Our division has a number of full-time clinical researchers who conduct investigations in a broad variety of topics and who also provide mentorship, methodologic expertise, and assistance with manuscripts and grants to other faculty, fellows, residents, and students.
Research in the Division of Hospital Medicine focuses on a number of key areas: 1) evaluation of hospital medicine services; 2) patient safety and healthcare quality measurement/improvement; 3) health communication; 4) health policy, particularly policy related to public reporting of quality and safety measures; and 5) outcomes research and cardiovascular epidemiology. In FY 2013, the division received nearly $4.6M in extramural funding for research, providing an incredible environment for investigators.
The Division’s Research Director is Andrew Auerbach, MD, MPH, Professor of Medicine at UCSF and a nationally-recognized leader in the field of quality measurement and improvement. Andrew Auerbach's research has primarily focused on assessments of patient outcomes in different systems of care and exploring novel approaches for translating research into clinical practice. In addition to his research projects, Auerbach teaches courses in Advanced Training for Clinical Research, and is the Associate Program Director of General Internal Medicine Research Fellowship, and Chairs the Clinical Content Oversight Committee for APEX, the UCSF Medical Center EHR.
Other DHM researchers are:
Wendy Anderson, MD, MS, whose work focuses on understanding gaps in communication between hospitalists and patients, and developing methods for addressing these gaps.
Margaret Fang, MD, MPH, whose research focuses on improving use of anticoagulants through improved risk prediction and novel testing approaches (including pharmacogenetics).
Ryan Greysen, MD, MHS, MA, whose primary focus is on transitions of care for hospitalized older adults and interventions to improve post-discharge continuity of care including novel uses of social media.
Kirsten Kangelaris, MD, whose research focuses on the use of biological markers and genomic data to improve health outcomes for hospitalized patients with infection-related critical illness.
Raman Khanna, MD, MAS, whose work focuses on the connection between health information technology, care efficiency, and team communication.
Michelle Mourad, MD, whose research interests focus on quality improvement and patient safety in the areas of transitions in care as well as procedural safety and education.
Steve Pantilat, MD, whose work focuses on improving the quality of palliative care services and improving the quality of care and quality of life of people with serious illness.
Niraj Sehgal, MD, MPH, whose work is focused on systems innovation and change through the evaluation of strategies (e.g., educational interventions, quality improvement initiatives, and leadership development programs) that lead to the improved quality, safety, and value of care.
Robert Wachter, MD, whose work has focused on the impact of hospitalists and other new models of hospital care, and on practical and policy issues in the areas of healthcare quality and patient safety.
Recent Divisional Research Projects:
- Coordination of a multicenter Hospital Medicine research network (HOMERUN).
- Site participant in multicenter telemedicine study (BEAT-HF) and multicenter study of medication reconciliation (MARQUIS).
- Site participant in UC-Wide collaboratives targeting transitions of care, venous thromboembolism prevention (VTEP).
- Improving use of medications in surgical patients through a multidisciplinary QI program.
- Volume, outcomes, and quality of care for major surgery.
- A randomized clinical trial of the efficacy of pharmacogenomic testing to guide warfarin initiation (COAG Study).
- A multicenter study on the management of outcomes of acute venous thromboembolism (CVRN VTE Study).
- The use and outcomes associated with peri-operative venous thromboembolism prophylaxis in patients undergoing spinal surgery.
- Improving patient-doctor communication in hospitalized patients.
- Policy analyses of a variety of initiatives to improve safety and quality.
- Evaluating a multimodal intervention on reducing the unnecessary ordering of inpatient radiology studies.
- Balancing "no blame" and accountability in patient safety.
- A pilot randomized control trial of symptom management and palliative care for patients with heart failure.
- The establishment of a Palliative Care Quality Network to bring together established Palliative Care Services that share a passion for providing quality care for patients and their families. The Network will support the sustainability, growth, and improvement of Palliative Care Services by collecting, reporting and sharing a uniform set of operational, clinical, satisfaction, and financial data that will be used to identify and share best practices.
- A qualitative study of post-discharge needs and concerns among older, hospitalized adults.
- Improving the quality and timeliness of discharge summaries.
- Understanding a population of high users on the inpatient medical service.
Works in Progress:
The Division of Hospital Medicine Research "Incubator" program was founded in 2008 by Drs. Auerbach and Fang to provide junior faculty and trainees one-on-one assistance with research projects, grant applications, and writing and presenting clinical research. The program has provided guidance to hospitalist fellows, junior faculty from the Division, and faculty from other departments, including Emergency Medicine and Pediatrics.
In partnership with the Division of General Internal Medicine and Department of Family Medicine, the Division offers research training through a 2-year Research Fellowship. Fellows undergo formal training in research methods and biostatistics and actively conduct mentored clinical research with an aim of becoming independent researchers. The one-year Academic Hospitalist Fellowship exposes fellows to courses and mentoring in basic research methods, but fellows who aspire to faculty positions as Clinician-Investigators (with substantial extramural research funding) are encouraged to pursue the Research Fellowship (or similar research-oriented training at other institutions). For those individuals interested in global health with a major focus on quality improvement, advanced topics in tropical medicine, delivery and implementation of care in resource poor settings should consider the Global Health Hospital Medicine Fellowship. In this one year program, fellows spend about 2/3 of their time in the field with our partners abroad. The rest of the time is spent as an Academic hospitalist within DHM. An innovative curriculum and strong mentorship aims to shape the next generation of expert Global health practitioners who are effective in resource poor settings.