Ralph Gonzales, MD, MSPH
Associate Dean
EVP - Physician Serv
Chancellor/EVC/FAS

Dr. Ralph Gonzales is Associate Dean for Clinical Innovation and Chief Innovation Officer for UCSF Health. His research has played a significant role in national and global efforts to combat antimicrobial resistance by improving antibiotic prescribing practices - the body of which provides a successful roadmap for translating evidence into practice, policy and public health.

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Dr Gonzales’ research is multidisciplinary, patient-centered, and informed by relevant stakeholders and policy makers such as the CDC, NCQA, professional societies and community clinicians and patients. It represents the full spectrum of translational research - from practice guideline development, to implementation of innovative health care interventions, to conducting larger community-based trials to examine the comparative effectiveness of different health care interventions. In addition, Dr. Gonzales is currently leading several project teams in designing, implementing and evaluating new ways to improve primary care-specialty care communication and care coordination, focusing on strategies that achieve the triple aim of improving quality, outcomes and decreasing costs. One includes the use of eReferrals and eConsults to streamline the referral and coordination process; another project is evaluating new team-based strategies to reduce unnecessary follow-up visits in specialty care.

Education & Training

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• Diversity, Equity, and Inclusion Champion Training University of California 2019
• MSPH Preventive Medicine & Biometrics University of Colorado Health Sciences Center 1997
• Residency School of Medicine University of California, San Francisco 1995
• M.D. Medicine University of California, San Francisco 1991

Interests

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• Implementation Science
• Improvement Science
• Delivery System Re-Design
• Change Management
• Telehealth
• eConsults
• Patient-Facing Computerized Applications
• Antimicrobial Stewardship
• Acute Bronchitis
• Physician Behavior
• Health Care Value
• Acute Respiratory Tract Infections

Websites

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• UCSF Continuous Process Improvement Site (cpi.ucsf.edu)
• Clinical Profile at UCSF Medical Center (ucsfhealth.org)
• Center for Health Care Value (healthvalue.ucsf.edu)
• Caring Wisely Site (healthvalue.ucsf.edu)
• Posts on X ImSatCTSI (X.com)

Grants and Projects

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• UCSF Learning Health System K12 Career Development Program, NIH, 2018-2023
• Development, Implementation and Evaluation of Novel Strategies to Reduce Inapprop, NIH, 2008-2012
• Improving Antibiotic Use in Acute Care Settings, NIH, 2003-2008
• Minimizing Antibiotic Resistance in Colorado (MARC), NIH, 2001-2006

Publications (169)

Top publication keywords:
Ambulatory CareInappropriate PrescribingPatient PortalsEmergency Service, HospitalOffice VisitsBronchitisPneumoniaReferral and ConsultationDrug UtilizationPharyngitisAnti-Bacterial AgentsPractice Patterns, Physicians'Drug PrescriptionsPatient Education as TopicRespiratory Tract Infections

• Readiness of General Hospitals That Participate in Pediatric Quality Improvement Initiatives.
  Hospital pediatrics 2025 Vaughan J, Edwards Y, Rodean J, McCulloch C, Gonzales R, Kaiser SV
• Accuracy of Patient-Collected Vital Signs.
  Telemedicine journal and e-health : the official journal of the American Telemedicine Association 2024 Metlay JP, Gonzales R, Judson TJ, Chang Y, Margolin J, Oza S, Parry BA, Tagerman MD, Hayden E
• Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness-implementation, cluster-randomized trial.
  Journal of hospital medicine 2024 Edwards Y, Yang N, Auerbach AD, Gonzales R, McCulloch CE, Howell EE, Goldstein J, Thompson S, Kaiser SV
• eConsultation for Deprescribing Among Older Adults: Clinician Perspectives on Implementation Barriers and Facilitators.
  Journal of general internal medicine 2024 Growdon ME, Hunt LJ, Miller MJ, Halim M, Karliner LS, Gonzales R, Sudore RL, Steinman MA, Harrison KL
• Establishment of an artificial urine model in vitro and rat or pig model in vivo to evaluate urinary crystal adherence.
  Scientific reports 2024 Hayashi K, Shigemura K, Tanimoto H, Kumagai K, Gonzales RR, Yang YM, Maeda K, Matsuyama H, Fujisawa M

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• Engaging GME Learners in Health System-Aligned Improvement Work in the Clinical Learning Environment.
  American journal of medical quality : the official journal of the American College of Medical Quality 2023 Rosenbluth G, Choi LW, Boscardin CK, Gonzales R, Green A, Hernandez A, Vidyarthi AR, Julian KA, Baron RB
• Barriers and Facilitators of High-Efficiency Clinical Pathway Implementation in Community Hospitals.
  Hospital pediatrics 2023 Outram SM, Rooholamini SN, Desai M, Edwards Y, Ja C, Morton K, Vaughan JH, Shaw JS, Gonzales R, Kaiser SV
• Association of protective behaviors with SARS-CoV-2 infection: results from a longitudinal cohort study of adults in the San Francisco Bay Area.
