2024
Screening for cognitive impairment in the emergency department: agreement between older adult patient- and informant-completed Ascertain Dementia 8 tool.
Galske J, Sather A, Chera T, Hwang U, Carpenter C, Babcock M, Gettel C. Screening for cognitive impairment in the emergency department: agreement between older adult patient- and informant-completed Ascertain Dementia 8 tool. Dementia And Geriatric Cognitive Disorders 2024, 1-13. PMID: 39616991, DOI: 10.1159/000542895.Peer-Reviewed Original ResearchAscertain Dementia 8Intraclass correlation coefficientEmergency departmentCognitive impairmentTrained research assistantsDiagnosis of dementiaClinicians providing careModerate agreementSuspected CIEmergency careOlder adultsAnalytic sampleResearch assistantsED patientsCareScreening protocolSelf-identifyEarly interventionDementiaScoresCorrelation coefficientDepartmentDyadsPatientsImpairmentEmergency Department Visits Among Patients With Dementia Before and After Diagnosis
Gettel C, Song Y, Rothenberg C, Kitchen C, Gilmore-Bykovskyi A, Fried T, Brody A, Nothelle S, Wolff J, Venkatesh A. Emergency Department Visits Among Patients With Dementia Before and After Diagnosis. JAMA Network Open 2024, 7: e2439421. PMID: 39401040, PMCID: PMC11581500, DOI: 10.1001/jamanetworkopen.2024.39421.Peer-Reviewed Original ResearchEnd‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study
Gettel C, Kitchen C, Rothenberg C, Song Y, Hastings S, Kennedy M, Ouchi K, Haimovich A, Hwang U, Venkatesh A. End‐of‐life emergency department use and healthcare expenditures among older adults: A nationally representative study. Journal Of The American Geriatrics Society 2024 PMID: 39311623, DOI: 10.1111/jgs.19199.Peer-Reviewed Original ResearchEnd-of-lifeOut-of-pocket spendingED visitsTotal healthcare spendingMedicare beneficiariesHealthcare spendingEmergency departmentOlder adultsMedicare Current Beneficiary Survey dataAnalysis of Medicare beneficiariesPooled cross-sectional analysisEmergency department usePrimary outcomeDecreased likelihoodDiagnosis of dementiaOut-of-pocket costsNationally representative studyNationally representative sampleAdult decedentsHospice statusDepartment useED useED servicesHealth careHealthcare expenditures“What Matters” in the Emergency Department
Chera T, Tinetti M, Travers J, Galske J, Venkatesh A, Southerland L, Dresden S, McQuown C, Gettel C. “What Matters” in the Emergency Department. Medical Care 2024, 62: s50-s56. PMID: 39514495, PMCID: PMC11548826, DOI: 10.1097/mlr.0000000000002053.Peer-Reviewed Original ResearchConceptsOlder adultsEmergency departmentEmergency careED visitsAssociated with meetingAssociated with older adultsEnd-of-lifeFollow-upPatient characteristicsMultivariate logistic regression modelCare of oneselfLogistic regression modelsFollow-up interviewsMulticenter prospective observational studyHealthcare settingsED encountersFunctional independenceProspective observational studySecondary analysisSymptom identificationAssess concernsSecondary outcomesPrimary outcomeCareObservational studyRacial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department
Jivalagian P, Gettel C, Smith C, Robinson L, Brinker M, Shah D, Kumar A, Faustino I, Nath B, Chang-Sing E, Taylor R, Kennedy M, Hwang U, Wong A. Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department. American Journal Of Geriatric Psychiatry 2024 PMID: 39054237, DOI: 10.1016/j.jagp.2024.07.004.Peer-Reviewed Original ResearchPhysical restraint useRestraint useOlder adultsED visitsPhysical restraintEmergency departmentElectronic health record dataHealth record dataBlack non-HispanicPatient-level characteristicsAge-related disparitiesAssociated with increased useRegional hospital networkCross-sectional studyLogistic regression modelsChemical sedationRetrospective cross-sectional studyNon-Hispanic groupNon-HispanicAgitation managementHospital sitesHospital networkRecord dataWhite non-Hispanic groupPrimary outcomeTotal and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage
