Dr. Daniel Bouland Appointed Chief of the Division of Hospital Medicine

Wolfgang H. Dillmann, MD

Wolfgang H. Dillmann, MD

Wolfgang Dillmann, MD, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine

The Department of Medicine is very pleased to announce the appointment of Dr. Daniel Bouland as chief of the Division of Hospital Medicine effective July 1, 2016. Dr. Bouland will work with the Chair of Medicine and the CEO of the Health System to ensure continued growth of the division; additionally, Dr. Bouland will also continue to support the department of medicine in a new role as Vice Chair for Clinical Quality Improvement and Patient Experience.

Dr. Daniel L. Bouland

Daniel L. Bouland, MD, MS, FACP

Dr. Bouland is highly regarded as a clinician and educator as well as being an experienced leader in health care management and administration with vast experience in the field of hospital medicine across various governmental and private sectors.

Dr. Bouland received his medical training at Loma Linda University School of Medicine and completed an internal medicine residency at the same institution, serving an additional year as chief medical resident at affiliated Riverside General Hospital/University Medical Center (RGH/UMC). Commitments with the United States Public Health Service afforded Dan opportunities to work with indigent populations in southern California as well as the Indian Health Service. Upon his subsequent return to RGH/UMC, Dr. Bouland was progressively appointed Assistant, Associate, and then Chair of the Department of Medicine. During this time, additional functions included vice-chair of the Department of Medicine and Associate Program Director, Internal Medicine Residency Program, Loma Linda University Medical Center; president of hospital-based physicians RGH/UMC; and CEO/President of the Mission Medical Group of the Inland Empire. Of note internationally, in addition to lectures and clinical care, is his establishing and maintaining a US-style medicine residency program at Sir Run Run Shaw Hospital, Zhejiang Medical University in Hangzhou, China.

In 2000, Dan moved to Hawaii to serve as Associate Chief of Staff for Primary Care and Medicine of the Veterans Affairs Pacific Islands Health Care System (VAPIHCS), and then as Director of the Office of Referral and Management Services of the VAPIHC.

After joining the UCSD Division of Hospital Medicine in 2006, Dan completed a Master’s program in Health Care Management at Harvard. He has taken on many leadership roles within the University, including serving as Vice Chair for Clinical Operations in the department of medicine and as Director of Evaluation for the Altman Clinical and Translational Research Institute.

Current research efforts focus primarily on Quality Improvement initiatives, particularly the application of a results-oriented, business management approach to health care.

Please join me in congratulating Dr. Bouland in his formal appointment as Chief of the Division of Hospital Medicine.

Internal Medicine Resident Drs. Julie Chen and Darrin Wong Present Research at Department of Medicine Grand Rounds

Drs. Darrin Wong and Julie Chen at Medicine Grand Rounds.

Drs. Darrin Wong and Julie Chen at Medicine Grand Rounds.

On June 3, 2015, Drs. Julie Chen and Darrin Wong presented their research at Department of Medicine Grand Rounds.

The subject of Dr. Chen’s research was “Failure to Adjust Diabetes Medications at Discharge for Hospitalized Patients with Poorly Controlled Diabetes.”

Dr. Chen worked with members of the faculty in the Division of Endocrinology and Metabolism, including Drs. Robert El-Kareh and Kristen Kulasa as well as Dr. Pedro Ramos from the Division of Hospital Medicine.

Dr. Wong presented his research on the topic, “Right Ventricular Dyssynchrony in CTEPH.” He worked with Dr. Daniel Blanchard from the Division of Cardiovascular Medicine.

Dr. Wong presenting background information about echocardiography.

Dr. Wong presenting background information about echocardiography.

Drs. Chen and Wong won their places at Medicine Grand Rounds when they were chosen for their admirable research achievements at the UC San Diego Annual Internal Medicine Resident Research Symposium on May 7.

The other research symposium winners were Drs. Satya Das, Noel Lee, Michele Pham and Kevin Shah. Drs. Das, Lee, and Pham will present their research at Medicine Grand Rounds on June 10.