  Annals of epidemiology 2023 Judson TJ, Zhang S, Lindan CP, Boothroyd D, Grumbach K, Bollyky JB, Sample HA, Huang B, Desai M, Gonzales R, Maldonado Y, Rutherford G, TrackCOVID Consortium
• Utilization patterns and efficiency gains from use of a fully EHR-integrated COVID-19 self-triage and self-scheduling tool: a retrospective analysis.
  Journal of the American Medical Informatics Association : JAMIA 2022 Judson TJ, Pierce L, Tutman A, Mourad M, Neinstein AB, Shuler G, Gonzales R, Odisho AY
• Patient Experience and Feedback After Using an Electronic Health Record-Integrated COVID-19 Symptom Checker: Survey Study.
  JMIR human factors 2022 Liu AW, Odisho AY, Brown Iii W, Gonzales R, Neinstein AB, Judson TJ
• Training the next generation of learning health system scientists.
  Learning health systems 2022 Lozano PM, Lane-Fall M, Franklin PD, Rothman RL, Gonzales R, Ong MK, Gould MK, Beebe TJ, Roumie CL, Guise JM, Enders FT, Forrest CB, Mendonca EA, Starrels JL, Sarkar U, Savitz LA, Moon J, Linzer M, …
• Secondary Cases of Delta Variant Coronavirus Disease 2019 Among Vaccinated Healthcare Workers With Breakthrough Infections is Rare.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2022 Waldman SE, Buehring T, Escobar DJ, Gohil SK, Gonzales R, Huang SS, Olenslager K, Prabaker KK, Sandoval T, Yim J, Yokoe DS, Cohen SH
• Design of a population-based longitudinal cohort study of SARS-CoV-2 incidence and prevalence among adults in the San Francisco Bay Area.
  Annals of epidemiology 2021 Lindan CP, Desai M, Boothroyd D, Judson T, Bollyky J, Sample H, Weng Y, Cheng Y, Dahlen A, Hedlin H, Grumbach K, Henne J, Garcia S, Gonzales R, Craik CS, Rutherford G, Maldonado Y
• CLER Pursuing Excellence: Faculty Development Innovations in Quality, Safety, Equity, and Value.
  Journal of graduate medical education 2021 Choi LW, Moriates C, Payne AS, Varaklis K, Gonzales R, Baron RB
• Outcomes Following Implementation of a Hospital-Wide, Multicomponent Delirium Care Pathway.
  Journal of hospital medicine 2021 LaHue SC, Maselli J, Rogers S, Casatta J, Chao J, Croci R, Gonzales R, Holt B, Josephson SA, Lama S, Lau C, McCulloch C, Newman JC, Terrelonge M, Yeager J, Douglas VC
• Recommendations for strengthening the role of embedded researchers to accelerate implementation in health systems: Findings from a state-of-the-art (SOTA) conference workgroup.
  Healthcare (Amsterdam, Netherlands) 2021 Damschroder LJ, Knighton AJ, Griese E, Greene SM, Lozano P, Kilbourne AM, Buist DSM, Crotty K, Elwy AR, Fleisher LA, Gonzales R, Huebschmann AG, Limper HM, Ramalingam NS, Wilemon K, Ho PM, Helfrichfcr…
• A Comparison of Patient-Reported Outcomes Related to Telephone Follow-Up Visits and Conventional Office Visits in Medical Specialty Practices.
  Telemedicine journal and e-health : the official journal of the American Telemedicine Association 2020 Peng T, Gleason N, Gonzales R
• Association Between Physician Industry Payments and Cost of Anterior Cervical Discectomy and Fusion in Medicare Beneficiaries.
  World neurosurgery 2020 Liu C, Ahmed K, Chen CL, Dudley RA, Gonzales R, Orrico K, Yerneni K, Stienen MN, Veeravagu A, Desai A, Park J, Ratliff JK, Zygourakis CC
• Implementation of a digital chatbot to screen health system employees during the COVID-19 pandemic.
  Journal of the American Medical Informatics Association : JAMIA 2020 Judson TJ, Odisho AY, Young JJ, Bigazzi O, Steuer D, Gonzales R, Neinstein AB
• Patient Portal Reminders-Easy but Ineffective.
  JAMA internal medicine 2020 Judson T, Gonzales R
• Randomized Controlled Trials of Electronic Health Record Interventions: Design, Conduct, and Reporting Considerations.
  Annals of internal medicine 2020 Pletcher MJ, Flaherman V, Najafi N, Patel S, Rushakoff RJ, Hoffman A, Robinson A, Cucina RJ, McCulloch CE, Gonzales R, Auerbach A
• Rapid design and implementation of an integrated patient self-triage and self-scheduling tool for COVID-19.
  Journal of the American Medical Informatics Association : JAMIA 2020 Judson TJ, Odisho AY, Neinstein AB, Chao J, Williams A, Miller C, Moriarty T, Gleason N, Intinarelli G, Gonzales R
• A Safe Transitions Pathway for post-craniotomy neurological surgery patients: high-value care that bypasses the intensive care unit.
  Journal of neurosurgery 2020 Young JS, Chan AK, Viner JA, Sankaran S, Chan AY, Imershein S, Meary-Miller A, Theodosopoulos PV, Jacques L, Aghi MK, Chang EF, Hervey-Jumper SL, Ward T, Gibson L, Ward MM, Sanftner P, Wong S, Amara D…
• The University of California San Francisco (UCSF) Training Program in Implementation Science: Program Experiences and Outcomes.
