Monthly Newsletter | February 2022
News
DHM Internal Grants Awardees 2022
Shradha Kulkarni and Emily Insetta, mentored by Cindy Lai and Nancy Choi, are leading a project entitled, "An Innovative Curriculum to Improve and Modernize MS3 Oral Presentations." This project will continue work led by Emily and Shradha to redesign and standardize the MS3 oral presentation that involves surveying faculty, residents, and students on gaps and limitations of the current presentation within the clinical learning environment; designing an improved framework for presentation and standardizing expectations for faculty and residents. 

Sergio Torres, mentored by Liz Dzeng and Margaret Fang, is leading a project entitled, "Shared Decision-Making Across the Linguo-cultural Barrier: The Hispanic Perspective on End-Of-Life Discussions during Hospitalization." This 2-phase proposal will conduct 1) interviews and thematic analyses of chronically ill inpatients identifying as Latin/Hispanic to identify and describe barriers, areas of opportunity, and strengths in communication for end-of-life (EOL) discussions. The second phase of the project will focus on developing a culturally conscious communication skills workshop to improve EOL communications between patients/families and providers from different cultural backgrounds with a more expansive scope. 

This is the 7th year of funding for the DHM Internal Grants Program, designed to support junior faculty careers and projects within the division. Many careers and important divisional work have been launched with this funding. Calls for applications are sent out every fall, and new and junior faculty are encouraged to apply!

For questions about applying or for consideration of developing projects for the next Internal Grants Program cycle, please email kirsten.kangelaris@ucsf.edu.
Natalya Maisel
Senior Research Manager, Center for Clinical Informatics and Improvement Research (CLIIR) Team
NPR asked some doctors and Nobel Prize Laureates including Malala to make their wishes and predictions for 2022. 
Our very own DHM colleague Sri Shamasunder was asked to contribute. 
UCSF Staff Performance Evaluations are due March 15, 2022! Please schedule a time to meet with your supervisor or direct reports prior to the deadline.
Equity & Belonging in Hospital Medicine
We often forget how closely allyship is intertwined with good communication skills that relay respect. When we debrief instances of microaggressions or bias with each other or with our learners, it is critical to ensure optimal listening techniques. 

Here are some guidelines for good active listening that can help build relationships with others: 
Withholding judgment: Listening in order to process and understand, not to interrupt or to determine your next point/action. It helps to mindfully pause (physically or verbally) to make sure you are suspending judgment or your own preconceived notions before walking into a conversation.
Reflecting: It takes time and practice to understand and process words that reveal the impact of bias; it also involves de-centering your perceptions/experiences and re-centering on those of another individual.
Clarifying: Asking questions to elicit more perspective about an experience of another person, only if this is appropriate and does not lead to harmful triggering or re-traumatization.
Summarizing: Using our own words to show an individual that we value them, hear them and trust them to correct inaccuracies in our perception of their words.
Sharing: Offering support, resources, and options for following up on how they're doing.

Try to be intentional with active listening in other venues as well; let's see what happens!

For feedback, or to share pearls in the next DHM newsletter, please email Sneha.Daya@ucsf.edu
Publications
Nader Najafi and Sajan Patel published a study in JAMA IM of a novel clinical decision support (CDS) tool that used predictive analytics to notify providers if their hospitalized patients would be suitable for Sleep Promotion Vitals (i.e., stable enough to forego the overnight vital sign check to reduce sleep interruptions), and tested it with a randomized-control trial entirely embedded within the electronic health record. The study showed that the CDS tool was effective and safe in helping providers deescalate vital sign checks and reduce sleep interruptions.
Brandon Scott and Molly Kantor were coauthors on a study accepted for publication in Palliative Medicine which examined the frequency, quality, and predictors of advance care planning documentation among hospitalized medical patients with and without COVID-19. 
Margaret Fang and a team of UCSF investigators published a study in the Journal of General Internal Medicine which found that in five California safety net health systems, warfarin monitoring was implemented equally by patient language, race, and ethnicity.
Margaret Fang coauthored a study published in the American Heart Journal which found that in the Get With The Guidelines-AFIB registry, there remained opportunities to improve guideline-based care of people with atrial fibrillation. These include prescribing aldosterone antagonists in people with low systolic ejection fractions and avoiding unindicated coadministration of antiplatelet and anticoagulant medications.
Joshua Ronen coauthored a case report in Cureus titled "Amantidine-Induced Cardiac Arrest in a Patient with COVID-19" with a group of residents and faculty from his residency program at TTUHSC.
Liz Dzeng published an editorial with Randy Curtis in Intensive Care Medicine on how national, local, and institutional policies and laws can either hinder or facilitate high-quality end-of-life care.
Archna Eniasivam, Aimee Medieros, and Megha Garg wrote a commentary on their experience receiving a harmful peer review and offer recommendations for action. For more background, check out the recorded Incubator Session from September 2, 2021, focused on this issue. 
In collaboration with DHM Datacore, Manoj Maddali (formerly of DHM) was lead author, along with Wendi Zhao (formerly of DHM) and Kirsten Kangelaris who were coauthors, on a study published in Lancet Respiratory Medicine which found that a classifier model using only clinically available data was able to identify key ARDS subphenotypes that have potential to provide prognostic information and inform management strategies for patients with ARDS. 
More Publications from DHM
The DHM Quality Post
Jennifer Lee
I am most grateful to Jen Lee for her organizational skills and in guiding every step of the IGP Committee process.

- Kirsten Kangelaris