2014 Volume 12 - UCSF Department of Anesthesia and

Transcription

AnesthesiaNews
2014 | Vol. 12
Newsletter of the Department of Anesthesia and Perioperative Care | University of California, San Francisco
Seeking More Efficient,
More Patient-Centered
Perioperative Care
F
“
or the past few years our department has been involved in an effort to improve the
perioperative experience at UCSF,” says anesthesiologist Spencer Yost, MD, of the
UCSF Department of Anesthesia and Perioperative Care.
“The move to Mission Bay should accelerate that effort by allowing our department
to create a patient-centered surgical home that will facilitate new efficiencies, improve
care and enhance the patient experience.”
Integrated Pain Management
Due to open in 2015, the physical plant of UCSF Medical Center at Mission Bay will
provide the perfect home for these advances. At new cancer, women’s and children’s
hospitals, design features incorporate best practices from around the world for
delivering inpatient care.
“Just moving patients will be easier and faster,” says Yost. “But along with the
kinder, gentler, more human scale of the new facility, we want to make sure we have a
culture transplant that reflects and creates a more patient-centric experience.”
One element of that is a comprehensive pain service on all acute care floors that will
use a range of innovative, multi-modal approaches to pain management. In the cancer
continued on page 3
Renee Navarro on Diversity | Pathway to Scientific Independence | Change at SFGH | Clerkships
AnesthesiaNews
2014 | Vol. 12
1 Seeking More Efficient,
More Patient-Centered
Perioperative Care
2 From the Interim Chair
4 Ask the Expert:
Renee Navarro, PharmD, MD,
6 Maintaining Top Clerkship
Demands Innovation
7 Paving a Pathway to Scientific
Independence
8 Sue Carlisle Leads Physicians,
Researchers Through Tragedy,
Reform and Rebuild
10 New Faculty
12 New Residents
13 Peer Reviewed Publications
14 Active Research Grants
16 Honors, Awards & News
17 Upcoming Events
DEPARTMENT INTERIM CHAIR
EDITOR-IN-CHIEF
Michael Gropper, MD, PhD
EDITOR:
Morgen Ahearn
DESIGNER:
Laura Myers Design
PRINCIPAL WRITER:
Andrew Schwartz
PHOTOGRAPHERS:
Noah Berger, Brian Haux–SkyHawk
Photography, Christine Jegan,
Pekka Talke, Brant Ward
Anesthesia News is published by
the UCSF Department of Anesthesia
and Perioperative Care
521 Parnassus Avenue
Room C 450, Box 0648
San Francisco, CA 94143-0648
415/476-2131
http://anesthesia.ucsf.edu
Send all inquiries to
[email protected]
©2014 The Regents of the
University of California
FROM THE INTERIM CHAIR
A Time of Change
It is a time of notable
change in health care.
From remarkable
innovations in
treatment to the
Affordable Care Act,
the way we care for
our patients is undergoing momentous
change. This issue of
UCSF Anesthesia
News highlights some of the ways we are
adapting to those changes in the clinical,
research and educational settings.
On January 1, 2014, UCSF completed
its affiliation with Children’s Hospital
Oakland, at which time the name changed
to UCSF Benioff Children’s Hospitals (San
Francisco and Oakland). The combination
of the San Francisco and Oakland sites
will be among the top ten largest children’s
health care providers in the nation. On
July 1, 2014, UCSF Health was formed,
whereby UCSF became a health system,
with integration of the clinical departments
in the School of Medicine with UCSF
Medical Center. This partnership will help
align the interests of the physician group
and the hospital, and create the
infrastructure for additional affiliations with
Bay Area medical groups hospitals.
On the clinical front, Spencer Yost, MD,
discusses how we are using a move to the
new state-of-the-art hospitals at Mission
Bay (Benioff Children’s Hospital, Betty
Irene Moore Women’s Hospital, Bakar
Cancer Hospital) to accelerate and recast
ongoing efforts to improve patients’
perioperative experience. From integrated,
multi-modal pain management processes
through enhanced recovery strategies that
reduce length of stay and strategic use of
interdisciplinary teams, the new facility
presents a rare opportunity to transform
our care for the better.
