2023
Development and Internal Validation of an Emergency Department Admission Intensity Measure Using Data From a National Group
Oskvarek J, Zocchi M, Cai A, Venkat A, Janke A, Venkatesh A, Pines J, Group A. Development and Internal Validation of an Emergency Department Admission Intensity Measure Using Data From a National Group. Annals Of Emergency Medicine 2023, 82: 316-325. PMID: 36669915, DOI: 10.1016/j.annemergmed.2022.12.011.Peer-Reviewed Original ResearchConceptsAdmission ratesSeparate technical panelEvidence-based protocolsICD-10 diagnosisValue-based payment modelsPhysician's discretionED diagnosisEmergency physiciansInternational ClassificationPhysician levelFacility levelPhysiciansInternal validationQuarterly ratesAdministrative dataFace validityDiagnosisPayment modelsLinear probability modelsICCChoice 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
Development of a Novel Emergency Department Quality Measure to Reduce Very Low-Risk Syncope Hospitalizations
Probst MA, Janke AT, Haimovich AD, Venkatesh AK, Lin MP, Kocher KE, Nemnom MJ, Thiruganasambandamoorthy V. Development of a Novel Emergency Department Quality Measure to Reduce Very Low-Risk Syncope Hospitalizations. Annals Of Emergency Medicine 2022, 79: 509-517. PMID: 35487840, PMCID: PMC9117517, DOI: 10.1016/j.annemergmed.2022.03.008.Peer-Reviewed Original ResearchConceptsNationwide Emergency Department SampleLow-risk cohortHospitalization ratesUnexplained syncopeHeart diseaseED patient dataEmergency department evaluationHospital-level factorsSerious adverse eventsAdult ED patientsEmergency Department SampleSyncope hospitalizationsOutpatient managementAdult patientsAdverse eventsProspective cohortDepartment evaluationED patientsRelated hospitalizationsRisk stratificationED volumeSyncopePatientsHospitalizationMedian rate
2021
A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community‐Living Older Persons
Gettel CJ, Venkatesh AK, Leo‐Summers L, Murphy TE, Gahbauer EA, Hwang U, Gill TM. A Longitudinal Analysis of Functional Disability, Recovery, and Nursing Home Utilization After Hospitalization for Ambulatory Care Sensitive Conditions Among Community‐Living Older Persons. Journal Of Hospital Medicine 2021, 16: 469-475. PMID: 34328835, PMCID: PMC8340961, DOI: 10.12788/jhm.3669.Peer-Reviewed Original ResearchMeSH KeywordsAftercareAgedAged, 80 and overAmbulatory CareHospitalizationHumansNursing HomesPatient DischargeConceptsAmbulatory care sensitive conditionsTotal disability scoreDisability scoresFunctional recoveryOlder personsNH admissionFunctional disabilityAdverse patient-reported outcomesPatient-reported disability scoresCommunity-living older personsSensitive conditionsMean disability scoreCommunity-living personsMonths of dischargePatient-reported outcomesNursing home utilizationMonthly probabilityFunctional outcomeMean ageMonths 1HospitalizationHome utilizationAdmissionAnalytic sampleMonthsNational 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 ResearchMeSH KeywordsEmergency Service, HospitalHospitalizationHospitalsHumansInpatientsPatient AdmissionUnited StatesConceptsHospital-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 analysisBalancing 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 Research
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 analysisA Multimodal Intervention to Improve the Quality and Safety of Interhospital Care Transitions for Nontraumatic Intracerebral and Subarachnoid Hemorrhage
Sather J, Littauer R, Finn E, Matouk C, Sheth K, Parwani V, Pham L, Ulrich A, Rothenberg C, Venkatesh AK. A Multimodal Intervention to Improve the Quality and Safety of Interhospital Care Transitions for Nontraumatic Intracerebral and Subarachnoid Hemorrhage. The Joint Commission Journal On Quality And Patient Safety 2020, 47: 99-106. PMID: 33358659, DOI: 10.1016/j.jcjq.2020.10.003.Peer-Reviewed Original ResearchMeSH KeywordsEmergency Service, HospitalHospitalizationHumansPatient TransferQuality ImprovementSubarachnoid HemorrhageConceptsInterhospital transferQuality improvement interventionsIntracerebral hemorrhageMultimodal interventionImprovement interventionsClinical practice guideline disseminationEmergency department timeNeurocritical care cliniciansMultimodal quality improvement interventionNontraumatic intracerebral hemorrhageTimeliness of careED boarding timeRegionalization of careChi-square testIHT processED lengthPostintervention outcomesCare cliniciansSubarachnoid hemorrhageCare transitionsAdmission ordersDepartment timeGuideline disseminationOutcome measuresStudy populationAssociation between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system?
