2023
Dissemination 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 yearResearch 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 interventions
2019
Analgesic prescribing trends in a national sample of older veterans with osteoarthritis
Trentalange M, Runels T, Bean A, Kerns RD, Bair MJ, Brody AA, Brandt CA, Hwang U. Analgesic prescribing trends in a national sample of older veterans with osteoarthritis. Pain 2019, Publish Ahead of Print: &na;. PMID: 30913167, PMCID: PMC9486693, DOI: 10.1097/j.pain.0000000000001509.Peer-Reviewed Original ResearchConceptsPain intensity ratingsAnalgesic prescriptionPrescribing trendsOlder veteransIntensity ratingsNonopioid analgesic prescribingPatterns of opioidPre-post observational studyReported pain intensityInterrupted time seriesOlder U.S. veteransAcetaminophen prescriptionsAnalgesic classTotal prescribingAnalgesic prescribingOpioid prescribingPain intensityDrug prescribingObservational studyPrescribingU.S. veteransPrescribing programmeOsteoarthritisStudy periodBinomial regression models
2017
An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department
Moss JM, Bryan WE, Wilkerson LM, King HA, Jackson GL, Owenby RK, Van Houtven CH, Stevens MB, Powers J, Vaughan CP, Hung WW, Hwang U, Markland AD, Sloane R, Knaack W, Hastings SN. An Interdisciplinary Academic Detailing Approach to Decrease Inappropriate Medication Prescribing by Physician Residents for Older Veterans Treated in the Emergency Department. Journal Of Pharmacy Practice 2017, 32: 167-174. PMID: 29277130, PMCID: PMC6533068, DOI: 10.1177/0897190017747424.Peer-Reviewed Original ResearchMeSH KeywordsAgedClinical CompetenceDrug PrescriptionsEducation, MedicalEmergency MedicineEmergency Service, HospitalHealth Services for the AgedHumansInappropriate PrescribingInternship and ResidencyInterprofessional RelationsPhysiciansPotentially Inappropriate Medication ListQuality ImprovementSurveys and QuestionnairesUnited StatesUnited States Department of Veterans AffairsVeteransConceptsQuality improvement projectAcademic detailingEmergency departmentOlder adultsPIM ratesBeers criteriaPhysician residentsResident cohortVeterans Affairs emergency departmentInappropriate medication prescribingAcademic detailing interventionDrug-disease interactionsImprovement projectSelf-perceived barriersInappropriate medicationsMedication prescribingED populationAppropriate medicationOlder veteransSelf-reported confidenceCohortEducational interventionRate ratioSignificant decreaseSelf-rated confidenceEnhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUiPPED)
Stevens M, Hastings SN, Markland AD, Hwang U, Hung W, Vandenberg AE, Bryan W, Cross D, Powers J, McGwin G, Fattouh N, Ho W, Clevenger C, Vaughan CP. Enhancing Quality of Provider Practices for Older Adults in the Emergency Department (EQUiPPED). Journal Of The American Geriatrics Society 2017, 65: 1609-1614. PMID: 28388818, DOI: 10.1111/jgs.14890.Peer-Reviewed Original ResearchConceptsOlder adultsAmerican Geriatrics Society 2012 Beers CriteriaMulticomponent quality improvement initiativeEmergency department dischargeNumber of PIMsUse of PIMsElectronic clinical decision supportQuality improvement initiativesPost-intervention comparisonBeers criteriaPIM prescriptionInappropriate medicationsClinical decision supportEmergency departmentSafe prescribingCenter EDMedication safetyProvider practicesOlder veteransSustained reductionMulticomponent programPoisson regressionED sitesImprovement initiativesIndividual providers(233) Evaluating the agreement between self-reported and documented analgesic use in older veterans with osteoarthritis
Domanski A, Bair M, Balk R, Brandt C, Brody A, Dismore R, Gaetano V, Garrido M, Gittleman D, Kerns R, Krebs E, Linden E, Morrison R, Natividad D, Penrod J, Rinaldi A, Stefanis L, Sun D, Hwang U. (233) Evaluating the agreement between self-reported and documented analgesic use in older veterans with osteoarthritis. Journal Of Pain 2017, 18: s34. DOI: 10.1016/j.jpain.2017.02.125.Peer-Reviewed Original ResearchAnalgesic useOlder veterans
2016
Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use
Vandenberg AE, Vaughan CP, Stevens M, Hastings SN, Powers J, Markland A, Hwang U, Hung W, Echt KV. Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use. International Journal For Quality In Health Care 2016, 29: 117-123. PMID: 27852639, DOI: 10.1093/intqhc/mzw129.Peer-Reviewed Original ResearchConceptsEmergency departmentQuality improvement initiativesClinical decision supportOrder setsMedical recordsOrder set useSettings of carePatients' medical recordsGeriatric prescribingPrescribing practicesAdoption of CDSOlder veteransProvider groupsOlder adultsPhone interviewsImprovement initiativesPrescribingSafety concernsOrder entry processProvider autonomyQualitative studyProvidersEntry processImplementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments.
Vandenberg AE, Stevens M, Echt KV, Hastings SN, Powers J, Markland A, Hwang U, Hung W, Belbis S, Vaughan CP. Implementing the EQUiPPED Medication Management Program at 5 VA Emergency Departments. Federal Practitioner 2016, 33: 29-33. PMID: 27773986, PMCID: PMC5070380.Peer-Reviewed Original Research
2015
Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative
Stevens MB, Hastings SN, Powers J, Vandenberg AE, Echt KV, Bryan WE, Peggs K, Markland AD, Hwang U, Hung WW, Schmidt AJ, McGwin G, Ikpe-Ekpo E, Clevenger C, Johnson TM, Vaughan CP. Enhancing the Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department (EQUiPPED): Preliminary Results from Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department, a Novel Multicomponent Interdisciplinary Quality Improvement Initiative. Journal Of The American Geriatrics Society 2015, 63: 1025-1029. PMID: 25945692, DOI: 10.1111/jgs.13404.Peer-Reviewed Original ResearchConceptsQuality improvement initiativesOlder veteransPrescribing practicesStaff providersEmergency departmentProvider educationEmergency department studyNumber of PIMsUse of PIMsImprovement initiativesAverage monthly proportionBeers criteriaED dischargeInappropriate medicationsClinical decision supportAcademic detailingSustained reductionHealth outcomesPoisson regressionSuboptimal medicationOrder setsDepartment studyOlder adultsMonthly proportionVeterans