Gettel C, Salah W, Rothenberg C, Liang Y, Schwartz H, Scott K, Hwang U, Hastings S, Venkatesh A. Total and Out-of-Pocket Costs Surrounding Emergency Department Care Among Older Adults Enrolled in Traditional Medicare and Medicare Advantage. Annals Of Emergency Medicine 2024, 84: 285-294. PMID: 38864783, PMCID: PMC11343654, DOI: 10.1016/j.annemergmed.2024.04.023.Peer-Reviewed Original ResearchOut-of-pocketED visitsTraditional MedicareOlder adultsEmergency departmentMedicare AdvantageMedicare Advantage plan enrolleesMedicare Current Beneficiary SurveyEmergency department careTreat-and-releaseOut-of-pocket expensesOut-of-pocket health care spendingHealth care spendingCross-sectional analysisProportion of costsMedian totalEmergency careTreat-and-release emergency departmentBeneficiary SurveyMedian total costProportion of expensesCare spendingPlan enrolleesMedicareVisitsEstimating the size and scope of the academic emergency physician workforce
Gettel C, Camargo C, Bennett C, Courtney D, Kaji A, Fermann G, Gallahue F, Nelson L, Hebbard C, Rothenberg C, Raja A, Venkatesh A. Estimating the size and scope of the academic emergency physician workforce. Academic Emergency Medicine 2024, 31: 732-738. PMID: 38769602, DOI: 10.1111/acem.14931.Peer-Reviewed Original ResearchProportion of emergency physiciansAccreditation Council for Graduate Medical EducationClinical training sitesED visitsEM residency programsAcademic emergency departmentEmergency physiciansEmergency departmentEM workforceEmergency medicineACGME-accredited EM residency programsAcademic sitesProportion of emergency departmentCenters for Medicare & Medicaid ServicesEmergency physician workforceResidency programsProportion of ED visitsDepartment of Veterans AffairsAccredited EM residency programsTraining of resident physiciansAmerican Hospital AssociationTraining sitesNational proportionsAcademic Emergency MedicineGraduate Medical EducationGeriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients
Skains R, Koehl J, Aldeen A, Carpenter C, Gettel C, Goldberg E, Hwang U, Kocher K, Southerland L, Goyal P, Berdahl C, Venkatesh A, Lin M. Geriatric Emergency Medication Safety Recommendations (GEMS-Rx): Modified Delphi Development of a High-Risk Prescription List for Older Emergency Department Patients. Annals Of Emergency Medicine 2024, 84: 274-284. PMID: 38483427, PMCID: PMC11343681, DOI: 10.1016/j.annemergmed.2024.01.033.Peer-Reviewed Original ResearchOlder ED patientsHigh-risk prescriptionsED patientsHigh-risk medication usePrescribed high-risk medicationsEmergency departmentHigh-risk medicationsEnd of lifeShort-term adverse eventsAdverse drug eventsQuestionnaire response rateEmergency department patientsDrug eventsRound 2Prescription refillsPhysician expertsMedication useSkeletal muscle relaxantsDepartment patientsMedication categoriesAdverse eventsRisk of short-term adverse eventsMedication classesMedical indicationsPrescription list
2023
Development of the COMET tool: Caregiver‐reported Outcome Measure for Emergency care Transitions
Gettel C, Galske J, Uzamere I, Serina P, Hernandez‐Bigos K, Mane S, Chen K, Ottilie‐Kovelman S, Sandoval J, Venkatesh A, Cohen A, Monin J, Fried T, Hwang U. Development of the COMET tool: Caregiver‐reported Outcome Measure for Emergency care Transitions. Alzheimer's & Dementia 2023, 19 DOI: 10.1002/alz.074213.Peer-Reviewed Original ResearchCare transitionsOutcome measuresCare partnersED discharge processPhase 3Results Phase 1Phase 2Health care systemPhase 1Candidate itemsAcute illnessED encountersEmergency departmentCare considerationsPhase 4Outcome assessmentConclusion DevelopmentScreening toolCare systemResearch team membersContent validityPoor communicationEDMultidisciplinary stakeholdersDelphi approachAn Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments
