Featured Publications
Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice
Wong AH, Ray JM, Eixenberger C, Crispino LJ, Parker JB, Rosenberg A, Robinson L, McVaney C, Iennaco JD, Bernstein SL, Yonkers KA, Pavlo AJ. Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice. BMJ Open 2022, 12: e059876. PMID: 35545394, PMCID: PMC9096567, DOI: 10.1136/bmjopen-2021-059876.Peer-Reviewed Original ResearchMeSH KeywordsAggressionEmergency Service, HospitalHumansPatient Outcome AssessmentPsychomotor AgitationQualitative ResearchRestraint, PhysicalConceptsEmergency departmentAgitation eventsQualitative studyEmergency careQualitative studies of patients' experiencesPhysical restraintStudies of patients' experiencesAvoidance of physical restraintSystem of healthcare deliveryPhysical restraint useEmergency care networkCommunity-based teaching hospitalSystems-based practiceTertiary care academic centreInterviews of patientsVerbal de-escalationGrounded theory approachPatient-oriented strategiesExposure to psychological traumaExcessive psychomotor activityCare approachSocioeconomic inequalitiesPatient experienceRestraint useCare networkA qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department
Wong AH, Sabounchi NS, Roncallo HR, Ray JM, Heckmann R. A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Services Research 2022, 22: 75. PMID: 35033071, PMCID: PMC8760708, DOI: 10.1186/s12913-022-07472-x.Peer-Reviewed Original ResearchMeSH KeywordsBurnout, ProfessionalEmergency Service, HospitalHumansPatient SafetyWorkplaceWorkplace ViolenceConceptsExperience of workplace violenceClinician burnoutWorkplace violenceIncreased perceptions of safetyPhysical restraintPerceptions of safetyClinician stressWorkplace assaultsAgitated patientsEmergency departmentEffects of workplace violenceUse of restraintsQualitative system dynamics methodsModel building sessionsSymptoms of burnoutIncreased perceptionInterprofessional panelClinician stakeholdersResultsThe final modelRisk of assaultImpact future decisionsPatient safetyEpisodes of agitationAgitation managementClinician experienceDesign 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 ResearchMeSH KeywordsEmergency Service, HospitalHumansInterrupted Time Series AnalysisPsychomotor AgitationQuality ImprovementRestraint, PhysicalConceptsResponse 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 patientsAddressing Workplace Safety in the Emergency Department: A Multi-Institutional Qualitative Investigation of Health Worker Assault Experiences.
Vrablik MC, Lawrence M, Ray JM, Moore M, Wong AH. Addressing Workplace Safety in the Emergency Department: A Multi-Institutional Qualitative Investigation of Health Worker Assault Experiences. Journal Of Occupational And Environmental Medicine 2020, 62: 1019-1028. PMID: 32991380, DOI: 10.1097/jom.0000000000002031.Peer-Reviewed Original ResearchMeSH KeywordsCivil DefenseEmergency Service, HospitalHealth PersonnelHumansWorkplaceWorkplace ViolenceConceptsWorkplace violenceEmergency departmentGeographically distinct institutionsHealth workersPatient assaultsThematic analysisHealthcare systemPotential interventionsEmergency preparednessPhases of preparednessIdentified conceptsHealthQualitative investigationInterventionInterconnected influencesSustained impactWorkplace safetyWorkplacePreparednessAssault experiencesComprehensive approachIndividual workersDepartmentRecovery phaseWorkersHealing the Healer: Protecting Emergency Health Care Workers’ Mental Health During COVID-19
Wong AH, Pacella-LaBarbara ML, Ray JM, Ranney ML, Chang BP. Healing the Healer: Protecting Emergency Health Care Workers’ Mental Health During COVID-19. Annals Of Emergency Medicine 2020, 76: 379-384. PMID: 32534830, PMCID: PMC7196406, DOI: 10.1016/j.annemergmed.2020.04.041.Peer-Reviewed Original Research
2024
Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchMeSH KeywordsAdultDecision Support Systems, ClinicalEmergency Service, HospitalHumansInformed ConsentRandomized Controlled Trials as TopicResearch DesignConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physicians
2021
Improving Safety and Quality During Interhospital Transfer of Patients With Nontraumatic Intracranial Hemorrhage: A Simulation-Based Pilot Program
Ray JM, Wong AH, Finn EB, Sheth KN, Matouk CC, Sudikoff SN, Auerbach MA, Sather JE, Venkatesh AK. Improving Safety and Quality During Interhospital Transfer of Patients With Nontraumatic Intracranial Hemorrhage: A Simulation-Based Pilot Program. Journal Of Patient Safety 2021, 18: 77-87. PMID: 33852541, DOI: 10.1097/pts.0000000000000808.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalHospitalsHumansIntracranial HemorrhagesPatient TransferPilot ProjectsConceptsInterhospital transferNontraumatic intracranial hemorrhageThematic analysisRates of interhospital transfersQuality improvement initiativesQuality improvement strategiesInterhospital transfer of patientsTransfer of patientsCare handoffsCenter staff membersData saturationComplex handoffsImprovement initiativesInterprofessional debriefingFocus groupsEmergency physiciansQualitative studyEmergency departmentQuality improvementIll populationStaff membersTertiary care centerCare centerCommunication ChecklistSpecialized neurocritical care
2020
An Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation
Roncallo HR, Ray JM, Kulacz RC, Yang TJ, Chmura C, Evans LV, Wong AH. An Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation. The Joint Commission Journal On Quality And Patient Safety 2020, 46: 640-649. PMID: 32919910, PMCID: PMC7606488, DOI: 10.1016/j.jcjq.2020.08.005.Peer-Reviewed Original ResearchMeSH KeywordsCritical CareCurriculumEmergency Service, HospitalHealth PersonnelHumansInterprofessional RelationsNursesPatient Care TeamConceptsCritical care rolesCaring roleEmergency departmentNovice nursesOrientation programResident physiciansInterprofessional simulation programHealthcare (DASHInterprofessional education teamsHigh-functioning teamsQualitative evaluation dataGroups of resident physiciansNurse participantsED nursesInterprofessional simulationProgram's long-term impactDebriefing AssessmentHealth workersTeam trainingNurse learnersNursesPatient careParticipant feedbackEmergency physiciansOrientation session
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