  Frontiers in public health 2020 Shete PB, Gonzales R, Ackerman S, Cattamanchi A, Handley MA
• A step towards equitable clinical trial recruitment: a protocol for the development and preliminary testing of an online prostate cancer health information and clinical trial matching tool.
  Pilot and feasibility studies 2019 Borno HT, Bakke BM, Kaplan C, Hebig-Prophet A, Chao J, Kim YJ, Yeager J, Cinar P, Small E, Boscardin C, Gonzales R
• Healthcare Provider Perceptions of Cardiopulmonary Resuscitation Quality During Simulation Training.
  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies 2019 Troy L, Knight L, Olson M, Chen M, Gonzales R, Berg M, Su F, Revive Initiative at Stanford Children’s Health
• Operating Room Codes Redefined: A Highly Reliable Model Integrating the Core Hospital Code Team.
  Pediatric quality & safety 2019 Caruso TJ, Rama A, Knight LJ, Gonzales R, Munshey F, Darling C, Chen M, Sharek PJ
• Development and Validation of an Electronic Health Record-Based Machine Learning Model to Estimate Delirium Risk in Newly Hospitalized Patients Without Known Cognitive Impairment.
  JAMA network open 2018 Wong A, Young AT, Liang AS, Gonzales R, Douglas VC, Hadley D
• Analysis of National Rates, Cost, and Sources of Cost Variation in Adult Spinal Deformity.
  Neurosurgery 2018 Zygourakis CC, Liu CY, Keefe M, Moriates C, Ratliff J, Dudley RA, Gonzales R, Mummaneni PV, Ames CP
• Analysis of Cost Variation in Craniotomy for Tumor Using 2 National Databases.
  Neurosurgery 2017 Zygourakis CC, Liu CY, Yoon S, Moriates C, Boscardin C, Dudley RA, Lawton MT, Theodosopoulos P, Berger MS, Gonzales R
• Appropriate Reconciliation of Cardiovascular Medications After Elective Surgery and Postdischarge Acute Hospital and Ambulatory Visits.
  Journal of hospital medicine 2017 Lee JS, Gonzales R, Vittinghoff E, Corbett KK, Fleischmann KE, Sehgal N, Auerbach AD
• Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.
  Journal of hospital medicine 2017 Gonzales R, Moriates C, Lau C, Valencia V, Imershein S, Rajkomar A, Prasad P, Boscardin C, Grady D, Johnston S
• Geographic and Hospital Variation in Cost of Lumbar Laminectomy and Lumbar Fusion for Degenerative Conditions.
  Neurosurgery 2017 Zygourakis CC, Liu CY, Wakam G, Moriates C, Boscardin C, Ames CP, Mummaneni PV, Ratliff J, Dudley RA, Gonzales R
• Relationship Between a Sepsis Intervention Bundle and In-Hospital Mortality Among Hospitalized Patients: A Retrospective Analysis of Real-World Data.
  Anesthesia and analgesia 2017 Prasad PA, Shea ER, Shiboski S, Sullivan MC, Gonzales R, Shimabukuro D
• Trends in Utilization and Cost of Cervical Spine Surgery Using the National Inpatient Sample Database, 2001 to 2013.
  Spine 2017 Liu CY, Zygourakis CC, Yoon S, Kliot T, Moriates C, Ratliff J, Dudley RA, Gonzales R, Mummaneni PV, Ames CP
• Communicating Context in Quality Improvement Reports.
  JAMA internal medicine 2017 Gonzales R, Boscardin C, Auerbach A
• Association Between Surgeon Scorecard Use and Operating Room Costs.
  JAMA surgery 2017 Zygourakis CC, Valencia V, Moriates C, Boscardin CK, Catschegn S, Rajkomar A, Bozic KJ, Soo Hoo K, Goldberg AN, Pitts L, Lawton MT, Dudley RA, Gonzales R
• The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data.
  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 2016 Minnaard MC, de Groot JAH, Hopstaken RM, Schierenberg A, de Wit NJ, Reitsma JB, Broekhuizen BDL, van Vugt SF, Neven AK, Graffelman AW, Melbye H, Rainer TH, Steurer J, Holm A, Gonzales R, Dinant GJ, …
• Predictors of Variation in Neurosurgical Supply Costs and Outcomes Across 4904 Surgeries at a Single Institution.
  World neurosurgery 2016 Zygourakis CC, Valencia V, Boscardin C, Nayak RU, Moriates C, Gonzales R, Theodosopoulos P, Lawton MT
• 152 A Prospective Controlled Trial of the Effect of Surgeon Cost Scorecards on Operating Room Surgical Cost Reduction.
  Neurosurgery 2016 Zygourakis CC, Valencia V, Moriates C, Boscardin C, Catschegn S, Goldberg A, Bozic K, Hoo KS, Wustrack R, Pitts LH, Dudley A, Gonzales R, Lawton MT
• 153 Significant Interhospital Variation in Cranial Surgery Costs Using the Nationwide Inpatient Sample Database.
