EVCP Expresso – April 2018

April 2, 2018

Dear Colleagues:

April 4 marks the 50th anniversary of the assassination of Dr. Martin Luther King, Jr. I’ve said it before, and I’ll say it again. While we’ve made great strides in regard to civil rights thanks to him and other heroes like Linda Brown, Cesar Chavez, and Harvey Milk, we have much, much further to go. As our state grieves the tragic death of Stephon Clark, it is imperative that we truly listen to one another and recognize that things are still very broken. At every level, we must continue to strive to improve the situation. Towards that end, I encourage you to attend the 11th Annual Chancellor’s Leadership Forum on Diversity and Inclusion on April 26. I like to remember the words of Dr. King: “There comes a time when one must take a position that is neither safe, nor politic, nor popular, but he must take it because conscience tells him it is right.”

Now, on to this month’s Expresso, I hope you read on about the new California laws related to marijuana and how they intersect with what goes on here at UCSF. The other two stories relate to the perennial topic of space. Have you seen the claymation series “Creature Comforts?” This clip is priceless.

And, to continue our food security conversation from the March Expresso, please consider volunteering at the UCSF Student Food Market. Help is requested on Thursday afternoons to assist with unloading the delivery, setting up the market, and helping students in need to fresh produce and food at no cost. It’s a wonderful opportunity to engage with our students, and the time commitment is minimal with flexible hour-long shifts. Interested? Register here or contact Alece Alderson or Barbara Smith for information.

Finally, for those of you currently involved in international research at UCSF, please share your guidance and expertise by completing a brief survey to improve risk assessment and provide appropriate resources for research abroad. And there are prizes! An iPad could be in your future!!!

Is there another topic that I should address in Expresso? Don’t be shy – please write to me at [email protected].




One Toke Over The Line: How to cope with new cannabis laws

In November 2016, many people celebrated the passage of Prop. 64, which legalized recreational marijuana in California. While much of the reaction has been fairly light-hearted, UCSF will need to deal with many serious issues related to the new law, including how it pertains to our patients, students, and employees; status as a federally funded research institution; and role in helping shape our state’s health policies.

“This new law presents opportunities and challenges in the health community,” says Dr. Catherine Lucey, executive vice dean and vice dean for education in the School of Medicine.

The first concern is for our patients. A team of UCSF doctors—emergency physicians Craig Smollin and Christopher Colwell, toxicologist Timur Durrani, and Paul Blanc, in occupational and environmental medicine—has issued an informative document detailing the health issues that have arisen in other states where marijuana was legalized. They point out that health care professionals need to be aware of how cannabis use may manifest itself clinically. For instance, cannabis now comes in many forms, including “edibles,” which can range from baked goods to candies like gummy worms.

“One of the things our colleagues in Colorado had warned us about was, when the recreational use of marijuana is legalized, and it becomes easy for people to buy edibles, many naïve users don’t know how to use these food versions,” Dr. Lucey says. “After you eat something, it may take two hours to feel the effect. A naïve user may mistake the lack of an immediate effect for no effect and take a lot more. There tend to be overdoses in those situations.”

Or they may mistakenly believe marijuana is harmless and mix it with liquor or other drugs. “It’s like any other medication, like alcohol or other substances,” she continues. “A little alcohol may be recreational, but if you drink too much, you’ll get sick.”

With marijuana, people can get dizzy, have trouble walking, and experience hallucinations or psychosis. There’s also a syndrome that has been referred to as “scromiting,” a portmanteau meaning screaming while vomiting.

Dr. Lucey adds, “Remember, they are drugs. Because they’ve been legalized, people think they are in some way safer than other drugs, but they require thoughtful use like any other medication or substance you might ingest.” She also notes that while your system flushes out alcohol within 12 hours of your last drink, cannabis can stay in your urine for three to five days, and if you’re a chronic user, it could remain for weeks.

Second, to students, trainees, and employees who now say, “This is legal, and I can ingest marijuana like I might have a drink on a Saturday night,” Dr. Lucey responds, “That’s true, with caveats.”

