2023
Managing 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 shortagesPainMembership in the Council of Teaching Hospitals and Health Systems Among Emergency Medicine Residency Program–Sponsoring Institutions, 2001-2020
Bennett C, Boggs K, Gettel C, Sun W, Venkatesh A, Camargo C. Membership in the Council of Teaching Hospitals and Health Systems Among Emergency Medicine Residency Program–Sponsoring Institutions, 2001-2020. JAMA Network Open 2023, 6: e2312457. PMID: 37159203, PMCID: PMC10170334, DOI: 10.1001/jamanetworkopen.2023.12457.Peer-Reviewed Original Research
2022
Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19
Janke A, Nash K, Goyal P, Auerbach M, Venkatesh A. Pediatric mental health visits with prolonged length of stay in community emergency departments during COVID‐19. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12869. PMID: 36570374, PMCID: PMC9767857, DOI: 10.1002/emp2.12869.Peer-Reviewed Original ResearchPediatric mental health visitsLength of stayMental health visitsED LOSCommon diagnostic categoriesEmergency departmentHealth visitsIncident rate ratiosCOVID-19Diagnostic categoriesCommunity emergency departmentsVisit countsMental health syndromesMental health systemAvailable complete dataDepressive disorderData registrySecondary analysisHealth systemVisitsRate ratioComplete dataStayCountHoursA 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 environmentOutcomesEMS Non-Transport of Low-Risk COVID-19 Patients
Couturier K, Nelson AR, Burns K, Cone DC, Rollins M, Venkatesh AK, Ulrich A, Shapiro M, Joseph D. EMS Non-Transport of Low-Risk COVID-19 Patients. Prehospital Emergency Care 2022, 27: 310-314. PMID: 35639643, DOI: 10.1080/10903127.2022.2083278.Peer-Reviewed Original ResearchConceptsEMS cliniciansLow-risk COVID-19 patientsSuburban EMS systemLow-risk patientsED visit ratesEMS systemCOVID-19 patientsCOVID-19 infectionCOVID-19ED visitsRetrospective reviewEmergency departmentCOVID-19 casesProtocol violationsCommon reasonConnecticut OfficeHospital resourcesPatientsSmall studyVisit ratesVital signsHealth systemSymptomsReasonable adherenceCliniciansImplementation 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 pandemic
2021
Design and Implementation of an Agitation Code Response Team in the Emergency Department
Wong AH, Ray JM, Cramer LD, Brashear TK, Eixenberger C, McVaney C, Haggan J, Sevilla M, Costa DS, Parwani V, Ulrich A, Dziura JD, Bernstein SL, Venkatesh AK. Design and Implementation of an Agitation Code Response Team in the Emergency Department. Annals Of Emergency Medicine 2021, 79: 453-464. PMID: 34863528, PMCID: PMC9038629, DOI: 10.1016/j.annemergmed.2021.10.013.Peer-Reviewed Original ResearchConceptsResponse team interventionPhysical restraint useInterrupted time series analysisRestraint useEmergency departmentTeam interventionRates of physical restraint useTeam-based interventionAdministrative supportQuality improvement studyResponse teamBehavioral health systemManagement of agitated patientsInterprofessional collaborationRestraint ordersExcessive psychomotor activityRestraint ratesHealth systemED visitsImprovement studyPhysical restraintCompare trendsPrimary outcomeTime series analysisAgitated patientsUniversal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay
Sangal RB, Peaper DR, Rothenberg C, Landry ML, Sussman LS, Martinello RA, Ulrich A, Venkatesh AK. Universal SARS-CoV-2 Testing of Emergency Department Admissions Increases Emergency Department Length of Stay. Annals Of Emergency Medicine 2021, 79: 182-186. PMID: 34756452, PMCID: PMC8424016, DOI: 10.1016/j.annemergmed.2021.09.005.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 testingUniversal SARS-CoV-2 testingEmergency department lengthAdmission lengthED admissionPositivity rateSARS-CoV-2 testAcademic health systemCOVID-19 prevalenceSecondary outcomesED lengthPrevention needsED boardingPatientsStayPositive casesClinical costsHealth systemAdmissionTesting policiesContainment effortsTestingPrevalenceTesting changesPositivitySimulating approaches to emergency department pandemic physician staffing during COVID-19.
Sangal RB, Venkatesh AK, Kinsman J, Dashevsky M, Scofi JE, Ulrich A. Simulating approaches to emergency department pandemic physician staffing during COVID-19. American Journal Of Disaster Medicine 2021, 16: 85-93. PMID: 34392521, DOI: 10.5055/ajdm.2021.0391.Peer-Reviewed Original ResearchConceptsEmergency departmentInfection rateStaffing modelsPercent infection rateCohort modelHigher infection rateInfectious disease outbreaksEmergency physiciansED staffAvailable physiciansThree-teamWeek 5Health systemEM physiciansPhysiciansAdequate staffingImmunityPhysician attritionCOVID-19CohortDisease outbreaksPandemicPandemic disasterWeeksDisparities 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
2020
Study protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department
Wong AH, Ray JM, Auerbach MA, Venkatesh AK, McVaney C, Burness D, Chmura C, Saxa T, Sevilla M, Flood CT, Patel A, Whitfill T, Dziura JD, Yonkers KA, Ulrich A, Bernstein SL. Study protocol for the ACT response pilot intervention: development, implementation and evaluation of a systems-based Agitation Code Team (ACT) in the emergency department. BMJ Open 2020, 10: e036982. PMID: 32606062, PMCID: PMC7328814, DOI: 10.1136/bmjopen-2020-036982.Peer-Reviewed Original ResearchConceptsEmergency departmentRestraint useCode teamControlled interrupted time series designResponse interventionsRate of restraint useInterrupted time series designAcute care settingDe-escalation techniquesTime series designPeer-reviewed publicationsED staffIdentified teamworkPilot interventionCare settingsHealth systemPatient encountersAgitation managementHuman Investigation CommitteeWorkplace violenceEthical approvalStaff safetyPatient agitationReduce harmSeries design
2014
Opportunities for quality measurement to improve the value of care for patients with multiple chronic conditions.
Venkatesh A, Goodrich K, Conway PH. Opportunities for quality measurement to improve the value of care for patients with multiple chronic conditions. Annals Of Internal Medicine 2014, 161: s76-80. PMID: 25402407, DOI: 10.7326/m13-3014.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsQuality measurement effortsChronic conditionsAffordable Care ActValue of careHealth care spendingIndividual cliniciansMeaningful improvementsSustained quality improvementHealth systemACA expansionPatientsInsurance accessMedicaid ServicesVulnerable populationsPatient ProtectionCare spendingCare ActLongitudinal measurementsCliniciansMeasure developmentPopulationHospitalCarePrevention