Similarly, as San Francisco General
Hospital (SFGH) prepares for its own move
to a new hospital, Vice Dean for SFGH
Sue Carlisle, MD, outlines various
initiatives in place there, aimed at
enhancing patient safety and improving
clinical efficiency. Lean-driven
improvements are tightening up processes
and improving the patient experience in
the operating room and in urgent care
clinics. Implementation of a “just” culture
is fostering trust and more open reporting
so clinicians can better protect the lives of
their patients. A focus on service
excellence and efforts to become part of
an accountable care organization
recognize the need to put the patient at
the center of care and that reimbursement
structures are shifting to emphasize value.
In the research realm, Judith Hellman,
MD, describes how the department’s
Pathway to Scientific Independence
program enables us to nurture the careers
of young researchers who are making
important contributions to anesthesia
care specifically, and health care more
generally. By identifying and supporting
promising scientists, our department is
extending and enriching a storied
research history that reaches back more
than half a century.
As for education, Mark Rollins, MD,
PhD, our director of undergraduate
medical education clerkships is not resting
on the laurels of us regularly being ranked
the number one core clinical clerkship at
UCSF School of Medicine. While paying
careful attention to the factors that have
contributed to our success – particularly
personalized attention and dedicated
involvement from core faculty – Rollins
and his colleagues are continuing to
innovate with longitudinal clerkships,
efforts to improve feedback loops,
increasing student accountability and a
seat at the table as the medical school
curriculum undergoes dramatic change.
Finally, Vice Chancellor Diversity and
Outreach Renee Navarro, MD, PharmD,
talks about the essential work of
diversifying our department, UCSF and
the entire health care workforce. She
notes correctly, “The future of our health
care system demands that we be in tune
to the needs of different individuals from
different cultures and that we have access
to the best minds, no matter where they
come from.” She then goes on to discuss
some of the efforts in place to make sure
that happens.
These are remarkable leaders, doing
the work that helps us understand and
adapt to our ever-changing world. Their
presence gives me confidence that we
will remain one of the finest departments
of anesthesia care in the world, and
help keep anesthesia at the center of
perioperative care and research.
Professor and Interim Chair
UCSF Department of Anesthesia and Perioperative Care | Anesthesia News | 2014 | 2
Inpatient room mockup for the new UCSF Medical Center at Mission Bay, opening in 2015
“We know what’s gone on over the drapes, we
understand post-surgical complications and we are
the pre-operative, critical care and pain experts.”
— Spencer Yost (at left)
OR, we can often improve post-operative
recovery and short circuit long-term
chronic pain.”
Enhanced Recovery
Perioperative
Care
continued from front page
hospital, the service will integrate those
approaches with cancer symptom
management.
This approach begins with a rigorous
pre-operative assessment and, where
appropriate, includes innovative pain
management measures during and after
surgery, such as the use of IV ketamine
as a type of pre-emptive, intraoperative
analgesia. Such approaches are
especially important in cases where
acute inpatient pain might exacerbate a
patient’s existing chronic pain, a
notoriously difficult-to-manage problem.
“We’ve begun to understand a lot
more about the pathophysiology of pain,”
says Yost. “If we can block pain in the
Surgical and anesthesiology teams at
UCSF Medical Center at Mount Zion will
also bring with them an approach to
reducing length of stay (LOS) that they
have begun piloting for colorectal
surgery, particularly simple colectomies.
In the past, average (LOS) for such
procedures was 4-6 days because a
combination of pre-surgical bowel
preparation and overuse of opiates
delayed bowel recovery. By piloting an
approach based on successful European
studies, the Mount Zion teams hope to
reduce LOS to an average of 2 days, by:
■■ Ending traditional bowel prep and
encouraging patients to drink clear
liquids up to four hours before surgery,
especially something with some sugar
and protein in it to raise the blood
sugar level and speed recovery.
■■ Running a non-opiate epidural during
surgery to reduce nociceptive input.
■■ Having nursing staff mobilize patients
just a few hours after surgery, carefully
manage opiate use and provide
patients and families with colostomy
education that keeps them on top of
pain control and function – and sets
the expectation for a two-day stay.
“These patients may have return to
bowel function by end of day one and by
the end of day two are walking and
taking a full liquid diet,” says Yost. The
hope is that over time, at Mission Bay,
clinicians will be able to extend this
approach to other types of surgeries.
A Diversity of Providers,
Approaches
In addition, says Yost, there are plans to
expand the use of in-patient nurse
practitioners and pilot telemedicine
consults to create more consistency and
improve quality for patients and families.