  Neurosurgery 2016 Zygourakis CC, Liu C, Theodosopoulos PV, Lawton MT, Dudley A, Gonzales R
• Adoption and impact of an eConsult system in a fee-for-service setting.
  Healthcare (Amsterdam, Netherlands) 2016 Gleason N, Prasad PA, Ackerman S, Ho C, Monacelli J, Wang M, Collado D, Gonzales R
• Analysis of an electronic consultation program at an academic medical centre: Primary care provider questions, specialist responses, and primary care provider actions.
  Journal of telemedicine and telecare 2016 Wrenn K, Catschegn S, Cruz M, Gleason N, Gonzales R
• Operating room waste: disposable supply utilization in neurosurgical procedures.
  Journal of neurosurgery 2016 Zygourakis CC, Yoon S, Valencia V, Boscardin C, Moriates C, Gonzales R, Lawton MT
• Referring wisely: orthopedic referral guidelines at an academic institution.
  The American journal of managed care 2016 Otto ME, Senter C, Gonzales R, Gleason N
• External Validation of Prediction Models for Pneumonia in Primary Care Patients with Lower Respiratory Tract Infection: An Individual Patient Data Meta-Analysis.
  PloS one 2016 Schierenberg A, Minnaard MC, Hopstaken RM, van de Pol AC, Broekhuizen BD, de Wit NJ, Reitsma JB, van Vugt SF, Graffelman AW, Melbye H, Rainer TH, Steurer J, Holm A, Gonzales R, Dinant GJ, de Groot JA,…
• The Action Research Program: Experiential Learning in Systems-Based Practice for First-Year Medical Students.
  Teaching and learning in medicine 2016 Ackerman SL, Boscardin C, Karliner L, Handley MA, Cheng S, Gaither TW, Hagey J, Hennein L, Malik F, Shaw B, Trinidad N, Zahner G, Gonzales R
• Variation in Follow-Up Visit Practices Across Clinicians and Conditions: Findings From a University Cardiology Practice.
  Health services research and managerial epidemiology 2015 Liu CY, Gonzales R
• Changing Clinician Behavior When Less Is More.
  JAMA internal medicine 2015 Gonzales R, Cattamanchi A
• Predicting cost of care using self-reported health status data.
  BMC health services research 2015 Boscardin CK, Gonzales R, Bradley KL, Raven MC
• Optimizing the pre-referral workup for gastroenterology and hepatology specialty care: consensus using the Delphi method.
  Journal of evaluation in clinical practice 2015 Ho CK, Boscardin CK, Gleason N, Collado D, Terdiman J, Terrault NA, Gonzales R
• High Rate of Hospital Admissions Among Patients with Cirrhosis Seeking Care in US Emergency Departments.
  Digestive diseases and sciences 2015 Ho CK, Maselli JH, Terrault NA, Gonzales R
• Transforming the endocrine consult: asynchronous provider consultations.
  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2015 Cruz ML, Gleason N, Wang M, Wrenn K, Gonzales R
• Using Rapid Ethnography to Support the Design and Implementation of Health Information Technologies.
  Studies in health technology and informatics 2015 Ackerman S, Gleason N, Gonzales R
• An automated telephone nutrition support system for Spanish-speaking patients with diabetes.
  Journal of diabetes science and technology 2014 Khanna R, Stoddard PJ, Gonzales EN, Villagran-Flores M, Thomson J, Bayard P, Palos Lucio AG, Schillinger D, Bertozzi S, Gonzales R
• Variations in 30-day hospital readmission rates across primary care clinics within a tertiary referral center.
  Journal of hospital medicine 2014 Tang N, Maselli JH, Gonzales R
• When to repatriate? Clinicians' perspectives on the transfer of patient management from specialty to primary care.
  Journal of general internal medicine 2014 Ackerman SL, Gleason N, Monacelli J, Collado D, Wang M, Ho C, Catschegn-Pfab S, Gonzales R
• Development and sustainability of an inpatient-to-outpatient discharge handoff tool: a quality improvement project.
  Joint Commission journal on quality and patient safety 2014 Moy NY, Lee SJ, Chan T, Grovey B, Boscardin WJ, Gonzales R, Pierluissi E
• Emergency department visits in the neonatal period in the United States.
  Pediatric emergency care 2014 Lee HC, Bardach NS, Maselli JH, Gonzales R
• Patient attitudes about specialty follow-up care by telephone.
  The American journal of managed care 2014 Eng JA, Hunter CJ, Handley MA, Boscardin CK, Gonzales R, Ackerman SL
• One size does not fit all: evaluating an intervention to reduce antibiotic prescribing for acute bronchitis.
  BMC health services research 2013 Ackerman SL, Gonzales R, Stahl MS, Metlay JP
• What's cost got to do with it? Association between hospital costs and frequency of admissions among "high users" of hospital care.
  Journal of hospital medicine 2013 Nguyen OK, Tang N, Hillman JM, Gonzales R
• Shifting the paradigm for promoting appropriate antibiotic use.
  Journal of general internal medicine 2013 Gonzales R, Metlay JP
• Cultural capital: accounting for power in patient-physician interactions.