Gettel C, Hwang U, Janke A, Rothenberg C, Tomasino D, Schneider S, Goyal P, Venkatesh A. An Outcome Comparison Between Geriatric and Nongeriatric Emergency Departments. Annals Of Emergency Medicine 2023, 82: 681-689. PMID: 37389490, PMCID: PMC10756927, DOI: 10.1016/j.annemergmed.2023.05.013.Peer-Reviewed Original ResearchConceptsGeriatric EDDiagnosis rateED lengthEmergency departmentMedian discharge rateAmerican CollegeRevisit ratesOlder adultsUrinary tract infectionAge categoriesGeriatric Emergency DepartmentHigher diagnosis ratesED visitsTract infectionsMental statusObservational studyDelirium/Outcome comparisonsData registryED statusProcess outcomesED sitesStayAnalytic sampleAdultsEmergency Department-to-Community Transitions of Care Best Practices for the Older Adult Population
Gettel C, Hastings S, Biese K, Goldberg E. Emergency Department-to-Community Transitions of Care Best Practices for the Older Adult Population. Clinics In Geriatric Medicine 2023, 39: 659-672. PMID: 37798071, PMCID: PMC10716862, DOI: 10.1016/j.cger.2023.05.009.Peer-Reviewed Original ResearchConceptsEmergency departmentOlder adultsTransitional care management servicesPatient-centered outcome measuresCare management servicesOlder Adult PopulationED settingFunctional statusCare transitionsOutcome measuresAdult populationEffective interventionsIntervention implementationUnique populationSocial isolationAdultsRiskDepartmentCommunity transitionFuture effortsPopulationImpairmentCare
2022
Trends In Treat-And-Release Emergency Care Visits With High-Intensity Billing In The US, 2006–19
Janke A, Gettel C, Koski-Vacirca R, Lin M, Kocher K, Venkatesh A. Trends In Treat-And-Release Emergency Care Visits With High-Intensity Billing In The US, 2006–19. Health Affairs 2022, 41: 1772-1780. PMID: 36469824, DOI: 10.1377/hlthaff.2022.00484.Peer-Reviewed Original ResearchConceptsRelease ED visitsEmergency departmentED visitsNationwide Emergency Department SampleEmergency care visitsEmergency Department SampleProportion of visitsHealth care systemMore comorbiditiesCare visitsOlder patientsED careBilling practicesSerious diagnosisObservational studyUndifferentiated patientsPatient complexityCare servicesHealth statusCare systemVisitsPatientsEvolving roleReimbursement reformTreat74EMF Early Phase Development of the PROM-OTED Tool: The Patient-Reported Outcome Measure – Older Adult Care Transitions from the Emergency Department
Gettel C, Serina P, Uzamere I, Hernandez-Bigos K, Venkatesh A, Feder S, Goldberg E, White M, Rising K, Hwang U. 74EMF Early Phase Development of the PROM-OTED Tool: The Patient-Reported Outcome Measure – Older Adult Care Transitions from the Emergency Department. Annals Of Emergency Medicine 2022, 80: s38-s39. DOI: 10.1016/j.annemergmed.2022.08.097.Peer-Reviewed Original ResearchEmergency department‐to‐community care transition barriers: A qualitative study of older adults
Gettel CJ, Serina PT, Uzamere I, Hernandez‐Bigos K, Venkatesh AK, Rising KL, Goldberg EM, Feder SL, Cohen AB, Hwang U. Emergency department‐to‐community care transition barriers: A qualitative study of older adults. Journal Of The American Geriatrics Society 2022, 70: 3152-3162. PMID: 35779278, PMCID: PMC9669106, DOI: 10.1111/jgs.17950.Peer-Reviewed Original ResearchConceptsCare transitionsOlder adultsClinical careImmediate post-discharge periodED discharge processEmergency clinical careEmergency department visitsPost-discharge periodAdverse health outcomesOutpatient clinical careDepartment visitsIntact patientsEmergency departmentHealth outcomesOlder adults' willingnessU.S. healthcare systemBaseline activityEffective interventionsIntervention developmentHealthcare systemAdultsCareAdults' willingnessSymptom explanationsEDA Qualitative Study of “What Matters” to Older Adults in the Emergency Department
