UC San Diego Health System Excels in Patient Safety

Awarded an “A” in Spring 2014 Hospital Safety Score

Designed to rate how well hospitals protect patients from accidents, errors, injuries and infections, the latest Hospital Safety Score honored UC San Diego Health System with an “A” – its top grade in patient safety. The Hospital Safety Score is compiled under the guidance of the nation’s leading experts on patient safety and is administered by The Leapfrog Group (Leapfrog), an independent industry watchdog. …Read the full story from the UC San Diego Newsroom

Grand Rounds Speaker March 6: Dr. Jeffrey Wiese, Tulane University Medical Educator

Dr. Jeffrey G. WiesePresenting at Medicine Grand Rounds on March 6 is medical educator and hospitalist Jeffrey Wiese, MD, FACP, SFHM.

Wiese is associate dean for graduate medical education and director of the Internal Medicine Residency Program at the Tulane University School of Medicine, where he is professor and associate chair of medicine in the Section of General Internal Medicine and Geriatrics.

He is Chief of Medicine, Charity and University Hospitals, Medical Center of Louisiana at New Orleans.

Among the many honors Wiese has received for his teaching:

Read about his teaching philosophy

Wiese is a past president of the Society of Hospital Medicine (2010-2011). He has served as board member for the Society of Hospital Medicine, the Association of Program Directors in Internal Medicine and the Association of Subspecialty Professors.

He earned his medical degree at The Johns Hopkins School of Medicine in 1995. He did his internal medicine residency, chief residency and a medical education fellowship at the University of California, San Francisco.

About Medicine Grand Rounds

UCSD’s Medicine Grand Rounds is held weekly on Wednesday mornings, 7:30 – 8:30 a.m., in the Liebow Auditorium, second floor, Biomedical Sciences Building on the UCSD School of Medicine Campus. There is a hiatus in summer.

To see this year’s schedule and find video viewing information, visit the Medicine Grand Rounds page on the Department of Medicine website.

Grand Rounds Speaker February 27: Dr. Gurpreet Dhaliwal of UC San Francisco

Dr. Gurpreet DhaliwalPresenting at Medicine Grand Rounds on February 27 is Dr. Gurpreet Dhaliwal, associate professor of clinical medicine in the Department of Medicine at the University of California, San Francisco.

His topic: Clinical Problem Solving.

Dr. Dhaliwal is widely recognized for his skill as a clinical diagnostician. At Medicine Grand Rounds, he will narrate his process of clinical reasoning as he evaluates an unknown case presented to him in piecemeal fashion.

The New York Times Health section profiled Dr. Dhaliwal and his diagnostic method in a December 2012 article that contrasts human abilities with those of medical diagnosis software programs.  Read the article

The National Institutes of Health offers Dr. Dhaliwal’s 2008 “Great Teachers – Mysterious Cases” presentation as a videocast in the Clinical Center Grand Rounds series. Watch the video

Dr. Dhaliwal trained in internal medicine at UCSF and served as chief medical resident there before he joined the faculty in 2002. He is based at the San Francisco Veterans Affairs Medical Center, where he directs the internal medicine student clerkships.

An elected member of the Academy of Medical Educators, Dr. Dhaliwal is the recipient of many awards for his teaching. See a list of highlighted publications

UCSD’s Medicine Grand Rounds is held weekly on Wednesday mornings, 7:30 – 8:30 a.m., in the Liebow Auditorium, second floor, Biomedical Sciences Building on the UCSD School of Medicine Campus. There is a hiatus in summer.

To see this year’s schedule and find video viewing information, visit the Medicine Grand Rounds page on the Department of Medicine website.

UC San Diego Health System Awarded “A”s for Patient Safety

UC San Diego Health System was honored with two separate “A” Hospital Safety Scores by The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits. The A scores were awarded in the latest update to the Hospital Safety Score℠, the A, B, C, D or F scores assigned to US hospitals based on preventable medical errors, injuries accidents, and infections. … Read the full story from the UCSD Newsroom

UC San Diego Medical Center Named One of the Nation’s 100 Top Hospitals by Thomson Reuters

UC San Diego Medical Center, located in Hillcrest, has been named one of the nation’s 100 Top Hospitals® by Thomson Reuters. Ranked among the country’s major teaching hospitals, the Medical Center was also one of twelve hospitals to receive the Everest Award. This award honors hospitals that have achieved both the highest current performance and the fastest long-term improvement over a five-year period in Reuter’s national benchmarking study…. Read the full story from the UCSD Newsroom

UC San Diego Medical Center hospital in Hillcrest
More about the 100 Top Hospitals® Award:

UC San Diego Health System Receives Leapfrog Group’s Top Hospitals Award for its Commitment to High Quality Care

The Leapfrog Group’s annual class of top hospitals – 65 from a field of nearly 1200 – was announced December 6th in Washington, D.C. and included UC San Diego Health System in San Diego, California for the first time…. Read the full story from the UCSD Newsroom

UC San Diego Health System - Medical Center in Hillcrest
More information about quality and safety at UC San Diego Health System is found here.