Lord K, Rothenberg C, Parwani V, Finn E, Khan A, Sather J, Ulrich A, Chaudhry S, Venkatesh A. Association between emergency department chief complaint and adverse hospitalization outcomes: A simple early warning system? The American Journal Of Emergency Medicine 2020, 45: 548-550. PMID: 32839053, DOI: 10.1016/j.ajem.2020.07.040.Peer-Reviewed Original ResearchMedicaid expansion and resource utilization in the emergency department
Janke AT, Danagoulian S, Venkatesh AK, Levy PD. Medicaid expansion and resource utilization in the emergency department. The American Journal Of Emergency Medicine 2020, 38: 2586-2590. PMID: 31982222, DOI: 10.1016/j.ajem.2019.12.050.Peer-Reviewed Original ResearchMeSH KeywordsAdultChest PainComputed Tomography AngiographyCoronary AngiographyDiagnostic Techniques, CardiovascularDisease ManagementEchocardiography, StressEligibility DeterminationEmergency Service, HospitalExercise TestFemaleHealth PolicyHospitalizationHumansMaleMedicaidMedically UninsuredMiddle AgedMyocardial Perfusion ImagingOdds RatioPatient Protection and Affordable Care ActUnited StatesConceptsChest pain visitsOdds of admissionAdvanced cardiac imagingPain visitsAffordable Care ActChest painED visitsMedicaid expansionED visit dataCardiac imagingEmergency department visitsEligibility expansionsSubgroup of patientsExpansion statesLikelihood of admissionProportion of visitsNon-expansion statesMedicaid eligibility expansionsDepartment visitsClinician's discretionEmergency departmentMedicaid patientsAdmissionProvider behaviorVisits
2018
Opening of Psychiatric Observation Unit Eases Boarding Crisis
Parwani V, Tinloy B, Ulrich A, D'Onofrio G, Goldenberg M, Rothenberg C, Patel A, Venkatesh A. Opening of Psychiatric Observation Unit Eases Boarding Crisis. Academic Emergency Medicine 2018, 25: 456-460. PMID: 29266537, DOI: 10.1111/acem.13369.Peer-Reviewed Original ResearchConceptsED LOSLength of stayMedian ED LOSTotal LOSPsychiatric admission ratesCrisis intervention unitSecondary outcomesPrimary outcomeObservation unitAdmission ratesPrimary analysisTertiary care academic medical centerPsychiatric chief complaintsBehavioral health staffInpatient psychiatric bedsAcute psychiatric careAcademic medical centerHours of careEmergency department boardingAdult EDAdult patientsPreintervention periodChief complaintPediatric hospitalInpatient admissions
2014
Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes
Safavi KC, Li SX, Dharmarajan K, Venkatesh AK, Strait KM, Lin H, Lowe TJ, Fazel R, Nallamothu BK, Krumholz HM. Hospital Variation in the Use of Noninvasive Cardiac Imaging and Its Association With Downstream Testing, Interventions, and Outcomes. JAMA Internal Medicine 2014, 174: 546-553. PMID: 24515551, PMCID: PMC5459406, DOI: 10.1001/jamainternmed.2013.14407.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionNoninvasive cardiac imagingDownstream testingReadmission ratesRevascularization proceduresCardiac imagingHospital variationCardiac ischemiaProportion of patientsNoninvasive imagingLower readmission ratesPrincipal discharge diagnosisCross-sectional studyCardiac biomarker testsQ4 hospitalsChest discomfortCoronary angiographyCoronary diseaseDischarge diagnosisCoronary angiogramEmergency departmentMyocardial infarctionSame hospitalCurrent guidelinesInpatient wards