“All of these innovations should
enable us to take care of patients with
terrible disease in the most comfortable
and humane way,” says Yost. And, he
adds, the Department is the logical
choice to oversee all aspects of
intrahospital care, because, “We know
what’s gone on over the drapes, we
understand post-surgical complications
and we are the pre-operative, critical
care and pain experts.”
ASK THE EXPERT
Renee Navarro, PharmD, MD,
UCSF Vice Chancellor Diversity and Outreach
How and why should we create a more diverse faculty, residency and staff in the
Department of Anesthesia and Perioperative Care?
state and caring for them on a minuteto-minute basis; this requires cultural
humility and respect for difference. It
takes a very special skill to establish the
necessary comfort level with both the
patients and the families. I’ve seen this
play out on multiple occasions in the
care of trauma and obstetric patients,
as well as in scheduled elective cases.
Understanding Bias
T
he UCSF mission is to advance
health worldwide. Our vision is that
in advancing health worldwide,
UCSF will build upon our commitment to
diversity, provide a supportive work and
learning environment, recruit and retain
the best people and position UCSF
as an innovator of the future. If our goal
is to have the best and brightest, then
we must actively recruit women and
underrepresented individuals to our
program, because to not engage these
segments of the population effectively
limits our capacity.
Also, the diversity of our country and
particularly the state of California is
increasing rapidly. These are the patients
we serve. The future of our health care
system necessitates, especially if we
intend to make an impact on health
disparities, that we have more cultural
awareness and inclusion in our practice.
In addition, science is increasingly teambased. Evidence clearly shows that
diverse teams are more effective in
solving problems. We need to leverage
the advantages that diversity brings.
Anesthesiologists are in a unique
position in terms of our relationship with
the patient and family. We have a limited
amount of time with patients, but we’re
putting them in the most vulnerable
It’s important to reflect on the need for
an awareness and understanding of our
own biases, and how unconscious bias
impacts our interpersonal interactions
as well as how we make decisions
(admissions, hiring, promotions). It’s
increasingly evident that clinician bias
or lack of awareness about race and
ethnicity has a role in health disparities;
disparities are not just about access to
care and socioeconomic issues. For
example, research has shown differential
treatment for pain management in
orthopedic patients presenting to an
emergency room. When you think about
the responsibility of being a doctor, we
have to be cognizant of what comes into
play during doctor-patient interactions.
My office launched an Unconscious
Bias Education initiative in 2013-14 and
we have trained over 400 members of
our campus community to date.
Diversity work is not rocket
science; it’s harder than that because
it addresses individuals and how we
behave. Creating a more diverse,
inclusive and more culturally aware
department requires a complex set
of interventions.
I did a Grand Rounds with the
department in 2012 on the status of
diversity and tried to engage the
department to start thinking about
outreach, about getting more
underrepresented residents into our
program. At UCSF medical school,
students of color make up between
25-33 percent of our population – and
then we see a drop off beginning with
our resident population and a greater
drop off to faculty. We’re still trying to
understand whether people are choosing
to go elsewhere or wish to stay at UCSF
and we are not ranking them highly in
the match. Do students in the majority
match at a higher rate than students of
color? Was the experience different for
the two groups? Are there family
reasons? We need to tease out some of
those things, because we haven’t gotten
to the why yet. We are starting to see
improvement in the matching of LGBT
students to the residency program as we
are increasingly seen to be welcoming
and inclusive.
Outreach
The Association of American Medical
Colleges has data that shows anesthesia
is the fifth most popular subspecialty
among African-Americans, so as a
specialty we don’t do poorly in attracting
people of color for residency programs
but we have to figure out how to attract
them to come to UCSF. We do some
targeted outreach to Latino, African
American, Native American and LGBT
medical school groups to increase
visibility and the number of applicants.
And we’ve gotten some community
partners to fund scholarships, but people
still have to match into our residency.
In anesthesia, we need to look at how
we are approaching medical students.
Are they exposed to a wide variety of
faces from the department and are we
talking about and discussing topics of
wide interest, including health disparities
and access to care issues? Role models
matter as well. Sometimes you don’t see
yourself as a part of something if you
don’t see others like yourself.
We also need to nurture potential
faculty members early in residency,
engage people so they will want to stay.
