2023
Inequities among patient placement in emergency department hallway treatment spaces
Tuffuor K, Su H, Meng L, Pinker E, Tarabar A, Van Tonder R, Chmura C, Parwani V, Venkatesh A, Sangal R. Inequities among patient placement in emergency department hallway treatment spaces. The American Journal Of Emergency Medicine 2023, 76: 70-74. PMID: 38006634, DOI: 10.1016/j.ajem.2023.11.013.Peer-Reviewed Original ResearchEscalation of careAdjusted odds ratioED revisitsHallway bedsEmergency departmentHigher oddsPatient placementPatient insurance coverageSocial risk factorsPatient social factorsDischarge AMAED visitsSecondary outcomesPatient agePatient demographicsPrimary outcomeMale sexPatient sexTreatment spaceED censusFemale sexRisk factorsOdds ratioED staffingObservational studyRapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T
Malaeb H, Vera M, Sangal R, Venkatesh A, Possick S, Maciejak L, Oberle E, El-Khoury J. Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T. Clinica Chimica Acta 2023, 551: 117630. PMID: 37931733, DOI: 10.1016/j.cca.2023.117630.Peer-Reviewed Original ResearchRapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T.
Malaeb H, Vera M, Sangal R, Venkatesh A, Possick S, Maciejak L, Oberle E, El-Khoury J. Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T. Clinica Chimica Acta 2023, 551: 117630. PMID: 38420909, DOI: 10.1016/j.cca.2023.117630.Peer-Reviewed Original ResearchConceptsRapid Serum TubesPlasma separation tubesHigh-sensitivity troponin THs-cTnT valuesHs-cTnTSource of hemolysisEmergency departmentTroponin TSerum tubesFalse positive resultsMedian reductionEffect of hemolysisED patientsSample collectionEffects of tube typeHemolysisPatientsPositive resultsSeparator tubesCorrelations 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 ResearchSociodemographic Disparities in Queue Jumping for Emergency Department Care
Sangal R, Su H, Khidir H, Parwani V, Liebhardt B, Pinker E, Meng L, Venkatesh A, Ulrich A. Sociodemographic Disparities in Queue Jumping for Emergency Department Care. JAMA Network Open 2023, 6: e2326338. PMID: 37505495, PMCID: PMC10383013, DOI: 10.1001/jamanetworkopen.2023.26338.Peer-Reviewed Original ResearchConceptsCross-sectional studyHigh acuityPatient demographicsSame acuityLatino ethnicityNon-Hispanic raceEmergency department careBed placementTime of triageNon-Hispanic blacksNon-Hispanic whitesED visitsPrimary outcomeED arrivalED patientsMedicaid insuranceMean ageTriage acuityStudy visitAcuity patientsSociodemographic disparitiesED outcomesHigher oddsMAIN OUTCOMECare accessReal-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 policiesInterventionOutcomesPrescriptionChoice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering
Sangal R, Venkatesh A, Cahill J, Pettker C, Peaper D. Choice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering. The Journal Of Applied Laboratory Medicine 2023, 8: 98-105. PMID: 36610419, DOI: 10.1093/jalm/jfac104.Peer-Reviewed Original ResearchConceptsRSV testingSymptomatic visitsED visitsSARS-CoV-2 nucleic acid amplification testsCOVID-19Respiratory syncytial virus testingNucleic acid amplification testsElectronic health record ordersSystems-based interventionsSARS-CoV-2Symptomatic patientsPrimary outcomeInfluenza testingClinical guidelinesClinician educationClinician practiceVirus testingAmplification testsPatientsTest orderingInstitutional guidelinesClinical needHospital systemVisitsTesting patterns
2022
Prehospital emergency department care activations during the initial COVID-19 pandemic surge.
Leff R, Fleming-Nouri A, Venkatesh AK, Parwani V, Rothenberg C, Sangal RB, Flood CT, Goldenberg M, Wira C. Prehospital emergency department care activations during the initial COVID-19 pandemic surge. American Journal Of Disaster Medicine 2022, 17: 23-39. PMID: 35913181, DOI: 10.5055/ajdm.2022.0417.Peer-Reviewed Original ResearchConceptsCOVID-19 hospital admissionsCOVID-19 pandemic surgeTotal ED volumeNumber of patientsCOVID-19 hospitalizationScatterplot smoothing curvesPublic health measuresCritical medical conditionPublic health emergencyPrehospital presentationStroke activationHospital admissionPrimary outcomeTrauma activationsUrban EDAcademic EDCOVID-19 casesPrehospital settingClinical indicationsType of presentationMedical conditionsED volumePandemic surgeAbsolute decreaseHealth measuresImplementation 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
Universal 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 disasterWeeksLeadership communication, stress, and burnout among frontline emergency department staff amid the COVID-19 pandemic: A mixed methods approach
Sangal RB, Bray A, Reid E, Ulrich A, Liebhardt B, Venkatesh AK, King M. Leadership communication, stress, and burnout among frontline emergency department staff amid the COVID-19 pandemic: A mixed methods approach. Healthcare 2021, 9: 100577. PMID: 34411923, PMCID: PMC8361146, DOI: 10.1016/j.hjdsi.2021.100577.Peer-Reviewed Original ResearchDisparities 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 speakersCan metrics give physicians insight?