Dr. Shah presented his research, along with fellow resident Dr. Nick Marston, on the topic, “Serial Sampling of Copeptin Levels Improves Diagnosis and Risk Stratification in Patients Presenting with Chest Pain: Results from the CHOPIN Trial” last June.

2015 Resident Research Symposium Winners

Research winners at last month’s Annual Internal Medicine Resident Research Symposium. Left to right: Drs. Shah, Lee, Das, Chen, Pham and Wong.

2009 “San Diego’s Top Doctors” List Includes 36 Department of Medicine Physicians

For their excellence in the opinion of their fellow physicians in San Diego County, 36 doctors from the Department of Medicine have been named to the “San Diego’s Top Doctors” list for 2009.

This year’s list includes a total of 475 doctors in 46 specialties. Eighty of the doctors are from UC San Diego.  |  Read the full story from UC San Diego News

“We can be very proud of the fact that UC San Diego Medical Center has more doctors on the list than any other medical center or medical group in the region,” said Dr. Kenneth Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine.

In 2008, the “Top Doctors” list included 449 physicians, 61 from UC San Diego and 25 from the Department of Medicine.Of the 36 Department of Medicine physicians honored this year, 24 have been named to the list at least once before. Four are being recognized for the sixth straight year:

A place on the “Top Doctors” list is a particular honor for those who are chosen because it reflects the confidence of their peers.

In the “Top Doctors” survey, the members of the San Diego County Medical Society are asked to name the board-certified physicians they would select when they refer their own family members or patients to a specialist. They are permitted to vote across medical specialties.  |  Read more about how Top Doctors are chosen

The list is published each year in the October issue of San Diego Magazine.The magazine and the San Diego County Medical Society have collaborated to produce the “Top Doctors” list since 2004. San Diego Magazine first published a “Top Doctors” list in 2002.

Here are the names of this year’s Department of Medicine awardees, listed by subspecialty division and followed by the number of years each has been named to the “Top Doctors” list:

Division of Cardiology

Division of Emergency Medicine

Division of Endocrinology and Metabolism

Gastroenterology

General Internal Medicine

Geriatrics

  • Kwi Young Bulow, MD, voted a Top Doctor in both Geriatric Medicine and Internal Medicine (3 years)
    Health Sciences Clinical Professor

Division of Hematology-Oncology

Division of Hospital Medicine

Division of Pulmonary & Critical Care Medicine

Dr. Gregory A. Maynard Is Named a Top Hospitalist in the U.S.

Dr. Greg MaynardDr. Gregory A. Maynard, chief of Hospital Medicine at UCSD, is one of the top 10 U.S. hospitalists in a new ranking from the prestigious American College of Physicians.

The honor was announced in November. It recognizes Dr. Maynard’s outstanding contributions in improving the quality of hospital care and mentoring hospitalists in the U.S. and abroad.

Dr. Maynard has led the UCSD hospitalist team in developing nationally-recognized patient safety and quality improvement programs.

These efforts have advanced two crucial aspects of patient safety in the hospital: venous thromboembolism prevention and glycemic control.

Dr. Maynard is also an active mentor in the developing field of hospital medicine.

He’s advising a number of institutions as they develop hospital medicine programs. Among these is the Pontificia Catholic University of Chile in Santiago, where Dr. Maynard helped conduct the first-ever Chilean hospitalist meeting last November.


Dr. Maynard and the other “Top Hospitalist” honorees are profiled in the November 2008 issue of ACP Hospitalist.  |  Read the article


UCSD’s advances in patient care quality improvement

Gregory A. Maynard, M.D., M.Sc., joined the UCSD faculty in 2003 as head of the new Hospital Medicine division.

Since then, the division has expanded to 23 faculty members and has won national awards for its achievements in hospital care quality improvement.

In 2008, the Society of Hospital Medicine honored Dr. Maynard and the UCSD hospitalists with the Team Improvement Award for their venous thromboembolism prevention program.