Often minorities have higher debt and
see advantages in private practice as
opposed to academic medicine. This
has to become part of the conversation
about how to make people feel welcome
and see the advantages. I would never
have joined the faculty except for Dr.
Cedric Bainton pulling me aside and
explaining how the department would
support me so I could be successful.
He was a mentor and sponsor who
helped me navigate the written and
unwritten rules and identify
opportunities. These efforts need to
be replicated among the faculty.
Support
Graduate medical education has
implemented programming, which I
support, that brings residents together
across all the different programs as a
community. The goal is to foster the
sense of belonging. Through the efforts
of Dr. Rene Salazar, we sponsor diversity
day interview dates, 2nd look weekend
events, and visiting elective scholarships
for senior medical students. The dean
sponsors an annual multicultural
reception. The Multicultural Resource
Center also supports our students,
residents, faculty and staff through
visibility projects, speaker forums and
film events. It matters and we need to
pay attention so when people do come
in they feel included, not isolated.
The other thing that we need to
consider is having in place education
and support for the faculty. One model is
the School of Nursing’s DIVA (Diversity in
Action) initiative, which teaches faculty
how to discuss and address diversity
and conflicts that arise in the classroom.
We need to have ongoing conversations
about health disparities, race and gender
disparities as well as homophobia so we
gain a greater understanding of the
causes, contributing factors and our
individual impact on solutions. If we
make the unconscious more conscious,
we can better institute tools and
processes to mitigate the impact of race,
gender and/or LGBT status.
It’s challenging to maintain an ongoing
conversation and plan for diversity and
inclusion because of the multitude of
issues within health care. This goes
beyond anesthesia and so the challenge
for someone in my position is to get
systems in place that force people to
think about the importance and benefits
of a diverse and inclusive university by
interfacing with search and admission
committees to educate people about
unconscious bias, as well as UC’s
commitment to diversity. And by
providing assistance in identifying
qualified candidates nationwide we can
start to move the needle. Once at UCSF,
I have a responsibility to assure that we
have a climate that is inclusive. Through
the efforts of the Multicultural and LGBT
resource centers we build community,
facilitate collaborations and increase
education and awareness.
Acountability
We are working to establish accountability measures for department chairs,
who are responsible for diversifying
all aspects of the health care team –
not just faculty, but also the workroom,
nurse anesthetists, the full breadth
of the department – so we send a
message that diversity is valued. The
Dean is developing a dashboard as
part of a chair’s annual evaluation that
looks at the efforts and successes
in recruitment, hiring, retention and
promotion. Accountability is a key
component of our strategic plan. In
an era of team-based science, where
everyone acknowledges we need multidimensional teams, we have to take
advantage of the excellence, of great
minds across populations and groups.
“It’s challenging to maintain an ongoing conversation and plan for diversity and
inclusion because of the multitude of issues within health care.” — Renee Navarro
UCSF Department of Anesthesia
EDUCATION
Maintaining Top Clerkship Demands Innovation
A
nesthesia has consistently been
ranked the number one core
clinical clerkship at UCSF School
of Medicine for a variety of reasons,
says Mark Rollins, MD, PhD, director
of undergraduate medical education
anesthesia clerkships. Certainly, the
fact that anesthesia is a mandatory
clerkship at UCSF helps, as does the
fact that Rollins’ predecessor, Martin
Bogetz, MD, established an exemplary
program that imparts translatable
knowledge and skills, regardless of a
student’s chosen specialty.
The skills – including intubation,
airway evaluation, resuscitation,
preoperative risk assessment, sedation,
pain and crisis management – intersect
with other core disciplines in medicine,
but students primarily learn them in
the anesthesia clerkship, says Rollins.
“Another key factor is that our
faculty, residents and chair have an
enormous commitment to undergraduate
education,” says Rollins. “But to
maintain our ranking, it’s important that
we continue to adapt to changes in
clinical medicine, medical education
and the ways students learn.”
Personal, Comprehensive
Attention
One tradition Rollins wants to enhance is
the close, personal attention that medical
students in the anesthesia clerkship
receive. They are typically paired oneon-one with a resident or faculty member
through the entire two-week clerkship,
during which hands-on, skill-based
teaching gives students a strong taste
of the entire, perioperative experience.
“I attribute much of our success to the
residents’ teaching abilities and
dedication to education,” says Rollins.
