Fellow Incentive Program

Building on the success of the housestaff incentive program, our Department submitted a proposal for the first fellow-specific incentive program in 2010-11. While the first two years were programs focused on the fellowships as a whole, subsequent years have seen fellowship programs develop and submit program-specific initiatives.


The DOM Fellowship Programs focused their initial quality goal on engaging clinical fellows in a peer-reviewed assessment of initial inpatient consultation notes to promote practice-based learning improvement and high-quality consultative skills. For more information on the objectives of this initiative and the designed tool, please review the DOM QCAT Primer that was developed for participating fellows, a poster that was presented at the 2011 Quality and Safety Symposium, and an article describing the program, which was published in the American Journal of Medicine.

Delphine Tuot presents at the Quality & Safety Symposium.


Building on the previous year's program, the DOM Fellowships focused on improving the QCAT peer evaluation program by providing more timely data and increasing engagement among fellows and fellowship directors. The program, including its results and lessons learned, was presented at the 2012 Quality & Safety Symposium.


The following DOM fellowship programs participated in the incentive program:

  • Oncology: Improving communication between outpatient and inpatient oncologists: Fellows designed a new discharge note template that summarized the hospitalization and chemotherapy-related complications; they were required to complete it for >75% of discharged patients.
  • Transplant Hepatology: Increasing communication with non-UCSF primary physicians upon hospital discharge from the Liver Transplant Unit (LTU):Fellows were required to communicate with outside providers within 72 hours of discharge in >75% of patients.


The following DOM fellowship programs participated in the incentive program:

  • Nephrology: Promoting communication between the nephrology consult service and outpatient nephrologists in the care of patients with End Stage Rental Disease (ESRD):Fellows were required to communicate with the outpatient nephrologist during >75% of inpatient ESRD consultations and identify predictors associated with successful communications. 
  • Palliative Medicine: Improving pain in patients seen by an inpatient Palliative Care Service (PCS):   Fellows implemented a program that resulted in steady improvements of pain control, particularly in patients who reported suffering from severe pain on the day of initial PCS consultation.
  • Gastroenterology: Increasing pneumococcal vaccinations for patients with Inflammatory Bowl Disease (IBD): Fellows developed a process for systematically measuring vaccination rates, coupled with an educational intervention to improve communication with patients around this goal.
  • Pulmonary: Reducing fluoroscopy times: Fellows developed an educational-based intervention along with changes to the procedure note template to reduce radiation exposure and procedure times.


For additional information or questions, please contact us.