Patient-Reported Outcomes for Acute Asthma Care & Treatment (PROAACT). National Heart Lung and Blood Institute (NHLBI/ NIH) K23 HL143042-01A1. Validate a novel instrument to assess patient-reported outcomes after adult ED asthma visits, test the association between ED clinical quality and PROs, and evaluate the association between PROs and subsequent acute care utilization, after adjusting for geospatially coded environmental & social risk factors.
Ambulatory Follow-up and Outcomes Among Medicare Beneficiaries After Emergency Department Discharge. 70% of Medicare beneficiaries had ambulatory follow-up within 30 days of ED discharge (40% within 7 days), with lower rates among Medicaid-eligible beneficiaries, Black beneficiaries, and those treated at rural emergency departments. Ambulatory follow-up was associated with a higher risk of subsequent hospitalization but a lower risk of 30-day mortality. Published in JAMA Network Open.
Evaluating ED Clinical Work Intensity and the Shift from Inpatient to Outpatient Care. Emergency Medicine Foundation Clinical Work Intensity Grant. This project aims to quantify the value of ED clinical work intensity by examining health care utilization and costs that previously occurred in inpatient settings, building on our prior work demonstrating a 10% decrease in ED admission rates from 2006 to 2014, Fig 2 ->
Early Adoption of Alternative Payment Models (APMs) for Emergency Medical Care: A Mixed Methods Study of Accountable Care Organizations (ACOs). Emergency Medicine Foundation Health Policy Research Grant (Schuur). This is national mixed-methods study of ACOs to examine how emergency care redesign and payment has been affected by accountable care. We published a survey study showing ACOs prioritize primary care redesign to influence acute care, including incentives for PCPs to reduce avoidable hospitalizations, despite the fact that emergency physicians are more likely to influence the decision to admit. Findings from the qualitative portion are forthcoming.
Identify and Intervene with Frequent Emergency Department Users. Brigham and Women’s Provider Organization Care Redesign & Incubator Startup Program (Lin, Schuur). and American Board of Medical Specialties Visiting Scholar Award (Lin). We performed a randomized control trial of an ED community health worker intervention, which led to fewer ED visits and hospitalizations in the intervention group compared to controls (usual care) during the 7-month follow-up period.
Identifying Best Practices to Reduce Hospital Admission from the Emergency Department. Blue Cross Blue Shield Foundation of Massachusetts (Schuur). This mixed-methods study identified common diagnoses with variation in ED admission rates (ex. atrial fibrillation) and identified best practices at high performing/ low admitting EDs.
Evaluating Choosing Wisely. Emergency Medicine Foundation Health Policy Scholar Award (Lin). We surveyed nearly 800 emergency physicians regarding knowledge, attitudes, and behaviors related to ACEP's Choosing Wisely recommendations.
The Impact of Women-Focused Professional Organizations on Career Development. Academy for Women in Academic Emergency Medicine. Qualitative study and podcast series to assess the impact of a woman-focused professional organization for academic emergency physicians consisting of interviews with past leaders and women emergency physicians of varying career stages.