Those caveats are:

  • Prop. 64 does not change UC policy; marijuana remains prohibited on all university property and at all university events, except for approved academic research. As an institution that receives federal money, we have to comply with federal laws on the use of illicit substances. UCSF Police Chief Mike Denson distributed a safety bulletin, which points out that while California doesn’t consider marijuana use or possession a criminal offense, federal law still does. That means that marijuana can’t be used on campus, at campus events, or in campus housing.
  • Our health professionals have licenses that hold them to certain standards. Physicians, nurses, dentists, pharmacists, and others need to make sure they’re not impaired on the job. Also, of particular note to students and residents who may travel to other states for work or study, some programs still require drug testing before you start. Dr. Lucey cautions, “If you use marijuana in any way, shape, or form, even though it’s legal recreationally here, if you do a mandatory drug screen that turns up positive for cannabis, that could be a problem.”

And, here’s a shout out to UCSF’s Center for Tobacco Control Research & Education (CTCRE), which after years of great work on tobacco issues, is now also taking a close look at those related to cannabis – especially in regard to children. There’s the natural temptation of candy and other sweets to young children, who might eat gummies or a brownie without knowing that cannabis is an ingredient. The result? They could wind up unconscious. As with tobacco, the CTCRE team is working hard to protect children from this risk.

“You really can’t talk about tobacco policy or smoking without thinking about cannabis,” comments Daniel G. Orenstein, a postdoc at the center and co-author of a paper published earlier this year, recommending ways to apply public health best practices from tobacco control to cannabis. “We’re afraid of this becoming another tobacco industry.”

The Legislature and state agencies are in charge of regulating the new cannabis industry, which is a great opportunity. States have a chance to be proactive and apply years of knowledge gained about tobacco, alcohol, and pharmaceuticals in making rules for cannabis consumption.

One particular challenge: While tobacco has been researched scientifically, which has proven its dangers, the research on cannabis is much more limited because the federal government has restricted access to the controlled substance. The 2017 report from the National Academies summarizes current evidence on the impact on health – both positive and negative – and identifies gaps in research. “It’s getting better, but it’s still really hard to do even the bench science,” Dr. Orenstein says. “That’s really bad, from a policy perspective.”

So you can see, the passage of Prop. 64 is not without its complexities. Regardless of your leanings, please be aware of the danger posed to your patients (especially children) and you by mind-altering substances of any kind, and stay mindful of your professional responsibilities. And please look out for one another…

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Space Jam: UCSF’s ongoing effort to use space efficiently

It seems like almost everyone wants more space to do their work. In San Francisco, where supply is dwarfed by demand (I won’t go into affordability), we have more people requesting space than we have space available, despite all the development at Mission Bay in recent years.

Therefore, it’s imperative that we use our space efficiently and wisely. Yet when we assessed how well we were doing, we found that, in the case of research, 40 percent of our space appeared underutilized. That’s a real problem—we have to spend money to maintain space, but without research happening in the space, we don’t receive any indirect costs to cover the maintenance. In the meantime, it’s lying fallow while people are crammed into other spaces.

I’ve been working very closely with Paul Jenny, senior vice chancellor for Finance and Administration, and Bruce Wintroub, vice dean of the School of Medicine, on this issue for several years now; I wrote about it in December 2015, as our work got under way, and now provide you with an update. You can see more at the UCSF Space Committees and Policies web page.

In addition to underutilization, we’ve identified other problems, including an unclear space policy that is enforced inconsistently. We also don’t have sufficiently good data on how we’re using space. And a common issue is hoarding of space (a natural human inclination!)—if space becomes vacant, units virtually always hold onto it for a future potential use, rather than returning it to help someone else with an immediate need.

Last year, after talking to the deans, faculty members, and others, we decided to tackle three things first:

  • Come up with a set of objective metrics for the efficient utilization of space.
  • Update our policies to make those measures effective.
  • Adjust the governance structure to better oversee the assignment of space.

To accomplish these goals, we formed the Research and Administrative Space Policy Working Group, or RASP, with representation from each school, including both faculty and administrators, and facilitators from the UCSF Program Management Office. Intended to be temporary, RASP met eight times in the fall to address the needs of our faculty and staff, and develop a set of proposed metrics to assess the productivity of research space.

RASP sought to be as thorough as possible in its approach, leveraging external benchmarking research, evaluating policies and peer institutions (e.g., Columbia University, University of Michigan, and UCLA), and scenario testing current campus data. Given the breadth and complexity of UCSF’s research enterprise, it’s clear that one metric alone would be insufficient for evaluating space productivity. And while financial measures are important for the campus’ long-term sustainability, aspects such as overall utilization, educational outcomes, and scientific impact are also key considerations.

