Featured Publications
Association of a Geriatric Emergency Department Innovation Program With Cost Outcomes Among Medicare Beneficiaries
Hwang U, Dresden SM, Vargas-Torres C, Kang R, Garrido MM, Loo G, Sze J, Cruz D, Richardson LD, Adams J, Aldeen A, Baumlin KM, Courtney DM, Gravenor S, Grudzen CR, Nimo G, Zhu CW, Abraham G, Amoko C, Genes N, Morano B, Nassisi D, Ortiz J, Rivera-Reyes L, Sanon M, Shapiro J, Winkel G, Malik S, Rosenberg M, Christensen M, Karounos M, Schultz R, Sumberg D. Association of a Geriatric Emergency Department Innovation Program With Cost Outcomes Among Medicare Beneficiaries. JAMA Network Open 2021, 4: e2037334. PMID: 33646311, PMCID: PMC7921898, DOI: 10.1001/jamanetworkopen.2020.37334.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCost SavingsCross-Sectional StudiesEmergency Medical ServicesEmergency Service, HospitalFee-for-Service PlansGeriatric AssessmentHealth Services for the AgedHospital CostsHospitalsHumansMedicarePatient CareReferral and ConsultationSocial WorkTransitional CareUnited StatesConceptsTransitional care nursesFirst ED visitIndex ED visitED visitsMAIN OUTCOMEMedicare feeMedicare beneficiariesService beneficiariesEmergency department programComparison groupCross-sectional studyUnique Medicare beneficiariesLower Medicare expendituresMost patientsMean ageCare nursesVisit encountersCare programGeriatric treatmentCost outcomesPatient careMedicare expendituresHealth systemMean savingsPatients
2024
Screening 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 coefficientDepartmentDyadsPatientsImpairmentDaily care hours among caregivers of older emergency department patients with dementia and undiagnosed cognitive impairment
Galske J, Chera T, Hwang U, Monin J, Venkatesh A, Lam K, Leggett A, Gettel C. Daily care hours among caregivers of older emergency department patients with dementia and undiagnosed cognitive impairment. Journal Of The American Geriatrics Society 2024, 72: 3261-3264. PMID: 38970304, PMCID: PMC11461120, DOI: 10.1111/jgs.19062.Peer-Reviewed Original Research
2022
Feasibility of the Transport PLUS intervention to improve the transitions of care for patients transported home by ambulance: a non-randomized pilot study
Munjal KG, Yeturu SK, Chapin HH, Tan N, Gregoriou D, Garcia D, Grudzen C, Hwang U, Morano B, Neher H, Gorbenko K, Youngblood G, Misra A, Dietrich S, Gonzalez C, Appel G, Jacobs E, Siu A, Richardson LD. Feasibility of the Transport PLUS intervention to improve the transitions of care for patients transported home by ambulance: a non-randomized pilot study. Pilot And Feasibility Studies 2022, 8: 169. PMID: 35932067, PMCID: PMC9354351, DOI: 10.1186/s40814-022-01138-5.Peer-Reviewed Original ResearchCommunity health workersEmergency medical techniciansPatient acceptanceNon-randomized pilot studyRate of readmissionMajority of patientsPopulation of patientsEmergency room visitsTransitions of careRandomized control trialElectronic health recordsEligible patientsED revisitsFeasibility outcomesClinical outcomesRoom visitsDischarge instructionsGeriatric populationHealth workersHigh riskControl trialHome visitsPatientsPatient encountersCommunity paramedicineA 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 environmentOutcomes
2021
Evaluation and disposition of older adults presenting to the emergency department with abdominal pain
