1. < CARE Unit

Each day, I receive a report of the inpatient medicine hospital census at Ronald Reagan UCLA Medical Center and UCLA Santa Monica Medical Center. For example, nearly 440 patients in both facilities were being taken care of by internal medicine faculty and trainees last Friday. As I have shared before, our house staff take care of the bulk of these patients, as they develop into world class internists. It is important to stop and acknowledge the work that they do, and the essential contributions that they make to our health system. Each year, the house staff spend a weekend together to reflect on the program, plan for improvement, while relaxing and enjoying the company of peers. This year’s retreat concluded this weekend at Lake Arrowhead, CA. The chief residents offered the following report of their activities.

“The UCLA IM Residency Program hosted its Annual Spring Retreat from May 3rd to 5th at the picturesque UCLA Lake Arrowhead Lodge. The retreat offered residents a magical experience in the snowy mountains where they focused on community building, programmatic activities, and professional development.

The retreat began with Dr. E. Dale Abel welcoming the residents with inspiring opening remarks about the significance of becoming a physician leader. Later, Dr. Carol Mangione and Dr. Tisha Wang led a captivating plenary session where they shared insights from their illustrious career paths. The chief residents conducted interactive breakout groups on various aspects of the program to gain feedback and develop the curriculum for the upcoming year.

The residents also had a chance to unwind and engage in recreational activities, including a fun scavenger hunt, yoga sessions, and entertainment from the Ultrasounds Band and resident-made skits. The retreat was an overwhelming success that rejuvenated everyone's spirits and fostered a sense of camaraderie among the residents. We are extremely grateful to the DoM and everyone who made this getaway possible.”

You can view more pictures HERE.

A few days earlier one of our residents, Kaustav Shah, MD was announced as a winner of the National Abstract Competitions at the American College of Physicians (ACP) Annual Meeting.

The American College of Physicians hosted its annual meeting on April 27-29 in San Diego. The department of medicine’s leadership was evident throughout the meeting as our faculty and staff participated in panels, workshops, and were recognized for their leadership in medicine. It was particularly gratifying to see one of our second-year internal medicine residents, Dr. Kaustav Shah was announced as a winner of the National Abstracts Competition of the ACP. Winners are selected in one of five categories: basic research, clinical research, quality improvement-patient safety, high value care, and clinical vignette.

Dr. Shah’s award-winning abstract

“summarized the preliminary analysis of a natural language processing tool to risk stratify patient portal messages. The goal is to have this tool flag messages from patients that may require more urgent triage and automatically move them to the top of the queue, so they are seen and potentially acted on faster by the primary care clinic staff and providers. [They] are also studying the distribution of patient messages to see what amount of higher risk messages come in overnight or on weekends when response times may be slower.”

Dr. Shah adds,

“There has been significant press coverage and increase in public awareness about artificial intelligence over the last year. Understanding the potential benefits and the limitations of the hype will be important in medicine as the technology continues to improve and become more prevalent in our daily lives. This ongoing work illustrates a potential use case in helping clinicians sort through a high volume of unstructured patient generated communication to potentially improve care.”

Congratulations Kaustav and collaborators which include Cliff Pang, DO, family medicine, Jeffrey Fujimoto, MD, department of medicine, Clinical Services Manager Scott Teplin, and Kamran Kowsari from the Office of Health Informatics and Analytics.

Kaustav’s work is particularly appropriate given the major challenges that many of our faculty, particularly in our ambulatory and primary care practices face. They report that a major driver of stress and burnout is the large burden of InBasket messages that they have to deal with each day. I am hopeful that innovative solutions like those being championed by Dr. Shah will contribute to a multipronged approach to address this issue. The DoM is evaluating additional solutions and we will have more to say about these in the near future.

Additional highlights from the ACP Annual Meeting will be forthcoming!

UC LEND Program Hosts Inaugural Pathways Mock Clinic for Trainees and Individuals with Neurodevelopmental Disabilities

In 2016, the Med-Peds division in the department of medicine (DoM) established the UC LEND (Leadership Education in Neurodevelopmental Disabilities) Program, with the goal of understanding the impact of neurodevelopmental conditions on individuals, their families, and how healthcare professionals can improve care and outcomes for these individuals throughout their lifespan. The program provides graduate and clinical level trainees hands-on experience and training in the delivery of care to individuals with neurodevelopmental conditions, as well as opportunities for research and advocacy for public policy.