The program was developed with funding from the Agency for Healthcare Research and Quality.

Dr. Maynard and his colleagues developed a risk assessment tool that allows healthcare professionals to identify quickly and accurately the most appropriate venous thromboembolism prevention measures for each hospitalized patient.

As a result, the UCSD Medical Center is among the leaders in the U.S. in preventing venous thromboembolism in its inpatients.

At the UCSD Medical Center in Hillcrest alone, the program prevents approximately 50 cases of venous thromboembolism each year.

The tool, now part of the Venous Thromboembolism Resource Room on the Society of Hospital Medicine website, is now in use at medical centers around the nation.

UCSD’s hospitalists also play a major part in the Society of Hospital Medicine’s Inpatient Glycemic Control Task Force, which is headed by Dr. Maynard.

The work of the task force was presented recently in a special supplement issue of the Journal of Hospital Medicine (JHM).

“Most of the work on the SHM website, this supplement, and the SHM QI pre-courses features contributions and lessons learned from the hospitalists at UCSD,” Dr. Maynard said.

The term “hospitalist” was first used in 1996 in a New England Journal of Medicine article that highlighted the importance of inpatient-focused care in healthcare today.  |  Read the article

The role of the hospitalist

In creating the “Top Hospitalists” list, the American College of Physicians is recognizing the increasing importance of the new specialty of hospital medicine.

Hospitalists dedicate themselves to improving the quality of care for hospitalized patients. Their efforts range from creating new disease management protocols to revamping hospital information systems.

According to the Society of Hospital Medicine, there are an estimated 20,000 hospitalists in practice today.

As experienced attending physicians who are continuously available on the wards, hospitalists also play a central role in training students, residents, and fellows.

More Information

Hospitalist Program, Dr. Timothy Morris, and Dr. Davey Smith Honored as 2008 Health Care Champion Finalists

Three Department of Medicine individuals and teams are among UCSD Medical Center’s honorees in the 2008 “Health Care Champions” awards from the San Diego Business Journal.

Pulmonary specialist Dr. Timothy Morris, infectious disease physician-scientist Dr. Davey M. Smith, and the Division of Hospital Medicine were honored August 21 as “Health Care Champion” finalists.In all, 5 individuals and teams from UCSD Medical Center received a Champion award and 20 were selected as finalists.

Dr. Greg MaynardThe Division of Hospital Medicine, headed by Dr. Gregory Maynard (left), has achieved national recognition for its contributions in health care quality improvement.

These include a venous thromboembolism (VTE) prevention program that has made the UCSD hospitals a national leader in protecting inpatients from the risk of developing blood clots.

Read the full story
from UC San Diego
Health Sciences Communications

The program was developed as a joint venture between Dr. Maynard and the Hospitalist Program and Dr. Timothy Morris. A clinical and research specialist in VTE, Dr. Morris helped create the VTE prevention protocols and oversees the follow-up on individual cases.

Dr. Timothy Morris

Dr. Morris, left, is Professor of Medicine and Clinical Service Chief in the Division of Pulmonary and Critical Care Medicine. He is medical director for both the Respiratory Care program and the Pulmonary Function Laboratory.

In July, the California Thoracic Society honored Dr. Morris with the Outstanding Clinician Award for 2008.

The Pulmonary and Critical Care Medicine division was recognized by U.S. News & World Report in 2008 for the 14th consecutive year as one of the top ten centers in the nation, and #1 in California, for the treatment of respiratory diseases.

Davey M. Smith, M.D., M.A.S., Assistant Adjunct Professor of Medicine, is a physician-scientist in the Division of Infectious Diseases. Dr. Smith is medical director of the Early Intervention Program at the Antiviral Research Center.  A translational research virologist, he specializes in the study of HIV transmission.

Dr. Davey M. SmithEarlier this year, Dr. Smith (left) received an R01 grant award from the National Institute of Mental Health for a 5-year, multi-national study of HIV and the brain.