Friedman AB, Chen AT, Wu R, Coe NB, Halpern SD, Hwang U, Kelz RR, Cappola AR. Evaluation and disposition of older adults presenting to the emergency department with abdominal pain. Journal Of The American Geriatrics Society 2021, 70: 501-511. PMID: 34628638, PMCID: PMC10078825, DOI: 10.1111/jgs.17503.Peer-Reviewed Original ResearchConceptsNational Hospital Ambulatory Medical Care SurveyAbdominal painUS emergency departmentsEmergency departmentED visitsOlder adultsOlder patientsChief complaintAmbulatory Medical Care SurveyRepresentative emergency departmentsCommon chief complaintSurvey-weighted analysisDischarge homeIncident disabilityED encountersCare SurveyPatient outcomesCritical careSerious conditionSyndromic presentationHigh riskPainDiagnostic testingPatientsCT imagingResearch priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement
Kayser J, Morrow-Howell N, Rosen TE, Skees S, Doering M, Clark S, Hurka-Richardson K, Bin Shams R, Ringer T, Hwang U, Platts-Mills TF, Network TG. Research priorities for elder abuse screening and intervention: A Geriatric Emergency Care Applied Research (GEAR) network scoping review and consensus statement. Journal Of Elder Abuse & Neglect 2021, 33: 123-144. PMID: 33797344, PMCID: PMC8204570, DOI: 10.1080/08946566.2021.1904313.Peer-Reviewed Original ResearchConceptsEmergency departmentEmergency department-based interventionsEmergency Department ScreeningHealth care utilizationResearch NetworkUsual careCare utilizationConsensus statementSafety outcomesConsensus conferenceElder abuseReference listsComparative effectivenessAbuse screeningPsychosocial impactGoogle ScholarAbuse assessmentInterventionPatientsCurrent literatureCareDepartmentAbuseScreeningResearch priorities
2016
Shared Decision Making to Improve the Emergency Care of Older Adults: A Research Agenda
Hogan TM, Richmond NL, Carpenter CR, Biese K, Hwang U, Shah MN, Escobedo M, Berman A, Broder JS, Platts‐Mills T. Shared Decision Making to Improve the Emergency Care of Older Adults: A Research Agenda. Academic Emergency Medicine 2016, 23: 1386-1393. PMID: 27561819, DOI: 10.1111/acem.13074.Peer-Reviewed Original ResearchConceptsOlder adultsEmergency careOlder emergency department (ED) patientsEmergency department patientsGoals of careTypes of patientsUse of SDMAdverse eventsDepartment patientsEmergency physiciansAggressive approachHigh riskSide effectsSerious illnessDiagnostic testsCarePatientsAdultsHigh rateLack of knowledgeSDMInjuryIllnessPhysiciansPreparing Older Adults with Serious Illness To Formulate Their Goals for Medical Care in the Emergency Department
Ouchi K, Knabben V, Rivera-Reyes L, Ganta N, Gelfman LP, Sudore R, Hwang U, on behalf of the GEDI WISE Investig. Preparing Older Adults with Serious Illness To Formulate Their Goals for Medical Care in the Emergency Department. Journal Of Palliative Medicine 2016, 20: 404-408. PMID: 27797638, PMCID: PMC5385414, DOI: 10.1089/jpm.2016.0109.Peer-Reviewed Original ResearchOlder ED patientsED patientsOlder adultsEmergency department cliniciansAdvance care planning conversationsPercent of participantsED visitsSecondary outcomesPrimary outcomeED careEmergency departmentMean ageInclusion criteriaACP educationSerious illnessHealth educationED surveyMedical careYears ageParent cohortED implementationVision impairmentPlanning conversationsFurther studiesPatientsFeasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients
Tucker PW, Evans DD, Clevenger CK, Ardisson M, Hwang U. Feasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients. Geriatric Nursing 2016, 37: 453-457. PMID: 27477084, DOI: 10.1016/j.gerinurse.2016.06.015.Peer-Reviewed Original ResearchConceptsGait speedCommunity-dwelling adults 65 yearsDescriptive pilot projectED screening toolsED social workersFeasibility of nursesGait speed assessmentRoutine nursing assessmentRoutine nursing practiceEmergency department patientsAdults 65 yearsAdverse eventsDepartment patientsNursing assessmentUnfavorable outcomeED treatmentDisposition planningPatientsNursing practiceScreening toolNursesIndividualized resourcesObjective measuresSpeed assessmentSocial workersA Multicenter Evaluation of Emergency Department Pain Care Across Different Types of Fractures
