2024
Quality improvement interventions to reduce coagulation testing overuse in the emergency department
Venkatesh A, Duke J, Wong S, Shah A, Rothenberg C, Patel A, Sun W, Shapiro M, Ulrich A, Parwani V. Quality improvement interventions to reduce coagulation testing overuse in the emergency department. The American Journal Of Emergency Medicine 2024 DOI: 10.1016/j.ajem.2024.10.037.Peer-Reviewed Original Research
2023
Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures
Roberts S, Barbell E, Barber D, Dahlberg S, Heimer R, Jubanyik K, Parwani V, Pettigrew M, Tanner J, Ulrich A, Wade M, Wyllie A, Yolda-Carr D, Martinello R, Tanner W. Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) RNA and viable virus contamination of hospital emergency department surfaces and association with patient coronavirus disease 2019 (COVID-19) status and aerosol-generating procedures. Infection Control And Hospital Epidemiology 2023, 45: 244-246. PMID: 37767709, PMCID: PMC10877528, DOI: 10.1017/ice.2023.183.Peer-Reviewed Original ResearchCorrelations 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 access
2022
Patient cost consciousness in the emergency department
Gaylor JM, Chan E, Parwani V, Ulrich A, Rothenberg C, Venkatesh A. Patient cost consciousness in the emergency department. The American Journal Of Emergency Medicine 2022, 61: 61-63. PMID: 36054987, DOI: 10.1016/j.ajem.2022.08.039.Peer-Reviewed Original ResearchConceptsEmergency departmentPocket costsED patientsLarge academic hospital systemAcademic hospital systemCertain patient demographicsEmergency department settingPerceptions of patientsCost of careMedicare/MedicaidPatient demographicsED careUnscheduled careUninsured patientsDepartment settingPatients' estimatesPatient's abilityEmergency careHigh school educationPatientsPrivate insuranceFinal analysisHospital systemCareConvenience sampleEMS 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 patientsImproving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians
Scofi J, Parwani V, Rothenberg C, Patel A, Ravi S, Sevilla M, D'Onofrio G, Ulrich A, Venkatesh AK. Improving Emergency Department Throughput Using Audit-and-Feedback With Peer Comparison Among Emergency Department Physicians. Journal For Healthcare Quality 2021, 44: 69-77. PMID: 34570029, DOI: 10.1097/jhq.0000000000000329.Peer-Reviewed Original ResearchConceptsAdmission ratesEmergency department throughputEmergency physiciansMean timeUrban academic EDEmergency department physiciansMean admission rateLower admission ratesFirst study periodED physiciansAcademic EDDepartment physiciansPatient visitsPractice variationAdmissionPeer comparisonPhysiciansPhysician performanceStudy periodPatientsAcademic emergency physiciansReportAuditMinutesHoursUniversal 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 ResearchA Cross-Sectional Analysis of High-Acuity Professional Services Performed by Urban and Rural Emergency Care Physicians Across the United States
Gettel CJ, Canavan ME, Greenwood-Ericksen MB, Parwani VL, Ulrich AS, Pilgrim RL, Venkatesh AK. A Cross-Sectional Analysis of High-Acuity Professional Services Performed by Urban and Rural Emergency Care Physicians Across the United States. Annals Of Emergency Medicine 2021, 78: 140-149. PMID: 33771412, PMCID: PMC8238845, DOI: 10.1016/j.annemergmed.2020.11.019.Peer-Reviewed Original ResearchConceptsCross-sectional analysisCare EvaluationRural physiciansMedicare feeEmergency careUrban physiciansMedicare Public Use FilesManagement service codesEmergency care physiciansLogistic regression analysisPrimary outcomeCare physiciansPhysician levelService beneficiariesPublic Use FilePhysiciansIndividual physiciansUse FileRegression analysisQuintileCareProportion of servicesReimbursementPart B.Urban settingsBalancing quality and utilization: Emergency physician level correlation between 72 h returns, admission, and CT utilization rates
Parwani V, Thomas M, Rothenberg C, Ulrich A, Venkatesh A. Balancing quality and utilization: Emergency physician level correlation between 72 h returns, admission, and CT utilization rates. The American Journal Of Emergency Medicine 2021, 48: 365-366. PMID: 33597095, DOI: 10.1016/j.ajem.2021.01.078.Peer-Reviewed Original ResearchFailure Mode and Effect Analysis: Engineering Safer Neurocritical Care Transitions
Chilakamarri P, Finn EB, Sather J, Sheth KN, Matouk C, Parwani V, Ulrich A, Davis M, Pham L, Chaudhry SI, Venkatesh AK. Failure Mode and Effect Analysis: Engineering Safer Neurocritical Care Transitions. Neurocritical Care 2021, 35: 232-240. PMID: 33403581, PMCID: PMC8255326, DOI: 10.1007/s12028-020-01160-6.Peer-Reviewed Original ResearchConceptsPatient safetyInter-hospital transferEmergency department throughputIntracerebral hemorrhageAcute careSubarachnoid hemorrhageNeurocritical careCare transitionsMulti-disciplinary teamPatient transferHemorrhageSignificant reductionInterventionCareHazard analysisOutcomesRiskSafetyMultiple providersSpecific use-case examplesEvidence of successPatientsStrokeMethodsWe
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 workersWorkers