We are pleased to announce that Ambrose Wong, MD, MSEd, MHS, Assistant Professor in Emergency Medicine, has been awarded a K23 grant from the National Institute of Mental Health. The K23MH126366 grant, “Clinical Decision Support Tool to Assess Risk and Prevent Agitation Events” began on 9/15/21 and was awarded for four years. The aim of this career development award is to investigate the use of health IT in preventing episodes of agitation for behavioral patients in the emergency department. To achieve project goals, Dr. Wong will develop a clinical decision support system that assesses and recommends pre-emptive techniques to treat patients with behavioral conditions likely to develop agitation. It will apply prediction modeling, user-centered design, and clinical informatics to address significant knowledge gaps regarding specific risk factors that lead to development of agitation and help clinicians detect and prevent them at the bedside.
Specializing in patient safety, behavioral health, and healthcare disparities, Dr. Wong’s research focus is to apply healthcare technology to address workplace violence and improve behavioral care in the emergency setting. This K23 award builds on Dr. Wong’s prior work to address both patient and staff safety during agitation episodes, including a recent NIH CTSA KL2 award through the Yale Center for Clinical Investigation (YCCI) and the Robert E. Leet and Clara Guthrie Patterson Trust Mentored Research Award to implement an agitation code response team intervention. Mentors and collaborators on the K23 Award include Yale Emergency Medicine faculty, James D. Dziura, PhD, MPH, and Ted Melnick, MD, MHS. Steven L Bernstein, MD of Dartmouth-Hitchcock and Kimberly Yonkers, MD of UMass Medical School will also be co-mentors.
Behavioral conditions in emergency settings are rapidly rising in the United States. National estimates show a 53% increase in number of general emergency department visits for mental health conditions over the past decade while overall visits only rose by 8.6%. Dr. Wong and his team propose addressing these challenges by creating the Early Detection and Treatment to Reduce Events with Agitation Tool (ED-TREAT), a user-centered clinical decision support system that will aid clinicians in both risk assessment and use of recommended treatments in patients at risk for agitation at the beginning of a visit.
“Clinicians work in a complex, ever-changing environment in the emergency department, and face many systems-level challenges that counteract the time and effort needed to build a strong rapport and trusting therapeutic relationship with the patient. Our long-term goal for ED-TREAT is to help clinicians better strategize and apply behavioral, patient-centered techniques for patients most at-risk for agitation before more severe symptoms develop. This helps prevent the unnecessary use of physical restraints on the most vulnerable and marginalized populations that seek emergency care in this country,” said Wong.
A physician-scientist in the Department of Emergency Medicine for over six years, Dr. Wong is also the Research Director and Associate Fellowship Director at the Yale Center for Medical Simulation. He has extensive expertise in qualitative and mixed-methods techniques for health services research. He holds a Master of Science in Health Professions Education from the Massachusetts General Hospital Institute of Health Professions, and recently received a Master of Health Science from the Yale School of Medicine.
The grant discussed in this article was awarded by the National Institute of Mental Health of the National Institutes of Health under Award Number 1K23MH126366-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.