EVCP Expresso – January 2020

Dear Colleagues,

With multiple anti-Semitic attacks in the New Jersey/New York area at the close of 2019, and the prospects of war with Iran at the start of 2020, I am reminded that we have a long way to go toward acceptance, respect, and peace. As Nelson Mandela once said, and I also believe, “No one is born hating another person because of the color of their skin or their religion or their background. People must learn to hate. And if they can learn to hate, they can be taught to love.”

I look forward to seeing UCSF into 2020. It would be pretty fair to say there’s a lot of anticipation in the air, but last year’s initiatives are on solid ground and promising ones are on the horizon. For those of you who do research, one is the potential of adding electronic lab notebooks (ELN) to our campuswide research toolbox. Diana Laird and Stephen Floor are co-leading a task force to explore ELN options, and they need your input – please complete this brief survey.

Other ideas led to this month’s stories:

We are embarking on a new decade with new realities. While the title of the following poem, by U.S. Poet Laureate Joy Harjo, may not reflect my wish for a new sense of hope and peace in the midst of what’s shaping up to be a potentially anxious year…its sentiment does.

Perhaps the World Ends Here

The world begins at a kitchen table. No matter what, we must eat to live.

The gifts of earth are brought and prepared, set on the table. So it has been since creation, and it will go on.

We chase chickens or dogs away from it. Babies teethe at the corners. They scrape their knees under it.

It is here that children are given instructions on what it means to be human. We make men at it, we make women.

At this table we gossip, recall enemies and the ghosts of lovers.

Our dreams drink coffee with us as they put their arms around our children. They laugh with us at our poor falling-down selves and as we put ourselves back together once again at the table.

This table has been a house in the rain, an umbrella in the sun.

Wars have begun and ended at this table. It is a place to hide in the shadow of terror. A place to celebrate the terrible victory.

We have given birth on this table, and have prepared our parents for burial here.

At this table we sing with joy, with sorrow. We pray of suffering and remorse. We give thanks.

Perhaps the world will end at the kitchen table, while we are laughing and crying, eating of the last sweet bite.

With my wishes for you and yours to enjoy health and happiness in the new year,


UCSF Fitness & Recreation: Belonging since 1958

One of the many things I love about my office here at Parnassus Heights is the proximity to the gym. I have to admit that I don’t find working out to be an overwhelmingly rapturous experience, but I definitely value the benefit of regular exercise to good health. Thankfully, Millberry Fitness & Recreation Center at Parnassus and the Bakar Fitness & Recreation Center at Mission Bay make it easy to get my sweat on…and maybe even do my PT exercises.

Even better, the gym is a great equalizer – our appointed mantles are left in the locker room. That’s the beauty of it. There are no titles. All everyone wants to do is leave feeling better, motivated, and healthy, with a clear head. UCSF has offered membership at Parnassus since 1958, when the Millberry Union opened, and it’s always had a special sense of community – one in which faculty, students, and staff play basketball or trade weightlifting techniques. Some of us who have been here a certain number of years will recall stories of Dentistry faculty member Sol Silverman’s affinity for afternoon pick-up games at the MU basketball court.

Of course, here it is 2020, and I know everyone has heard of both centers. What you might not know is the thought process behind the great facilities and programs available. Bottom line, the UCSF ethos drives the quality that members can expect: convenience, cleanliness (this is huge), respect for your time via class reservations system, quality (all instructors and trainers are certified professionals), boutique culture and pockets of community within the “big box” gym, i.e., F45, Zumba, Senior Weight Training (amazingly popular), Masters/Pre-Masters/adult private swim programs and lessons, and the UC WorkStrong Program – a UC occupational health program that provides 12 free one-on-one personal training/Pilates/nutritional sessions to promote recovery and prevent future workplace injury.

But it’s a “heavy lift” (pun intended). Gail Mametsuka, director of fitness and recreation, explains the challenges that are largely due to increasing operational costs: maintaining affordability for UCSF employees (currently, membership fees for the general public offset employee and student fees), balancing wages with the cost of Bay Area living for limited staff (especially lifeguards and Group X instructors), and avoiding increases to membership dues.

Given these significant considerations, what’s in the future for our fitness and recreation centers? Some options on the table are: expanding the boutique experience, making more space for functional training, providing more targeted opportunities for friendships to develop among members with similar interests, and capitalizing on and promoting the power of the UCSF Fitness & Recreation Center brand through partnerships with local retailers (Timbuk2, Sports Basement) and sports teams (Giants, Warriors).

I see the Fitness & Recreation Centers as a snapshot of what it means to be a member of the larger UCSF community and how to engage with faculty, staff, and learners as well as neighbors. A hub of activity, they can be an oasis in the journey toward advancing your health or simply an afternoon respite from a hectic work day. Gail sees it this way: “Advancing health worldwide starts with our own faculty, staff, trainees, and students.”

I get it. It’s a commitment (mentally and financially), but it works for me and for many on team EVCP. To quote a phrase I’ve heard somewhere before? Just do it.

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Human-Centered Design: Considering a new way of thinking

We are always looking for ways to improve. On the clinical side of the house, improving life for our patients is an eternal effort. How can we truly advance health worldwide? New ideas can come from so many places. We just need to be open to them.

You’re familiar with the idea of design, which to me has generally meant making something beautiful as well as functional. I think most notably of how Steve Jobs brought the principles of design to the world of tech. The iPhone isn’t just a utilitarian piece of equipment dreamed up by engineers, but a sleek and gorgeous artifact of craftsmanship that people love to use. Technology, in addition to transforming our lives, has brought a different approach to innovation: design thinking.