Siddiqui A, Belland L, Rivera-Reyes L, Handel D, Yadav K, Heard K, Eisenberg A, Khelemsky Y, Hwang U. A Multicenter Evaluation of Emergency Department Pain Care Across Different Types of Fractures. Pain Medicine 2016, 18: 41-48. PMID: 27245631, PMCID: PMC5283699, DOI: 10.1093/pm/pnw072.Peer-Reviewed Original ResearchConceptsPain careEmergency departmentType of fractureFracture typeOlder patientsBaseline pain scoresRetrospective cohort studyLong bone fracturesOpioid doseAnalgesic administrationAnalgesic usePain scoresCohort studyTriage acuityFinal diagnosisSubgroup analysisMulticenter evaluationED crowdingPatientsBone fracturesSecondary analysisAge-based differencesCareProcess outcomesGreater likelihoodThe effect of surgical consult in the treatment of abdominal pain in older adults in the ED
Roberts ES, Belland L, Rivera-Reyes L, Hwang U. The effect of surgical consult in the treatment of abdominal pain in older adults in the ED. The American Journal Of Emergency Medicine 2016, 34: 1524-1527. PMID: 27241564, PMCID: PMC5027841, DOI: 10.1016/j.ajem.2016.05.010.Peer-Reviewed Original ResearchConceptsPain score reductionScore reductionAbdominal painSurgical consultAnalgesic administrationAnalgesic medicationConsult patientsEmergency departmentOlder adultsAdministration of analgesicsProspective cohort studyEmergency Severity IndexRace/ethnicityDecreased administrationCohort studyOlder patientsSecondary data analysisPatientsPainAdministrationConsultsSeverity IndexAnalgesicsOpioidsMedicationsIncreased Identification of Emergency Department 72‐hour Returns Using Multihospital Health Information Exchange
Shy BD, Kim EY, Genes NG, Lowry T, Loo GT, Hwang U, Richardson LD, Shapiro JS. Increased Identification of Emergency Department 72‐hour Returns Using Multihospital Health Information Exchange. Academic Emergency Medicine 2016, 23: 645-649. PMID: 26932394, DOI: 10.1111/acem.12954.Peer-Reviewed Original ResearchConceptsEmergency departmentHealth information exchangeED returnIndex visitReturn visitsEarly ED returnsInitial ED dischargeCases of patientsReturn visit rateLarge health information exchangeIndividual emergency departmentsPatient safety effortsED dischargeED visitsEarly returnVisit ratesPatient encountersStudy periodPatient dataVisitsNew York metropolitan areaSafety effortsDepartmentHoursPatients
2015
Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures
Dickman E, Pushkar I, Likourezos A, Todd K, Hwang U, Akhter S, Morrison S. Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures. The American Journal Of Emergency Medicine 2015, 34: 586-589. PMID: 26809928, PMCID: PMC4799725, DOI: 10.1016/j.ajem.2015.12.016.Peer-Reviewed Original ResearchConceptsUltrasound-guided femoral nerve blockExtracapsular hip fracturesMean pain scoreFemoral nerve blockHip fracturePain scoresNerve blockPain reliefExtracapsular groupIntracapsular groupEmergency departmentUltrasound-guided nerve blocksSubgroup analysisClinical trialsExtracapsular hipAcademic hospitalPatientsSimilar reductionPainScoresReliefHoursFracturesGroupNew York City
2014
Is all pain is treated equally? A multicenter evaluation of acute pain care by age
Hwang U, Belland LK, Handel DA, Yadav K, Heard K, Rivera-Reyes L, Eisenberg A, Noble MJ, Mekala S, Valley M, Winkel G, Todd KH, Morrison R. Is all pain is treated equally? A multicenter evaluation of acute pain care by age. Pain 2014, 155: 2568-2574. PMID: 25244947, PMCID: PMC4250377, DOI: 10.1016/j.pain.2014.09.017.Peer-Reviewed Original ResearchConceptsAcute pain careFinal pain scoreOlder patientsYounger patientsPain carePain scoresCross-sectional observation studyType of painPatient-related characteristicsHealth care settingsFracture painAbdominal painPain medicationPain conditionsPain treatmentEmergency departmentCare treatmentCare settingsMulticenter evaluationPainPatientsOlder adultsCareAnalgesicsGreater reduction