  JAMA internal medicine 2013 Ackerman S, Auer R, Gonzales R
• The impact of demographic characteristics on nonresponse in an ambulatory patient satisfaction survey.
  Joint Commission journal on quality and patient safety 2013 Boscardin CK, Gonzales R
• A cluster randomized trial of decision support strategies for reducing antibiotic use in acute bronchitis.
  JAMA internal medicine 2013 Gonzales R, Anderer T, McCulloch CE, Maselli JH, Bloom FJ, Graf TR, Stahl M, Yefko M, Molecavage J, Metlay JP
• Can implementation science help to overcome challenges in translating judicious antibiotic use into practice?
  Archives of internal medicine 2012 Gonzales R, Ackerman S, Handley M
• Computed tomography use among children presenting to emergency departments with abdominal pain.
  Pediatrics 2012 Fahimi J, Herring A, Harries A, Gonzales R, Alter H
• Benefit or burden? A sociotechnical analysis of diagnostic computer kiosks in four California hospital emergency departments.
  Social science & medicine (1982) 2012 Ackerman SL, Tebb K, Stein JC, Frazee BW, Hendey GW, Schmidt LA, Gonzales R
• Computer-assisted provision of hormonal contraception in acute care settings.
  Contraception 2012 Schwarz EB, Burch EJ, Parisi SM, Tebb KP, Grossman D, Mehrotra A, Gonzales R
• The context of antibiotic overuse.
  Annals of internal medicine 2012 Ackerman S, Gonzales R
• Unintended consequences of a quality measure for acute bronchitis.
  The American journal of managed care 2012 Roth S, Gonzales R, Harding-Anderer T, Bloom FJ, Graf T, Stahl MS, Maselli JH, Metlay JP
• Regional differences in emergency medical services use for patients with acute stroke (findings from the National Hospital Ambulatory Medical Care Survey Emergency Department Data File).
  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2012 Govindarajan P, Gonzales R, Maselli JH, Johnston SC, Fahimi J, Poisson S, Stein JC
• The use of classification and regression trees to predict the likelihood of seasonal influenza.
  Family practice 2012 Afonso AM, Ebell MH, Gonzales R, Stein J, Genton B, Senn N
• A framework for training health professionals in implementation and dissemination science.
  Academic medicine : journal of the Association of American Medical Colleges 2012 Gonzales R, Handley MA, Ackerman S, O'sullivan PS
• Antibiotic knowledge and self-care for acute respiratory tract infections in Mexico.
  Salud publica de Mexico 2012 Gonzales R, López-Caudana AE, González-Flores T, Jayanthan J, Corbett KK, Reyes-Morales H
• Development and validation of a clinical decision rule for the diagnosis of influenza.
  Journal of the American Board of Family Medicine : JABFM 2012 Ebell MH, Afonso AM, Gonzales R, Stein J, Genton B, Senn N
• Improving glycemic control when "usual" diabetes care is not enough.
  Archives of internal medicine 2011 Gonzales R, Handley MA
• A randomized trial of computer kiosk-expedited management of cystitis in the emergency department.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2011 Stein JC, Navab B, Frazee B, Tebb K, Hendey G, Maselli J, Gonzales R
• Antimicrobial resistance in uncomplicated urinary tract infections in 3 California EDs.
  The American journal of emergency medicine 2011 Moffett SE, Frazee BW, Stein JC, Navab B, Maselli J, Takhar SS, Gonzales R
• Radiological imaging of patients with suspected urinary tract stones: national trends, diagnoses, and predictors.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2011 Westphalen AC, Hsia RY, Maselli JH, Wang R, Gonzales R
• Adverse drug events in U.S. adult ambulatory medical care.
  Health services research 2011 Sarkar U, López A, Maselli JH, Gonzales R
• A computerized education module improves patient knowledge and attitudes about appropriate antibiotic use for acute respiratory tract infections.
  Patient education and counseling 2011 Price EL, Mackenzie TD, Metlay JP, Camargo CA, Gonzales R
• Differential use of diagnostic ultrasound in u.s. Emergency departments by time of day.
  The western journal of emergency medicine 2011 Stein JC, Jacoby VL, Vittinghoff E, Wang R, Kwan E, Reynolds T, McAlpine I, Gonzales R
• National trends in visit rates and antibiotic prescribing for children with acute sinusitis.
  Pediatrics 2010 Shapiro DJ, Gonzales R, Cabana MD, Hersh AL
• Does this coughing adolescent or adult patient have pertussis?
  JAMA 2010 Cornia PB, Hersh AL, Lipsky BA, Newman TB, Gonzales R
• Trends and characteristics of US emergency department visits, 1997-2007.
  JAMA 2010 Tang N, Stein J, Hsia RY, Maselli JH, Gonzales R
• Decreasing out-of-pocket costs of antibiotics: the good, the bad, and the unknown.
  Archives of internal medicine 2010 Hersh AL, Gonzales R
• Physician champions are key to improving antibiotic prescribing quality.
  Joint Commission journal on quality and patient safety 2010 Aagaard EM, Gonzales R, Camargo CA, Auten R, Levin SK, Maselli J, Metlay J
• Trends in antibiotic utilization in eight Latin American countries, 1997-2007.