Dr. Greg Maynard: Two New Leadership Roles in Hospital Quality Improvement

Directing QI Initiatives for UC San Diego and the Society of Hospital Medicine


Dr. Greg Maynard Accepting new leadership positions in hospital quality improvement with UC San Diego and the Society of Hospital Medicine (SHM), Dr. Greg Maynard has stepped down as Hospital Medicine division chief effective July 1.

He will direct the UC San Diego Center for Innovation and Improvement Science (CIIS) and serve as Senior Vice President of the Society of Hospital Medicine’s new Center for Healthcare Improvement and Innovation (CHII).  |  Read the SHM press release >

“I’m excited about the opportunities for collaboration, improvement, and innovation afforded by each of these positions, as well as the potential synergy between them,” said Maynard.

A member of the UC San Diego Department of Medicine faculty since 2003, Maynard was the founding chief of the Division of Hospital Medicine when it was established in 2005.

“As division chief, Greg Maynard has developed one of the most respected and effective hospitalist programs in the country,” said Department of Medicine Interim Chair Wolfgang H. Dillmann, MD.

“I have no doubt that UC San Diego Health System and the Society of Hospital Medicine will make important advances in hospital quality and patient safety through his leadership.”

DrGregSeymannLongtime UC San Diego hospitalist Gregory B. Seymann, MD, SFHM, Health Sciences Clinical Professor, is the new Hospital Medicine division chief. For the past year, he has served as associate division chief with Dr. Bryan Huang.

“The Division of Hospital Medicine has benefited greatly from Dr. Maynard’s leadership.” Seymann said. “I will work hard during this transition to maintain the excellent patient care, teaching, and systems improvement efforts that our division has championed.”

Dr. Bryan Huang

Health Sciences Assistant Clinical Professor Bryan Huang, MD, will continue in his role as associate division chief.

Maynard will carry out his SHM duties largely from San Diego, with periodic visits to SHM headquarters in Philadelphia.

With a part-time appointment in Hospital Medicine, he will continue to be involved in the division’s clinical, teaching, and quality improvement activities.

He will also continue as chair of the UC San Diego Health System Patient Safety Committee.

Leading The Center in the Society of Hospital Medicine

The Society of Hospital Medicine (SHM) is the primary professional medical society for hospitalists. Its Center for Healthcare Improvement and Innovation, known as The Center, is a new division that gathers all quality improvement initiatives under Maynard’s direction.   |   Read the SHM press release >

Maynard has played influential roles in developing these initiatives. He has served as a leader in SHM collaboratives on venous thromboembolism (VTE) prevention, glycemic control, and transitions of care for older adults in the hospital.

A founder of the SHM’s Mentored Implementation Program, he has guided numerous hospital medicine programs through quality improvement processes that mirror what he and his colleagues have done at UC San Diego.

Now, as Senior Vice President of The Center, Maynard will oversee all QI initiatives and assist the SHM in designing its strategies for supporting and expanding its healthcare quality improvement efforts.

The Center provides a suite of QI tools and resources for hospitalists. Online collaboration programs offer expert guidance in VTE prevention, glycemic control, and transitions of care.

Through The Center, hospitalists can obtain mentored implementation programs, communicate with other QI program directors via a collaborative network, and access an online QI data repository.

The Agency for Healthcare Research and Quality recently recognized The Center as a Patient Safety Organization, which makes it possible for medical centers to submit protected health information to the SHM for analysis of patient safety events without violating HIPAA guidelines.

Leading the UC San Diego Center for Innovation and Improvement Science

UC San Diego Medical Center in Hillcrest The Center for Innovation and Improvement Science is a new entity that conducts quality improvement efforts in collaboration with UC San Diego Health System management, the Performance Improvement and Patient Safety Office, the Clinical and Translational Research Institute, and the Division of Biomedical Informatics.

As director of the CIIS, Maynard is leading UC San Diego’s efforts to address local and regional quality improvement goals:

  • Accelerating inpatient quality and safety initiatives and developing tools to assess their progress
  • Fostering QI skills in UC San Diego personnel and their collaborators and disseminating their successful QI tools through mentorship, consultation, and publication
  • Reviewing new technologies and fostering new research programs

One of the specific goals of the CIIS is to help other local and regional medical centers improve their quality of care, particularly in VTE prevention, glycemic control, anticoagulation management, and transitions of care.