Gettel CJ, Venkatesh AK, Dowd H, Hwang U, Ferrigno RF, Reid EA, Tinetti ME. A Qualitative Study of “What Matters” to Older Adults in the Emergency Department. Western Journal Of Emergency Medicine 2022, 23: 579-588. PMID: 35980413, PMCID: PMC9391017, DOI: 10.5811/westjem.2022.4.56115.Peer-Reviewed Original ResearchConceptsOlder adult patientsAdult patientsEmergency departmentOlder adultsED careAge-Friendly Health SystemIntact older adultsSymptom resolutionED cliniciansED settingPatient 1Clinician recommendationsPatient concernsPatient prioritiesDyadic semi-structured interviewsSymptom reductionClinical practicePatientsCliniciansHealth systemConversation guideHealthcare systemAdultsHome environmentOutcomesPragmatic clinical trial design in emergency medicine: Study considerations and design types
Gettel CJ, Yiadom MYAB, Bernstein SL, Grudzen CR, Nath B, Li F, Hwang U, Hess EP, Melnick ER. Pragmatic clinical trial design in emergency medicine: Study considerations and design types. Academic Emergency Medicine 2022, 29: 1247-1257. PMID: 35475533, PMCID: PMC9790188, DOI: 10.1111/acem.14513.Peer-Reviewed Original ResearchConceptsPragmatic clinical trialsClinical trial designTrial designReal-world clinical practicePragmatic clinical trial designElectronic health recordsEmergency departmentClinical trialsStudy design typeClinical practiceStudy typeTrial componentsHealth recordsEmergency medicineEmergency medicine investigatorsHuman subjects concernsInvestigatorsStudy findingsStudy considerationsTrialistsTrials
2021
Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement
Hammouda N, Carpenter CR, Hung WW, Lesser A, Nyamu S, Liu S, Gettel C, Malsch A, Castillo EM, Forrester S, Souffront K, Vargas S, Goldberg EM, Network T. Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement. Academic Emergency Medicine 2021, 28: 1214-1227. PMID: 33977589, PMCID: PMC8581064, DOI: 10.1111/acem.14279.Peer-Reviewed Original ResearchConceptsRecurrent fallsFall risk assessment toolsFall screening toolsEmergency medical services personnelSelf-reported fallsFall-related outcomesFall assessment toolsHigh-priority research focusMedical services personnelPreferred Reporting ItemsHealth services researchersAssessment toolRisk assessment toolHarmonizing definitionFall interventionsMultifactorial interventionED patientsED physiciansExercise programRisk stratificationOutcome ascertainmentEmergency departmentFalls screeningFall preventionConsensus statement
2020
Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?
Venkatesh AK, Gettel CJ, Mei H, Chou SC, Rothenberg C, Liu SL, D’Onofrio G, Lin Z, Krumholz HM. Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home? Journal Of Applied Gerontology 2020, 40: 828-836. PMID: 32842827, PMCID: PMC7904961, DOI: 10.1177/0733464820950125.Peer-Reviewed Original ResearchConceptsAcute care visitsCare visitsEmergency departmentMedicare beneficiariesSNF staySNF servicesSkilled nursing facility residentsNursing facility residentsSkilled nursing facility servicesAcute care capabilitiesCross-sectional analysisNursing facility servicesHigher proportionAcute careMedical homeFacility residentsCare capabilitiesVisitsNumber of daysStayCareDepartmentFacility servicesBeneficiariesProportionA Systematic Review of Interventions to Improve Nursing Home to Emergency Department Care Transitions.
Gettel CJ, Pertsch N, Goldberg EM. A Systematic Review of Interventions to Improve Nursing Home to Emergency Department Care Transitions. Annals Of Long-Term Care Clinical Care And Aging 2020, 28: e12-e19. PMID: 32542070, PMCID: PMC7295263.Peer-Reviewed Original ResearchPre-post intervention studyTransitions of careEmergency departmentNursing homesIntervention studiesEmergency Department Care TransitionsIntervention implementationED revisit ratesRetrospective cohort studyHealth care utilizationPatient-centered outcomesFull-text reviewHospital lengthCohort studyHospital readmissionCare utilizationCare transitionsSystematic reviewStudy reportingFacility transferRevisit ratesInterventionMedical errorsMultimodal approachPatients