  Revista panamericana de salud publica = Pan American journal of public health 2010 Wirtz VJ, Dreser A, Gonzales R
• ED antibiotic use for acute respiratory illnesses since pneumonia performance measure inception.
  The American journal of emergency medicine 2010 Fee C, Metlay JP, Camargo CA, Maselli JH, Gonzales R
• Sociodemographic trends in national ambulatory care visits for hepatitis C virus infection.
  Digestive diseases and sciences 2009 Tsui JI, Maselli J, Gonzales R
• Variation in outpatient antibiotic prescribing in the United States.
  The American journal of managed care 2009 Steinman MA, Yang KY, Byron SC, Maselli JH, Gonzales R
• Antibiotic prescriptions are associated with increased patient satisfaction with emergency department visits for acute respiratory tract infections.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2009 Stearns CR, Gonzales R, Camargo CA, Maselli J, Metlay JP
• Perceived social support among adults seeking care for acute respiratory tract infections in US EDs.
  The American journal of emergency medicine 2009 Levin SK, Metlay JP, Maselli JH, Kersey AS, Camargo CA, Gonzales R, IMPAACT Project Investigators
• Pediatricians' perspectives on the impact of MRSA in primary care: a qualitative study.
  BMC pediatrics 2009 Hersh AL, Cabana MD, Gonzales R, Shenkin BN, Cho CS
• C-reactive protein testing does not decrease antibiotic use for acute cough illness when compared to a clinical algorithm.
  The Journal of emergency medicine 2008 Gonzales R, Aagaard EM, Camargo CA, Ma OJ, Plautz M, Maselli JH, McCulloch CE, Levin SK, Metlay JP
• Computerized counseling for folate knowledge and use: a randomized controlled trial.
  American journal of preventive medicine 2008 Schwarz EB, Sobota M, Gonzales R, Gerbert B
• Interventions to reduce unnecessary antibiotic prescribing: a systematic review and quantitative analysis.
  Medical care 2008 Ranji SR, Steinman MA, Shojania KG, Gonzales R
• National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections.
  Archives of internal medicine 2008 Hersh AL, Chambers HF, Maselli JH, Gonzales R
• How do community practitioners decide whether to prescribe antibiotics for acute respiratory tract infections?
  Journal of general internal medicine 2008 Wigton RS, Darr CA, Corbett KK, Nickol DR, Gonzales R
• "Get smart Colorado": impact of a mass media campaign to improve community antibiotic use.
  Medical care 2008 Gonzales R, Corbett KK, Wong S, Glazner JE, Deas A, Leeman-Castillo B, Maselli JH, Sebert-Kuhlmann A, Wigton RS, Flores E, Kafadar K
• Computer-assisted provision of emergency contraception a randomized controlled trial.
  Journal of general internal medicine 2008 Schwarz EB, Gerbert B, Gonzales R
• Drug Resistant Infections in Poor Countries: A shrinking window of opportunity.
  BMJ (Clinical research ed.) 2008 Gonzales R, Corbett KK, Wirtz V, Dreser A
• Nothing to cough at.
  The New England journal of medicine 2008 Lurie P, Cornia PB, Lipsky BA, Gonzales R
• Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments.
  JAMA 2008 Pletcher MJ, Kertesz SG, Kohn MA, Gonzales R
• Public beliefs on antibiotics and respiratory tract infections: an internet-based questionnaire study.
  The British journal of general practice : the journal of the Royal College of General Practitioners 2007 Cals JW, Boumans D, Lardinois RJ, Gonzales R, Hopstaken RM, Butler CC, Dinant GJ
• Preferences for self-management support: findings from a survey of diabetes patients in safety-net health systems.
  Patient education and counseling 2007 Sarkar U, Piette JD, Gonzales R, Lessler D, Chew LD, Reilly B, Johnson J, Brunt M, Huang J, Regenstein M, Schillinger D
• Clinical problem-solving. Nothing to cough at--a 73-year-old man presented to the emergency department with a 4-day history of nonproductive cough that worsened at night.
  The New England journal of medicine 2007 Cornia PB, Lipsky BA, Saint S, Gonzales R
• Trainees, teams, and timely performance feedback.
  Journal of general internal medicine 2007 Gonzales R, Auerbach A
• Factors associated with longer ED lengths of stay.
  The American journal of emergency medicine 2007 Gardner RL, Sarkar U, Maselli JH, Gonzales R
• Vital-sign abnormalities as predictors of pneumonia in adults with acute cough illness.
  The American journal of emergency medicine 2007 Nolt BR, Gonzales R, Maselli J, Aagaard E, Camargo CA, Metlay JP
• Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments.
  Annals of emergency medicine 2007 Metlay JP, Camargo CA, MacKenzie T, McCulloch C, Maselli J, Levin SK, Kersey A, Gonzales R, IMPAACT Investigators
• Impact of hospital formularies on fluoroquinolone prescribing in emergency departments.
  The American journal of managed care 2007 Aspinall SL, Metlay JP, Maselli JH, Gonzales R
• Declining antibiotic prescriptions for upper respiratory infections, 1993-2004.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2007 Vanderweil SG, Pelletier AJ, Hamedani AG, Gonzales R, Metlay JP, Camargo CA
• Knowledge of and perceived access to emergency contraception at two urgent care clinics in California.