Without going too deep into the weeds here, I’ll note the group is looking at things like indirect cost recovery (a standard practice, albeit imperfect), expenditures per square foot, and what percentage of a department’s space is “PI pending,” or unassigned in hopes of recruiting a new scientist. (Some spaces remain “pending”—and vacant—for three or four years!) At RASP’s request, the Academic Senate Committee on Space agreed in late 2017 to investigate avenues for assessing scientific impact.

To be clear: no one is considering anything draconian. RASP is aware that metrics can only tell us so much, and that important structural differences exist like those between wet and dry labs, or between the indirect costs paid on private versus federal grants. The goal is to meet our responsibility of providing the resources needed by our faculty, which includes developing a set of objective and sufficiently nuanced tools to improve the management of our space.

RASP has continued its work into 2018, aiming to develop metrics for administrative space, as well as the necessary policy changes and governance structure. We’re also looking to other universities for best practices, while acknowledging our particular situation. As always, we are trying to maintain full transparency throughout this entire process. Please email me with your thoughts on the subject.

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Mission Possible: Fixing the floor plan at Mission Hall

On to more about space and how we sometimes learn lessons the hard way – and in a big way. That’s one view of our humbling experience at Mission Hall. The planners were very excited to complete and move people into this state-of-the-art building in September 2014. Modeled on some of the innovative workspaces in Silicon Valley, the building quickly demonstrated that many of the new features didn’t coalesce with the needs of our clinicians and researchers.

I wrote about Mission Hall nearly three years ago, and you can refer to that Expresso for some background. As I said then, we hear your complaints, and we want to make things right.

Work is under way to renovate the building. UCSF is spending $4.3 million on changes that we hope the 1,500 Mission Hall occupants will see as improvements. In part, the modifications also should help accommodate a new influx of people. Approximately 170 people from the cancer clinical program at Mount Zion will relocate there in 2019, and they’re recruiting even more.

Cristina Morrison, manager of Change Management and Facilities, and Adrian Miu, space and operations analyst, say a big change is the addition of new sound baffling in the “town centers,” or open areas, which will reduce the amount of noise that can be transmitted to other areas where people are working. This effort will soon be under way.

In addition, we’re reconfiguring some of the spaces inside Mission Hall. Currently there are focus rooms throughout the building. The original plan was that people could work in cubicles, and then use a focus room when they needed some privacy. In reality, people want offices and aren’t using the focus rooms as envisioned. So, 241 focus rooms will be converted into private, single-occupancy offices. “There’s no change in the walls,” Cristina explains. “It’s essentially a furniture solution.” Take a look at the project timeline.

The work requires that everyone in Mission Hall exercise patience (and I realize that for many people, this already has been stretched to the limit). There will be inconveniences as we go through yet another transition. I hope folks will recognize the broader context, as I mentioned in the preceding item about campus-wide space issues. In 2016, San Francisco surpassed Manhattan as the most expensive leased office space in the country, and as the cost of developing new buildings in San Francisco rises above $1,000 per square foot, efficiency is a must.

Adrian says, “The challenge lies in balancing between giving people a space that works for them, and being efficient with the space that we have. If any employee is assigned a workstation for a good portion of a week, and they’re only using it an hour a day, that’s neither efficient nor good economics.” I know that accomplishing this balance will require a culture shift. We all have to let go of traditional attitudes and old habits, in which we cling to space for as long as possible, and instead be open to recognizing space inefficiencies and releasing space to more effective and efficient use. As Cristina puts it, “We are essentially asking people to be good ‘space’ citizens.’”

To the Mission Hall occupants, thank you for your feedback, patience, and adaptability. Adrian says in the few years since the building’s September 2014 opening, “people have figured out how to make the space work a little bit better for them.” That’s the real spirit of creativity, problem-solving and cooperativity that helps define UCSF, and it is definitely helping with space plans going forward.

“The mission of the university is the same for every individual,” Cristina says. “We want to give them the space they need and empower them to succeed in the work they’re doing.”

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Dan’s Tip of the Month

bottle of Weiman cleaner and polishSpring also means cleaning – the closets, the garage, the attic, the kitchen! Do you have any stainless steel appliances? If so, and if you are also fairly compulsive like I am about keeping them looking shiny and new, then here’s an odd but helpful tip. A couple of years ago I was at Home Depot, and I picked up “Weiman Stainless Steel Cleaner & Polish.” It really works well – a great example of that rare experience of coming across something that works so much better than expected. (N.B. – I have no financial connections of any kind to Weiman Products!)

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