Dr. Smith directs the Center for AIDS Research Viral Pathogenesis Core on the UCSD campus.

More Information:

Hospitalists and Pharmacists win ASHP Grant for Glycemic Control Project

UCSD’s hospitalists, teaming with the Department of Pharmacy, have won funding for a new quality improvement project to make hospital stays safer for diabetic patients.

The American Society of Health-System Pharmacists (ASHP) Research and Education Foundation has awarded one of its two 2008 Hospital Pharmacist-Hospitalist Collaboration Research Grants to the UCSD Division of Hospital Medicine and the Department of Pharmacy.Hospitalist Gregory Maynard, M.D., M.Sc., and pharmacist Kevin W. Box, Pharm.D., are the principal investigators.

“With the help of other team members, we expect to achieve meaningful improvement”

Dr. Greg MaynardDr. Maynard is Chief of the Division of Hospital Medicine and a nationally recognized leader in quality improvement and patient safety.

“It definitely takes a multidisciplinary team to create a design change in health care delivery and then carry it out successfully,” Dr. Maynard says.

“We are fortunate that the hospitalists and pharmacists work so well together.

“With the help of other team members, we expect to achieve meaningful improvement with this transition from insulin infusion, just as we have with other related projects.”

Along with Dr. Maynard, hospitalists Dr. Pedro Ramos and Dr. Diana Childers are key participants for the Division of Hospital Medicine. Both are assistant clinical professors.

UCSD’s project will test a multidisciplinary model for managing diabetic inpatients’ blood glucose levels in the first 48 hours after an insulin infusion.

The goal is to find an effective team protocol that can be adapted easily for use in other areas.

Other quality improvement projects: success in VTE prevention

UCSD’s hospitalists are involved in several patient care quality improvement projects. These include an ongoing venous thromboembolism (VTE) prevention program that has set a national benchmark for patient safety.

Read our story
about UCSD’s
achievements in
VTE Prevention

About the ASHP grant program

The ASHP Research and Education Foundation is a nonprofit organization devoted to improving patients’ health and well-being through the appropriate, safe and effective use of medications.

The Foundation’s Hospital Pharmacist-Hospitalist Collaboration Research Grant Program supports innovative projects for improving patient care in hospitals and health systems.

This year, applicants were invited to submit proposals for improving glycemic control in hospitalized patients. The UCSD project won the grant in a highly competitive field.

Hospitalist-Pharmacy team awarded ASHP grant in 2007 as well

This is UCSD’s second consecutive year as an ASHP grant award winner.

Last year, the Division of Hospital Medicine and the Department of Pharmacy received the award for its “Hospitalist and Pharmacist VTE Treatment Protocol Collaborative.”

In that project, Dr. Maynard was Hospitalist Investigator and Dr. Robert Weibert, Pharm.D., was Pharmacist Investigator.

More Information:

UC San Diego VTE Prevention Team Wins National Award

The Society of Hospital Medicine (SHM) has awarded its first-ever Team Approaches in Quality Improvement Award to the UC San Diego Venous Thromboembolism (VTE) Prevention Program team.

The national award recognizes the team for its exemplary efforts in preventing VTE in hospitalized patients at UC San Diego Medical Center.

The program has significantly lowered the incidence of VTE in inpatients and has become a model for VTE prevention efforts nationwide.

For the program’s success, team leader Dr. Gregory Maynard credits the efforts of the multidisciplinary team and the support of the UC San Diego Medical Center and the Department of Medicine.

Dr. Maynard is Clinical Professor of Medicine and Chief of the Division of Hospital Medicine. The VTE Prevention Team includes UC San Diego hospitalists, other physician specialists, pharmacists, and nurses.

The Team Approaches in Quality Improvement Award was presented in a ceremony on April 5 at the Hospital Medicine 2008 meeting here in San Diego.