According to consulting firm IDEO, often credited with inventing the term “design thinking,” “thinking like a designer can transform the way organizations develop products, services, processes, and strategy. This approach… brings together what is desirable from a human point of view with what is technologically feasible and economically viable. It also allows people who aren’t trained as designers to use creative tools to address a vast range of challenges.” We’re lucky (and smart) to have people with design backgrounds working here at UCSF, and they are using what they call “human-centered design” to see if we can advance our approach to various problems in health.

Ralph Gonzales, the chief innovation officer for UCSF Health and the associate dean for Clinical Innovation in the School of Medicine, gives a good example: the Delirium Reduction Campaign, led by geriatrician Stephanie Rogers. You may know the problem: people, especially the elderly, can be vulnerable to experiencing delirium when they’re hospitalized, particularly for a lengthy stay. This delirium has major consequences, including added risk of falls, extending the stay (which is uncomfortable and expensive), the need for restraints, and sometimes a shorter life span. Yet it is often preventable and treatable.

As part of a comprehensive delirium care program at UCSF Health, neurologist Vanja Douglas developed a simple four-question screening tool that would generate a score identifying patients at high risk for developing delirium during their hospital stay. But how can we get nurses and doctors to implement the tool and subsequent actions, particularly without feeling like we’re piling on one more chore on an already-overloaded workforce?

That’s where design comes in. In 2016, Ralph’s team had hired Jan Yeager, a designer with a background in consumer products and service design (she has a master’s in human-centered design), to bring a sophisticated and elegant approach to the complex world of an urban hospital. The delirium project was a perfect fit.

Recognizing that people get information in a variety of ways, Jan and team applied a human-centered approach and rapid prototyping methodology to the communications around the rollout of the screening tool. They listened to people as to what was best for each stakeholder group and looked for opportunities to more seamlessly incorporate the screening tool into workflows. For example, they added four items to the workload only after they found four other less essential tasks they could take off the nurses’ plates.

And the project got results: within a year and a half, more than 90 percent of nurses across all UCSF Health inpatient units were running the screening, and hospital stays for delirium were down 10 percent. And today, that number continues to fall.

That’s just one example of how the team at the Clinical Innovation Center can help bring about change. If you have an idea for improving health care delivery – especially one that might benefit from some outside-the-box thinking – consider giving them a call.

I am very jazzed by the innovation taking place at UCSF on many levels due to design thinking – next month, you’ll learn about how some creative professionals at Zuckerberg San Francisco General Hospital and Trauma Center are using human-centered design principles to improve care for some of the most underserved people in our community. Watch this space!

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A New Normal: Preparing for wildfire smoke events

Our hearts go out to the citizens of Australia, where reports are that wildfires have now burned nearly six times more acres than the 2018 California wildfires. Here at home, we can be grateful that the worst predictions for this year’s Kincade Fire and PG&E power outages did not come to fruition. Experts are telling us the sobering news that, with our changing climate, these wildfire events are the “new normal.”

After the horrific Camp Fire that wiped out the town of Paradise in 2018, Chancellor Sam Hawgood convened a Wildfire Response Task Force so that UCSF could proactively look at all the issues that face an institution like ours in these situations, as well as develop an emergency management protocol for responding to wildfires and associated smoke.

The work of the task force is complete, thanks to the leadership of its co-chairs: Associate Chancellor Theresa O’Brien, Environmental Health and Safety Executive Director Mark Freiberg, and Senior Associate Chancellor – Campus Life Services Clare Shinnerl. A dozen UCSF faculty and staff filled out the group, bringing their expertise and insight regarding the health effects of wildfire smoke to establish the most effective operational and communications strategies. The task force also sought input from a broad array of stakeholders, including UCSF Health, Academic Senate, and Staff Assembly, as well as learners, lab managers, and key constituents from UCSF’s many campus locations – it was an intensely inclusive outreach effort.

We now have a comprehensive website devoted to wildfire impacts that includes resources and University guidance regarding air quality, power shutoffs, whether you’ll need to report to work under certain conditions, and how to volunteer to help in a wildfire situation. There are well-organized plans in place for what to do when the fires hit next time, and new protocols in the campus emergency structure including a supply of N95 masks that can provide one mask to any interested member of the UCSF community when conditions warrant that approach. Be advised, though, that the mask is no substitute for staying indoors in a clean air environment, which nearly all UCSF buildings provide. (Learn how to wear the masks and get other safety tips.) We’ve also become very familiar with the Environmental Protection Agency’s air quality site AirNow, and UCSF now has a range of protocols for action at each level from the clean and happy green, to the cautionary orange that’s unhealthy for sensitive groups, and all the way to the hazardous purple.

UCSF worked with other UC campuses in developing these and other protocols. In many respects, we’ve taken a leadership role and are now helping other institutions establish their own plans. While it may feel surreal to consider wildfire disasters a regular occurrence, the insight gained by the task force effort will help us to fulfill our mission even during these increasingly calamitous times.

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Dan’s Tip of the Month

 I am really excited to tell you about a great music video that my friend Emy Volpe from the Research Development Office sent me last month – “Ripple” – and how it took me down the proverbial rabbit hole. In searching for who produced it, I stumbled across Playing for Change, a nonprofit connecting the globe through music, building music and art schools for kids around the world, and creating hope and inspiration for the future of our planet. They hit streets worldwide with a mobile recording studio and cameras to film musicians performing the same song, each in their own locale. I could spend all day rolling through their video catalog Songs Around the World but found the combined talent, joy, and cultural power in “Love Train” and “All Along the Watchtower” outstanding and earworm-worthy. Enjoy!

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