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
2022
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 network
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 ResearchMeSH KeywordsEmergency Service, HospitalEvaluation Studies as TopicFeasibility StudiesHealth Plan ImplementationHumansPatient Care TeamPilot ProjectsConceptsEmergency 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 designManagement of Agitation During the COVID-19 Pandemic
Wong AH, Roppolo LP, Chang BP, Yonkers KA, Wilson MP, Powsner S, Rozel JS. Management of Agitation During the COVID-19 Pandemic. Western Journal Of Emergency Medicine 2020, 21: 795-800. PMID: 32726244, PMCID: PMC7390577, DOI: 10.5811/westjem.2020.5.47789.Peer-Reviewed Original ResearchMeSH KeywordsAnxietyBetacoronavirusCoronavirus InfectionsCOVID-19Emergency Service, HospitalHealth PersonnelHumansPandemicsPneumonia, ViralSARS-CoV-2ConceptsAmerican Association for Emergency PsychiatryTreatment of agitationSymptoms of agitationManagement of agitationCoronavirus disease 2019 (COVID-19) pandemicSevere behavioral symptomsCoronavirus SARS-CoV-2Delivery of careSARS-CoV-2Disease 2019 pandemicBroader psychosocial impactRespiratory depressionBehavioral symptomsEmergency departmentEmergency settingHealthcare workersBehavioral emergenciesEmergency psychiatryPsychiatric servicesFear of exposurePsychosocial impactEarly detectionHeightened riskCoercive strategiesStaff members