  Contraception 2007 Schwarz EB, Reeves MF, Gerbert B, Gonzales R
• Need for emergency contraception in urgent care settings.
  Contraception 2007 Schwarz EB, Gerbert B, Gonzales R
• Acceptability of a bilingual interactive computerized educational module in a poor, medically underserved patient population.
  Journal of health communication 2007 Leeman-Castillo BA, Corbett KK, Aagaard EM, Maselli JH, Gonzales R, Mackenzie TD
• Physician practice patterns: chest x-ray ordering for the evaluation of acute cough illness in adults.
  Medical decision making : an international journal of the Society for Medical Decision Making 2006 Aagaard E, Maselli J, Gonzales R
• An interactive computer kiosk module for the treatment of recurrent uncomplicated cystitis in women.
  Journal of general internal medicine 2006 Aagaard EM, Nadler P, Adler J, Maselli J, Gonzales R
• Improving antibiotic selection: a systematic review and quantitative analysis of quality improvement strategies.
  Medical care 2006 Steinman MA, Ranji SR, Shojania KG, Gonzales R
• Contraceptive counseling of diabetic women of reproductive age.
  Obstetrics and gynecology 2006 Schwarz EB, Maselli J, Gonzales R
• Balancing acts: deciding for or against antibiotics in acute respiratory infections.
  The Journal of family practice 2006 Hart AM, Pepper GA, Gonzales R
• Antibiotic treatment of acute respiratory infections in acute care settings.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2006 Gonzales R, Camargo CA, MacKenzie T, Kersey AS, Maselli J, Levin SK, McCulloch CE, Metlay JP, IMPAACT Trial Investigators
• Effectiveness of ceftriaxone plus doxycycline in the treatment of patients hospitalized with community-acquired pneumonia.
  Journal of hospital medicine 2006 Flanders SA, Dudas V, Kerr K, McCulloch CE, Gonzales R
• Prescription of teratogenic medications in United States ambulatory practices.
  The American journal of medicine 2005 Schwarz EB, Maselli J, Norton M, Gonzales R
• Hepatitis C and hospital outcomes in patients admitted with alcohol-related problems.
  Journal of hepatology 2005 Tsui JI, Pletcher MJ, Vittinghoff E, Seal K, Gonzales R
• Performance characteristics of clinical diagnosis, a clinical decision rule, and a rapid influenza test in the detection of influenza infection in a community sample of adults.
  Annals of emergency medicine 2005 Stein J, Louie J, Flanders S, Maselli J, Hacker JK, Drew WL, Gonzales R
• Characterization of viral agents causing acute respiratory infection in a San Francisco University Medical Center Clinic during the influenza season.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2005 Louie JK, Hacker JK, Gonzales R, Mark J, Maselli JH, Yagi S, Drew WL
• Assessing the suitability of intervention sites for quality improvement studies in emergency departments.
  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2005 Metlay JP, Camargo CA, Bos K, Gonzales R
• Antimicrobial drug prescribing for pneumonia in ambulatory care.
  Emerging infectious diseases 2005 MacDougall C, Guglielmo BJ, Maselli J, Gonzales R
• Fluoroquinolone prescribing in the United States: 1995 to 2002.
  The American journal of medicine 2005 Linder JA, Huang ES, Steinman MA, Gonzales R, Stafford RS
• Unintended consequences of a quality improvement program designed to improve treatment of alcohol withdrawal in hospitalized patients.
  Joint Commission journal on quality and patient safety 2005 Pletcher MJ, Fernandez A, May TA, Westphal JR, Gamez CA, Hersh DF, Gonzales R
• Appropriate antibiotic use: variation in knowledge and awareness by Hispanic ethnicity and language.
  Preventive medicine 2005 Corbett KK, Gonzales R, Leeman-Castillo BA, Flores E, Maselli J, Kafadar K
• The "minimizing antibiotic resistance in Colorado" project: impact of patient education in improving antibiotic use in private office practices.
  Health services research 2005 Gonzales R, Corbett KK, Leeman-Castillo BA, Glazner J, Erbacher K, Darr CA, Wong S, Maselli JH, Sauaia A, Kafadar K
• Management of acute bronchitis in healthy adults.
  Infectious disease clinics of North America 2004 Aagaard E, Gonzales R
• Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey.
  The American journal of medicine 2004 Pletcher MJ, Maselli J, Gonzales R
• Strategies to diagnose and treat group A streptococcal pharyngitis.
  JAMA 2004 Gonzales R, Cooper RJ, Hoffman JR
• Spectrum bias of a rapid antigen detection test for group A beta-hemolytic streptococcal pharyngitis in a pediatric population.
  Pediatrics 2004 Hall MC, Kieke B, Gonzales R, Belongia EA
• Office evaluation and treatment of elderly patients with acute bronchitis.
  Journal of the American Geriatrics Society 2004 Steinman MA, Sauaia A, Maselli JH, Houck PM, Gonzales R
• Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough.