Bright E, Scofi J, Sangal RB, Rothenberg C, Kinsman J, Patel A, Parwani V, Sather J, Pickens A, Ulrich A, Venkatesh AK. Can metrics give physicians insight? The American Journal Of Emergency Medicine 2021, 55: 219-220. PMID: 34301446, DOI: 10.1016/j.ajem.2021.06.059.Peer-Reviewed Original ResearchReal-world assessment of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nasopharyngeal swab testing in a region with a high burden of coronavirus disease 2019 (COVID-19)
Sangal RB, Peaper DR, Rothenberg C, Fadlallah H, Mobolaji-Lawal M, Landry ML, Sussman LS, Ulrich A, Venkatesh AK. Real-world assessment of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) nasopharyngeal swab testing in a region with a high burden of coronavirus disease 2019 (COVID-19). Infection Control And Hospital Epidemiology 2021, 43: 1051-1053. PMID: 33823949, PMCID: PMC8111191, DOI: 10.1017/ice.2021.153.Peer-Reviewed Original ResearchDelays in antibiotic redosing: Association with inpatient mortality and risk factors for delay
Kemmler CB, Sangal RB, Rothenberg C, Li SX, Shofer FS, Abella BS, Venkatesh AK, Foster SD. Delays in antibiotic redosing: Association with inpatient mortality and risk factors for delay. The American Journal Of Emergency Medicine 2021, 46: 63-69. PMID: 33735698, DOI: 10.1016/j.ajem.2021.02.058.Peer-Reviewed Original ResearchConceptsSecond dose administrationEmergency departmentDose administrationRisk factorsEmergency Severity IndexHospital mortalityFirst doseSecond doseED boardingAntibiotic dosesEnd-stage renal diseaseExtremes of weightHigh acuity presentationsRetrospective cohort studyStage renal diseaseWorse clinical outcomesSerious bacterial infectionsOdds of delayEarly hospital courseSingle healthcare systemAntibiotic redosingDosing intervalHospital courseCohort studyInpatient mortality
2020
The cost of waiting: Association of ED boarding with hospitalization costs
Baloescu C, Kinsman J, Ravi S, Parwani V, Sangal RB, Ulrich A, Venkatesh AK. The cost of waiting: Association of ED boarding with hospitalization costs. The American Journal Of Emergency Medicine 2020, 40: 169-172. PMID: 33272871, DOI: 10.1016/j.ajem.2020.10.058.Peer-Reviewed Original ResearchConceptsED boardingHospitalization costsED crowdingHospital spendingHospital care accessMultivariate linear regression analysisED patient volumeCost of careQuality of careEmergency department boardingCross-sectional analysisPublic health crisisED lengthEffective careCare accessHospital levelInpatient bedsED characteristicsLinear regression analysisPatient volumeCareMedicare spendingMultivariate regressionPatientsRegression analysisWork team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic
Sangal R, Wrzesniewski A, DiBenigno J, Reid E, Ulrich A, Liebhardt B, Bray A, Yang E, Eun E, Venkatesh A, King M. Work team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic. BMJ Leader 2020, 5: 51-54. DOI: 10.1136/leader-2020-000331.Peer-Reviewed Original ResearchFront-line healthcare workersHealthcare workersCOVID-19 pandemicEmergency department staffQuality improvement initiativesCOVID-19Cross-sectional surveyCross-sectional analysisEmergency departmentProtective effectOngoing COVID-19Mental healthWork stressImprovement initiativesDepartment staffProlonged stressFeelings of stressReduced reportsLess work stressFurther evidenceLongitudinal evidencePandemicFirst waveFront-line workersWorkersIdentification of Patients with Nontraumatic Intracranial Hemorrhage Using Administrative Claims Data
Sangal RB, Fodeh S, Taylor A, Rothenberg C, Finn EB, Sheth K, Matouk C, Ulrich A, Parwani V, Sather J, Venkatesh A. Identification of Patients with Nontraumatic Intracranial Hemorrhage Using Administrative Claims Data. Journal Of Stroke And Cerebrovascular Diseases 2020, 29: 105306. PMID: 33070110, PMCID: PMC7686163, DOI: 10.1016/j.jstrokecerebrovasdis.2020.105306.Peer-Reviewed Original ResearchLess social emergency departments: implementation of workplace contact reduction during COVID-19
Sangal RB, Scofi JE, Parwani V, Pickens AT, Ulrich A, Venkatesh AK. Less social emergency departments: implementation of workplace contact reduction during COVID-19. Emergency Medicine Journal 2020, 37: 463-466. PMID: 32581052, PMCID: PMC7418594, DOI: 10.1136/emermed-2020-209826.Peer-Reviewed Original ResearchMeSH KeywordsBetacoronavirusCoronavirus InfectionsCOVID-19Delivery of Health CareDisease Transmission, InfectiousEmergency Service, HospitalHumansInfection ControlInterdisciplinary CommunicationInterpersonal RelationsOrganizational InnovationPandemicsPneumonia, ViralPolicy MakingSARS-CoV-2United StatesWorkplaceConceptsHealthcare worker transmissionDirect patient carePublic health measuresCOVID-19 Task ForceNon-pharmaceutical interventionsEmergency departmentMultidisciplinary recommendationsHealthcare workersPatient careHealth measuresPatient arrivalED patient arrivalsTransmission riskPatientsPerson contactPandemic response effortsCOVID-19COVID-19 pandemicContact reductionClose personTask ForceSocial distancingUnique challengesStaffCare