Simulations enhance medical
students’ understanding. “We have
incredible site directors [at Mt. Zion,
San Francisco General Hospital (SFGH)
and the Veterans Administration
Medical Center], with slightly different
emphases in each location,” says Rollins.
“All of the simulations get rave reviews
from medical students.”
At SFGH, the focus tends to be on
crisis management, team dynamics
and leadership for cases such as
hypotension, hypoxia and failed
intubations. At the VA, says Rollins, the
focus is on more complex patients and
cases, as well as on the safe placement
of arterial lines, central lines, and PA
(pulmonary artery) catheters – and the
interpretation of these invasive monitors.
In addition, throughout the clerkship,
core faculty members deliver a series of
lectures on key topics in anesthesia and
perioperative care. “The amount of labor
and dedication it takes from our faculty to
deliver these lectures twenty times a year
is incredible,” says Rollins.
Maintaining Innovation
The Department is also exploring a
number of new innovations.
■■ The Longitudinal Clerkship: Under
the leadership of Kristina Sullivan, MD,
UCSF is one of only a few schools in
the country to offer a longitudinal
clerkship with anesthesia as a core
element. Each student pairs with
a single faculty member and
participates in clinical anesthesia for
two days at a time, spaced throughout
their third year. “It gives students
continuity in a preceptor and with
patients,” says Rollins. “We’re doing
some work to assess knowledge
retention…and, so far, have found
similar knowledge retention between
this and the two week clerkship,
despite the spaced learning.”
■■ Improve and standardize evaluation
and feedback: To reduce variance
in evaluations, the Department is
planning to use IT support to normalize
the average scores each instructor
gives. As for feedback – helping
students understand how and
where they can improve rather than
scoring how they did – Rollins has
implemented electronic reminders for
residents to provide students with clear
feedback at regular intervals. He also
draws on the work Manuel Pardo, MD,
initiated to help improve the quality
of the feedback.
■■ Documenting Student Competencies:
In response to the demands of
residency programs, Rollins is creating
new ways to document that students
have completed specific trainings and
have demonstrated understanding and
competency. This has resulted in two
on-line modules for students focused
on IV access and arterial sampling.
Finally, UCSF is exploring restructuring its
entire medical school curriculum by
weaving together across all four years the
classroom learning (traditionally offered
years one and two), with patient encounters,
core clerkships and electives (traditionally
offered in years three and four).
“We are working to make sure
anesthesia is at the table for these
discussions of the Bridge Curriculum,”
says Rollins.
RESEARCH
Paving a Pathway to Scientific Independence
T
he UCSF Department of Anesthesia
and Perioperative Care has a
storied research history that spans
nearly 60 years.
It has remained a powerhouse at least
in part because about twenty years ago,
Ronald Miller, MD – Chair of the
Department at the time – recognized that
while the need for anesthesia-related
research continued to grow, changes in
technology, medicine and health care
delivery were making it increasingly
difficult to attract and retain the best and
the brightest.
Miller and senior faculty members
created the UCSF Research Scholars
residency track to support a pool of
young researchers with the potential to
pursue exciting research careers. The
track is now part of the umbrella
Pathway to Scientific Independence
(PSI) program.
“The PSI puts our money and time
where our mouths are regarding research
in anesthesia,
perioperative medicine,
pain management and
critical care medicine,”
says Judith Hellman,
MD and director of the
PSI. “It creates a
meaningful pathway
Judith Hellman
that allows our most
promising researchers to be successful
and our department to grow.”
How the Program Works
The PSI helps train and develop clinical
and basic scientists by providing:
1.Training for early career researchers,
including intensive research and career
mentoring, education, and
presentation opportunities.
2.Departmental support of research
projects and programs, including
direct support of projects and
protected, nonclinical research time.
3.Administrative support for grant and
contract administration, resource
allocations and programs and events
that encourage collaboration.
One can enter the PSI in four different
ways: from the Research Resident
Scholar track, as a categorical resident,
as a post-doctoral fellow and as a junior
and do research on their own time,” says
Arun Prakash, MD, PhD, also a faculty
member who initially took a pay cut to
pursue his research but then began
receiving some support before the PSI
was a formal program. “With the
department’s help, I’ve had three years to
develop a research program, publish a
paper in Anesthesiology and get a FAER
grant, which helped me further establish
my research credentials.” He awaits
feedback on a K grant application.
