Liu S, Southerland L, Carpenter C, Hwang U, Lesser A, Tidwell N, Biese K, Kennedy M. Examination of geriatric care processes implemented in level 1 and level 2 geriatric emergency departments. Journal Of Geriatric Emergency Medicine 2022, 3 PMID: 36970655, PMCID: PMC10035774, DOI: 10.17294/2694-4715.1041.Peer-Reviewed Original ResearchGeriatric EDGeriatric fallsCare processesMedication reconciliationMedication-related adverse eventsOlder adultsGeriatric pain managementPain medication protocolUnique care needsEmergency department settingInappropriate medication administrationGeriatric Emergency DepartmentIndividual care processesDifferent screening toolsCross-sectional analysisAssessment of functionLevel 1Beers criteriaED administrationInappropriate medicationsAdverse eventsRenal functionMedication protocolsPain managementEmergency department