At UCLA, the program has partnered with the UCLA Pathway Extension Program to teach young adults with intellectual disabilities self-advocacy skills within the healthcare setting. As a result of this collaboration, the Med-Peds team hosted the inaugural Pathways Mock Clinic on Saturday, April 15th. Under the leadership of Med-Peds Chief and Principal Investigator Alice Kuo, MD, PhD, MBA, Med-Peds Clinical Chief Eric Curcio, MD, and Program Coordinator Alanna DeLeon, the mock clinic provided medical students and nursing students with the opportunity to develop their skills taking vitals, gathering patient information and learning how to provide individualized care that is sensitive to the needs of this patient population. Pathways students had a prep session with Dr. Ryan Clagg, med-peds/LEND faculty, who explained the importance of primary care and explored the potential topics they could bring up with their healthcare provider. During the activity, Pathways participants were empowered to speak with their healthcare provider and develop confidence in managing their health and be comfortable in a busy healthcare setting.

“The event was absolutely amazing. It was incredibly heartwarming to see multiple groups of students interacting in such an interprofessional manner. Learning was happening everywhere, and on multiple levels,”

said Dr. Kuo.

Over 40 participants and volunteers took part in the inaugural mock clinic and the Med-Peds team looks forward to growing the clinic to train a higher number of healthcare professionals in how to provide the best care to patients living with ADHD, autism, and related neurodevelopmental disabilities. The UC LEND Program is supported by a federally funded training grant awarded by the Maternal and Child Health Bureau at the Health Resources and Services Administration (HRSA).

You can view additional pictures from the event HERE.

Scott Kitchen, PhD Awarded $6.1 million as part of California Institute for Regenerative Medicine (CIRM) Grant to UCLA

Professor of Medicine Dr. Scott Kitchen has been awarded $6.1 million from the California Institute for Regenerative Medicine (CIRM), the state’s stem cell agency, to develop a gene therapy that will help boost the immune system’s ability to fight HIV. Currently, HIV can be controlled with antiretroviral therapy. However, when those medications are discontinued, individuals living with HIV experience a viral rebound that can lead to an increased risk of illness and complications. Dr. Kitchen’s lab has found that gene therapy can modify a patient’s blood stem cells to produce immune cells, which recognize and attack cells that are directly infected by HIV. Through this approach, a patient’s healthy cells would not become infected.

Mouse studies from Dr. Kitchen’s lab have demonstrated that this approach is safe and possible in the treatment of HIV. The CIRM grant will allow his team, which includes Co-Investigators Anjie Zhen, PhD, Jerome Zack, PhD, and Otto Yang, MD, to develop investigational new drug-enabling pre-clinical studies that will examine the efficacy and safety of the therapy, and the development of a human clinical trial.

“This grant will help get one step closer to putting a durable, lifelong therapy for HIV infection into people living with HIV in hopes of providing a functional cure of the disease.  This will allow us to truly “translate" what has been more than a decade-long development in the lab, into the first patients. We are very excited about receiving this California-based funding, which provides us with a unique opportunity to move this therapy forward,”

says Kitchen.

This grant is a part of a $17.9 million CIRM grant to advance the treatment of corneal scars, HIV, and vision loss, led by researchers at the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA. Get the full details about all the projects HERE.

Congratulations Scott!

Primary and Specialty Care Clinic Opens in Goleta

I am also thrilled to announce the opening of our new primary and specialty care clinic in Goleta! The teams on the central coast have had quite a year of challenges with the severe weather affecting the region, but our team of experienced healthcare professionals and staff are dedicated to providing high-quality care to our patients, and we are excited to expand our services to the community of Goleta. In addition to primary care services, the new clinic will offer endocrinology and rheumatology services. Patients have warmly welcomed the team, often expressing their excitement by saying "welcome to the neighborhood" when they check in. They have been providing positive feedback about the comfortable and relaxing environment, and the convenient location which eases their ability to access care. Most importantly, patients are expressing that they feel valued and well-taken care of by their healthcare team. Congratulations to everyone involved in opening the Goleta location! We are grateful to work alongside teams that include front office staff, medical assistants, nurses and faculty who exemplify our values and commitment to excellence.

Dale

P.S.

This weekend I saw a couple of sculptures, which reminded me of the importance of residents taking some time off.

The first one reminded me of what you might feel like, a tough night on call, and the second was "commissioned" to represent the positive benefits of the residency retreat.