2013
Transforming Emergency Care For Older Adults
Hwang U, Shah MN, Han JH, Carpenter CR, Siu AL, Adams JG. Transforming Emergency Care For Older Adults. Health Affairs 2013, 32: 2116-2121. PMID: 24301394, PMCID: PMC4070367, DOI: 10.1377/hlthaff.2013.0670.Peer-Reviewed Original ResearchConceptsEmergency departmentEmergency careHealth care systemOlder adultsCare systemComprehensive discharge planningUS emergency departmentsPatient health outcomesGeriatric emergency careGeriatric Emergency DepartmentBroader health care systemED visitsInitial hospitalizationDischarge planningCare coordinationHealth outcomesObservation unitCareAdultsLengthy evaluationRehospitalizationHospitalizationPatientsVisitsAcute Pain Management in Older Adults in the Emergency Department
Hwang U, Platts-Mills TF. Acute Pain Management in Older Adults in the Emergency Department. Clinics In Geriatric Medicine 2013, 29: 151-164. PMID: 23177605, DOI: 10.1016/j.cger.2012.10.006.Peer-Reviewed Original ResearchConceptsAcute painOlder adultsAcute pain careAcute pain managementPresence of painPatient-specific riskSystemic analgesicsAdverse eventsOlder patientsPain managementPain treatmentPain careEmergency departmentEmergency providersEffective treatmentFrequent reassessmentPainInitial assessmentAnalgesicsAdultsTreatmentCurrent knowledgeRiskPatientsRetreatment
2012
Solutions To Emergency Department ‘Boarding’ And Crowding Are Underused And May Need To Be Legislated
Rabin E, Kocher K, McClelland M, Pines J, Hwang U, Rathlev N, Asplin B, Trueger NS, Weber E. Solutions To Emergency Department ‘Boarding’ And Crowding Are Underused And May Need To Be Legislated. Health Affairs 2012, 31: 1757-1766. PMID: 22869654, DOI: 10.1377/hlthaff.2011.0786.Peer-Reviewed Original ResearchPredictors of patient length of stay in 9 emergency departments
Wiler JL, Handel DA, Ginde AA, Aronsky D, Genes NG, Hackman JL, Hilton JA, Hwang U, Kamali M, Pines JM, Powell E, Sattarian M, Fu R. Predictors of patient length of stay in 9 emergency departments. The American Journal Of Emergency Medicine 2012, 30: 1860-1864. PMID: 22633732, DOI: 10.1016/j.ajem.2012.03.028.Peer-Reviewed Original ResearchConceptsOverall LOSAmbulance diversionPredictors of LOSAnnual ED censusEmergency department lengthLength of stayPercentage of increaseLog-transformed LOSDaily percentageCalendar year 2009Multicenter studyRetrospective studyAdverse outcomesEmergency departmentED censusPatient satisfactionPatient presentationPatient categoriesPatient LOSED crowdingPatient lengthPatientsDaily admissionsStaySignificant predictors
2011
Research Priorities for Palliative and End‐of‐life Care in the Emergency Setting
Quest TE, Asplin BR, Cairns CB, Hwang U, Pines JM. Research Priorities for Palliative and End‐of‐life Care in the Emergency Setting. Academic Emergency Medicine 2011, 18: e70-e76. PMID: 21676052, PMCID: PMC3368013, DOI: 10.1111/j.1553-2712.2011.01088.x.Peer-Reviewed Original ResearchConceptsEmergency departmentPalliative careLife careEmergency careHigh-quality care experiencesPalliative care continuumPalliative care servicesHealth care utilizationPalliative care trainingLife-threatening illnessEducation of cliniciansCare utilizationEmergency cliniciansBody of evidenceCare continuumEmergency settingClinical providersCare servicesCare trainingCare experiencesOptimal rolePatientsHealthcare ResearchCareChronic trajectory