Another goal is to disseminate UC San Diego’s findings and achievements, establishing UC San Diego more firmly as an innovative center and a leader in hospital quality and patient safety.

About Dr. Maynard

Dr. Greg MaynardGregory A. Maynard, MD, MSc, SFHM, Health Sciences Clinical Professor, has led the development of patient safety and hospital quality improvement protocols that have gone on to widespread implementation through the Society of Hospital Medicine, the Agency for Healthcare Research and Quality, the Institute for Healthcare Improvement, and the American Society of Health-System Pharmacists.

For their work in venous thromboembolism (VTE) prevention, Maynard and his colleagues received the SHM Team Approaches in Quality Improvement Award in 2008 and the Venous Disease Coalition’s Venous Research Award for Quality Improvement and Implementation of Best Practices in 2009.

Maynard received his MD degree at the University of Illinois and completed his residency and chief residency in Internal Medicine at Good Samaritan Regional Medical Center in Phoenix, Arizona.

Thereafter, he directed the Good Samaritan Hospital Medicine program and served as Senior Associate Director of the Internal Medicine Residency Program.

He earned his MSc in Clinical Research Design and Biostatistics from the University of Michigan in 1993.

Since Maynard came to UC San Diego in 2003, the Hospital Medicine program has expanded from 4 faculty members covering Thornton Hospital to 30 faculty hospitalists covering both Thornton Hospital and the UC San Diego Medical Center in Hillcrest.

Maynard has served as chair of the Inpatient Glycemic Control Committee, the Patient Discharge Process Improvement /Transitions of Care Committee, and the Patient Safety Committee. He has been leader of the VTE Management Task Force and co-leader of the Inpatient Osteoporosis Identification and Management Task Force.

The American College of Physicians named Maynard a Top Hospitalist in the United States in November 2008. This year, he received the UC San Diego School of Medicine’s Leadership and Innovation in Patient-Centered Systems Award.

About Dr. Seymann

Dr. Greg SeymannGregory B. Seymann, MD, SFHM, received his MD degree from UCLA in 1994 and completed his residency training in internal medicine at UC San Diego in 1997. Upon his graduation, he joined the UC San Diego Department of Medicine faculty as an assistant professor.

Seymann helped to found the original group of hospitalists at UC San Diego in 1998.

Seymann’s clinical and research interests are in community-acquired and healthcare-associated pneumonia, performance measurement for hospitals and physicians, systems-based quality improvement, and perioperative consult medicine.

In 2008, the San Diego County Medical Society and San Diego Magazine named Seymann to the “San Diego’s Top Doctors” list. In the same year, graduating housestaff honored him with their annual teaching award.

This year, he received the Medicine 401 Excellence in Teaching Award.

In the Society of Hospital Medicine, Seymann chairs the Academic Practice and Promotions Task Force and is a member of the Academic Hospitalist Committee, the Performance and Standards Committee, and the Ethics QI Research Subcommittee.

He is a member of the UC San Diego Patient Safety Committee. In the Department of Medicine, he is a member of the Committee on Advancement and Promotions, the Peer Review Committee, and the Executive Committee. He chairs the Division of Hospital Medicine Peer Review Committee.

Seymann is a member of the UC San Diego ORYX Core Measures Team for Community Acquired Pneumonia. ORYX is an initiative of the Joint Commission for Accreditation of Healthcare Organizations.

About Dr. Huang

Dr. Bryan HuangBryan Huang, MD, Health Sciences Assistant Clinical Professor, received his MD degree from UC San Francisco. He has been a member of the Hospital Medicine faculty since his graduation from internal medicine residency training at Stanford University in 2006.

Huang has special interest in the areas of prevention and management of delirium, prevention of falls, transitions of care, VTE prevention, and treatment of pneumonia.

He has completed additional training in quality improvement through the mini-advanced training program offered by Intermountain Healthcare in Salt Lake City, as well as the SHM Leadership Academy.

He served as the Thornton site director for the Core Clerkship in Internal Medicine in the School of Medicine until this June, and will continue to serve on the Medicine 401 course committee.

Huang served on the SHM Early Career Hospitalists committee from 2007 to 2010.

Together with Dr. Greg Seymann, he has served as associate division chief of Hospital Medicine for the past year. His responsibilities have included workflow redesign, scheduling, budgeting, recruitment, and working with the Internal Medicine Residency Program.

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.