  The American journal of medicine 2004 Flanders SA, Stein J, Shochat G, Sellers K, Holland M, Maselli J, Drew WL, Reingold AL, Gonzales R
• Antibiotic treatment of acute respiratory tract infections in the elderly: effect of a multidimensional educational intervention.
  Journal of the American Geriatrics Society 2004 Gonzales R, Sauaia A, Corbett KK, Maselli JH, Erbacher K, Leeman-Castillo BA, Darr CA, Houck PM
• Obesity-associated hypoventilation in hospitalized patients: prevalence, effects, and outcome.
  The American journal of medicine 2004 Nowbar S, Burkart KM, Gonzales R, Fedorowicz A, Gozansky WS, Gaudio JC, Taylor MR, Zwillich CW
• A 65-year-old woman with acute cough illness and an important engagement.
  JAMA 2003 Gonzales R
• Optimizing antibiotic prescribing for acute respiratory tract infections in an urban urgent care clinic.
  Journal of general internal medicine 2003 Harris RH, MacKenzie TD, Leeman-Castillo B, Corbett KK, Batal HA, Maselli JH, Gonzales R
• Changing use of antibiotics in community-based outpatient practice, 1991-1999.
  Annals of internal medicine 2003 Steinman MA, Gonzales R, Linder JA, Landefeld CS
• Predictors of broad-spectrum antibiotic prescribing for acute respiratory tract infections in adult primary care.
  JAMA 2003 Steinman MA, Landefeld CS, Gonzales R
• Choosing an optimal strategy to assess and treat adults with pharyngitis.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2003 Hoffman JR, Cooper RJ, Gonzales R
• Modest serum creatinine elevation affects adverse outcome after general surgery.
  Kidney international 2002 O'Brien MM, Gonzales R, Shroyer AL, Grunwald GK, Daley J, Henderson WG, Khuri SF, Anderson RJ
• Public expectations and attitudes for annual physical examinations and testing.
  Annals of internal medicine 2002 Oboler SK, Prochazka AV, Gonzales R, Xu S, Anderson RJ
• Epidemiology of pediatric injury-related primary care office visits in the United States.
  Pediatrics 2002 Hambidge SJ, Davidson AJ, Gonzales R, Steiner JF
• Antibiotic prescribing: can we make it easier?
  Journal of general internal medicine 2002 Flanders S, Gonzales R
• Excessive antibiotic use for acute respiratory infections in the United States.
  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2001 Gonzales R, Malone DC, Maselli JH, Sande MA
• Principles of appropriate antibiotic use for acute pharyngitis in adults: background.
  Annals of emergency medicine 2001 Cooper RJ, Hoffman JR, Bartlett JG, Besser RE, Gonzales R, Hickner JM, Sande MA, Centers for Disease Control and Prevention
• Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background.
  Annals of emergency medicine 2001 Hickner JM, Bartlett JG, Besser RE, Gonzales R, Hoffman JR, Sande MA, Centers for Disease Control and Prevention
• Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods.
  Annals of emergency medicine 2001 Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA
• Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults: background.
  Annals of emergency medicine 2001 Gonzales R, Bartlett JG, Besser RE, Hickner JM, Hoffman JR, Sande MA, Centers for Disease Control and Prevention
• Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background.
  Annals of emergency medicine 2001 Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA, Centers for Disease Control and Prevention
• Impact of reducing antibiotic prescribing for acute bronchitis on patient satisfaction.
  Effective clinical practice : ECP 2001 Gonzales R, Steiner JF, Maselli J, Lum A, Barrett PH
• Principles of appropriate antibiotic use for acute pharyngitis in adults: background.
  Annals of internal medicine 2001 Cooper RJ, Hoffman JR, Bartlett JG, Besser RE, Gonzales R, Hickner JM, Sande MA, American Academy of Family Physicians, American College of Physicians-American Society of Internal Medicine, Centers …
• Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background.
  Annals of internal medicine 2001 Hickner JM, Bartlett JG, Besser RE, Gonzales R, Hoffman JR, Sande MA, American Academy of Family Physicians, American College of Physicians-American Society of Internal Mediciine, Centers for Disease …
• Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods.
  Annals of internal medicine 2001 Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA
• Principles of appropriate antibiotic use for treatment of nonspecific upper respiratory tract infections in adults: background.
  Annals of internal medicine 2001 Gonzales R, Bartlett JG, Besser RE, Hickner JM, Hoffman JR, Sande MA, American Academy of Family Physicians, Infectious Diseases Society of America, Centers for Disease Control, American College of …
• Principles of appropriate antibiotic use for treatment of uncomplicated acute bronchitis: background.
  Annals of internal medicine 2001 Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA, American Academy of Family Physicians, American College of Physicians-American Society of Internal Medicine, Centers …
• Uncomplicated acute bronchitis.
  Annals of internal medicine 2000 Gonzales R, Sande MA
• Acute bronchitis in the healthy adult.
  Current clinical topics in infectious diseases 2000 Gonzales R, Sande MA
• Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis.
  JAMA 1998 Nyquist AC, Gonzales R, Steiner JF, Sande MA
• Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians.
  JAMA 1997 Gonzales R, Steiner JF, Sande MA
• What will it take to stop physicians from prescribing antibiotics in acute bronchitis?
  Lancet (London, England) 1995 Gonzales R, Sande M