More Information

Leading Other Centers in Preventing Blood Clots in Hospital Patients

UCSD is setting a national standard for protecting hospital patients from the risk of developing blood clots, thanks to a dedicated effort of the Division of Hospital Medicine.

During any hospital stay, a patient has a significant risk of developing a blood clot in a limb (deep vein thrombosis, or DVT) that may travel to the lung (pulmonary embolism). Pulmonary embolism is considered the leading cause of preventable death in hospitalized patients.

The overall term for this phenomenon is hospital-acquired venous thromboembolism (VTE).

Careful measures can reduce the risk of hospital-acquired VTE substantially. These include activity, support hose, sequential compression devices, and blood-thinning medications such as heparin.

On average, hospitals across the nation are offering adequate blood clot prevention measures to about half of the patients who stay in the hospital.

That was UCSD’s level of performance before the Division of Hospital Medicine started a “Partners in Patient Safety” project funded by the Agency for Healthcare Research and Quality (AHRQ) of the US Department of Health and Human Services.

Now, just two years later, over 95% of UCSD inpatients are receiving adequate clot prevention regimens, setting a new national benchmark. The number of UCSD patients who develop hospital-acquired clots has dropped by about 35%.

Heading the UCSD blood clot prevention project is Dr. Greg Maynard, Chief of the Division of Hospital Medicine and a national leader in the field of patient safety.

The two-year study is titled “Optimal Prevention of Hospital Acquired Venous Thromboembolism” under AHRQ grant 1U18HS015826-01. Its purpose is to find the best ways to prevent hospital-acquired blood clots, and build tool kits that enable others to do the same.

Other major contributors include Dr. Tim Morris, Associate Professor of Clinical Medicine and Director of Pulmonary Clinical Programs at the UCSD Medical Center – Hillcrest) and pharmacists Robert Schoenhaus, Pharm.D., and Douglas Humber, Pharm.D.

Dr. Maynard and his coworkers have developed a VTE prevention protocol, tested it, found it highly successful, and published it for other centers to use.

Under the new protocol, every new or transferred patient is quickly evaluated for his or her risk of developing a blood clot, and the appropriate measures are ordered. Nurses act as another line of defense, and can help identify patients who might otherwise have slipped between the cracks as their bleeding risk or clot risk changed.

Whether the risk is low, average, or high depends on a patient’s age, medical condition, reason for hospitalization, and other factors.

The task called for Dr. Maynard and his colleagues to develop a quick, accurate, reliable way for nurses or other medical staff to screen each patient for blood clot risk. He said existing methods were discarded because they failed to be useful in actual practice.

“We needed a reliable tool that we could apply to any patient of any description in 10 seconds or less,” he said.

The tool kit is now housed at the Society of Hospital Medicine (SHM) website, where it is the centerpiece of a SHM VTE Prevention Collaborative involving 30 medical centers from all over the country.

About the VTE Prevention Collaborative, Dr. Maynard says, “We’re using tools, largely developed here, to help guide other medical centers through the process. We’re mentoring other hospitalists to be leaders in hospital improvement in general, not only as pertains to VTE.”

As part of the Collaborative, Dr. Maynard is one of two mentors who work with hospitalists around the country. By telephone and email, he advises hospitalists at about a dozen centers who download and use the patient care protocols he has helped to develop.

He sees this as part of the mission of hospital medicine. “We identify the best practices and try to build them into a protocol on the front line of use so that every patient is exposed to that treatment practice,” he says. “And we enable others beyond our local environment to do the same thing.”

Dr. Maynard has been a major figure in national efforts to improve the quality of inpatient care for many years. He is a leading member of the Society of Hospital Medicine, and has also worked nationally on inpatient management of diabetes and other common inpatient problems.

At UCSD, where he has headed the Division of Hospital Medicine since 2003, Dr. Maynard is Chairman of the Patient Safety Committee.

The UCSD Division of Hospital Medicine focuses on the special issues that affect the health and care of patients who are hospitalized at UCSD. Its mission is to improve the quality and safety of inpatient care.