The Geriatric Emergency Medicine research program is currently conducting a number of ongoing studies funded by internal and external grants and awards (listed alphabetically):
Alzheimer’s Disease Research Center Care Research Core
Our Aging Research Group supports innovative research into the pathobiology, early diagnosis, and treatment of Alzheimer’s disease and related illnesses.
The Care Research Core at the Wisconsin Alzheimer’s Disease Research Center provides novel expertise and resources to conduct innovative studies that will enhance patient care and change clinical practice. It provides guidance and training in multiple aspects of care research, including models of care, caregiver support, end-of-life and palliative care, mobile health technologies, telemedicine, geospatial analytics, and dissemination and implementation research. The Care Research Core at the Wisconsin Alzheimer’s Disease Research Center offers researchers consultations and study design support. If you would like to learn more about care research resources, please complete the Dementia Care Research Core Consultation Form.
Core Leader: Amy Kind, MD, PhD (Department of Medicine)
Core Co-Leader: Andrea Gilmore-Bykovskyi, PhD, RN (Department of Emergency Medicine)
Core Co-Leader: Nicole Rogus-Pulia, PhD (Department of Medicine)
ED-LEAD: Emergency Departments LEading the transformation of Alzheimer’s and Dementia care
Research led by UW professor Dr. Manish Shah is part of a national effort to improve health outcomes for people living with dementia by investigating multiple strategies for advancing health care delivery during and after visits to an emergency department. Through a $55 million NIH-funded grant, researchers will implement a large nationwide trial that will provide insight as to how standard of care interventions found to be beneficial in smaller, single-site trials may be effective in more diverse settings.
Engineering Safe Care Journeys for Vulnerable Populations
In this AHRQ-funded study, our team collaborates with a transdisciplinary team of engineers, health services researchers, nurses, physicians, and pharmacists. We will develop, design, implement, and evaluate a patient safety passport that will support the safe journey of older adults diagnosed with a fall or suspected urinary tract infection in the emergency department.
Older adults over 65 are more likely to present to the emergency department and experience patient safety issues after the emergency department visit as compared to younger people.
The innovative concept of patient safety passport will be used by patients, caregivers, and clinicians in the emergency department, hospital, and skilled nursing facility, and will facilitate communication and coordination as the patient transitions from the emergency department and travels to the hospital, skilled nursing facility, or home.
GEAR 2.0 – ADC Program: Improving Emergency Care for People with Dementia
Older adults use the emergency department as an important source of acute medical care, making 20 million visits annually. People with dementia are twice as likely to use the ED and 1.5 times more likely to have an avoidable visit. When in the ED, they often struggle and are at greater risk of poor outcomes; however, little research has studied how to improve emergency care for people with dementia.
The Geriatric Emergency Care Applied Research Network 2.0 – Advancing Dementia Care (GEAR 2.0 ADC) is an NIH funded program to advance the science supporting emergency care for people with dementia. It brings together key stakeholders from emergency medicine, geriatrics, nursing, and social work representing health care systems, clinicians, researchers, caregivers, and, most importantly, people with dementia. Together we will work to identify and prioritize research gaps in emergency care for people who have dementia and support research to improve the care delivered to this vulnerable population.
Dr. Shah is one of two principal investigators awarded a total of $7.5 million from the NIH to conduct this research.
Improving Antibiotic Stewardship for Long-Term Care Facility Residents Treated in the ED
Residents of long-term care facilities (LTCFs) (primarily those > 65 years old with several comorbidities) have been identified as a priority population by the Agency for Healthcare Research and Quality (AHRQ) in part because they are particularly vulnerable to harm related to suboptimal medical care. Each year, over 2.5 million LTCF residents receive care in the ED, often for serious bacterial infections such as pneumonia, urinary tract infections and sepsis. Estimates of inappropriate antibiotic use in this patient population are as high as 75%. Atypical presentations, lack of definitions for infections, and inadequate data exchange during transitions of care may explain the sub-optimal antibiotic use observed in this vulnerable population.
The overall objective of this project is to develop an intervention that can improve public health in Wisconsin by reducing inappropriate antibiotic use for LTCF patients in the ED. Given the complex nature of this clinical dilemma, we propose using a mixed methods approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) framework to identify barriers and facilitators to appropriate antibiotic use for LTCF residents in the ED. This will effectively test our hypothesis that an evidence-based intervention can improve antibiotic for this vulnerable population.
This project was funded by a new investigator grant from the Wisconsin Partnership Program.
Institutional Clinical and Translational Research KL2 Scholar Program
The goal of the UW Institute for Clinical and Translational Research (ICTR) is to create an environment that facilitates the transformation of research at the University of Wisconsin into a continuum extending from investigation through discovery to translation into practice. We aim to provide promising young clinical and translational investigators the training, mentoring, and protected time to develop an independent research program.
The KL2 Scholar Program is funded by the National Institutes of Health through the Clinical and Translational Science Award (CTSA).
Mentoring and Research in Patient-Oriented Geriatric Emergency Care
This NIH-funded study combines mentoring to train the next generation of patient-oriented investigators in geriatric emergency care research, career development in mentoring and implementation science, and research to translate the innovative model of community paramedicine to practice, thereby providing support to community-dwelling patients with Alzheimer’s disease and their caregivers.
Dr. Manish Shah is working to enhance acute illness care for older adults as well as identifying and addressing older adults’ medical and psychosocial needs using community-based paramedics and telemedicine, a model now called community paramedicine.
Paramedic-Coached ED Care Transitions to Help Older Adults Maintain their Health
In this NIH-funded study, the UW Aging Research Group is performing a randomized controlled trial of a new intervention to improve the health of older adults discharged home from the ED. We are adapting the Care Transition Intervention (CTI), a validated hospital-to-home transitions program, to the ED setting and using paramedics to deliver the coaching services. We hypothesize that our CTI program will improve older adults’ post-ED health outcomes, including decreasing the large proportion of older patients that return to an ED for care within 30 days.
Preventing Future Falls Among Older Adults Presenting to the Emergency Department
Older adults rely on the ED for acute, unscheduled care. These visits are an ideal opportunity to screen a high-risk population and intervene to prevent downstream morbidity such as falls. Unfortunately, such screening is not routinely performed in the ED setting. In our current AHRQ-funded study, we will evaluate the implementation and effectiveness of a novel automated screening and referral intervention tool utilizing existing EHR data to improve identification and coordination of care for older adults at high risk for future falls.