Directed Mentoring
Claire Harmon (right), Research Administration Manager in the Department of
Anesthesia, guides a young researcher
through the grant application process.
faculty member. All participants in the
first three categories typically join a
T-32 training grant. The goal is to provide
the structure and support necessary
for anesthesia research trainees on the
PSI to obtain a FAER (Foundation for
Anesthesia Education and Research)
grant and/or NIH K-level award – and
eventually to become fully independent
researchers with an RO1 or similar
level grant.
As of this writing, there are 13 PSI
trainees, seven of which are on the
research resident scholar track.
“There are some set requirements,
but participants have a lot of room to
shape their own program,” says Hellman.
Protected Time, Financial
Support
By providing participants with about 75
percent protected research time, the PSI
takes the onus off trainees to advocate
for their nonclinical time.
“It’s so important,” says Zhongui
Guan, MD, now a full-time faculty
member. “The grants I received from
outside resources are not sufficient to
support my salary while I focus on
research, so I’m very grateful that our
department gives me tremendous
financial support to compensate.”
“It may not be viable for someone
with a family and kids to sacrifice pay
In addition to funding and protected time,
early in the process, Hellman and
Anesthesia Department Professor in
Residence Roland Bainton, MD, PhD, help
participants identify and connect with an
NIH-funded research mentor either from
within or outside the department.
Usually this leads to participants
becoming part of a multi-disciplinary
team of basic and clinical scientists
attacking a similar problem from different
angles. The process helps participants
shape their own research questions.
“I got lucky and fell into a position as
[Hellman’s] mentee,” says Prakash, who
has lab space within Hellman’s lab. “She’s
been supremely supportive; she genuinely
cares about my success and progression
to becoming independently funded.”
The Tradition Continues
Given the changes in both science and
health care, Hellman believes some
version of the PSI is the only way
anesthesiology can continue to make
essential research contributions. Program
participants seem to agree.
“Eventually I need to compete for NIH
grants with top scientists who have [a lot
of] continuous research training and
experience before they apply for an NIH
grant,” says Guan. “Without support from
the Pathway to Scientific Independence,
there is no way I can get even close to
that goal.”
“It has offered me a tremendous
opportunity to develop into a better
physician-scientist,” says Irfan Kathiriya,
MD, PhD, another PSI participant and
faculty member. “I am very grateful for
the department’s investment in my
academic future.”
FACULTY PROFILE
Sue Carlisle Leads Physicians, Researchers
Through Tragedy, Reform and Rebuild
S
an Francisco General Hospital and
Trauma Center (SFGH) provides a
compelling case study for today’s
complex health care challenges.
Like many medical centers, SFGH
runs a variety of efficiency and patientcentered care initiatives designed to
deliver better, less expensive care to the
100,000 patients it serves annually with
inpatient, outpatient, emergency,
diagnostic and psychiatric services.
But in addition to those “usual”
responsibilities, SFGH hosts about
185 principal investigators running
between $140 and $150 million in
research programs, is responding to a
headline-grabbing tragedy, is about to
become part of a large accountable
care organization and is completing a
massive rebuild of its entire facility.
Because UCSF physicians provide
all clinical services at SFGH, Vice
Dean for SFGH Sue Carlisle, PhD, MD,
is usually at the center of all of this
activity. A veteran member of the
UCSF Department of Anesthesia and
Perioperative care, Carlisle has led
all UCSF faculty at SFGH since 2004.
She spoke recently about the challenges
of her job.
Lean Initiatives
We use Lean initiatives to fix things that
impact hospital efficiency and the patient
experience. In our urgent care clinic,
we’ve reduced wait times and made it
more convenient for patients by enabling
them to get x-rays and EKGs and have
blood drawn in the clinic. We’ve cut the
time patients are present in urgent care
from six hours to two – and patient
satisfaction scores have really improved.
We’ve also done Lean kaizens
(improvements) in the OR and in our
outpatient surgical clinics to make sure
the right materials are available at the
right time. We’re working on making the
scheduling of OR times more precise
and have worked with central supply to
implement electronic stocking; in the
future we hope to tie that to a total
electronic health record. Many of us
would really like to implement the same
[EHR] system as Parnassus, because so
many people go back and forth between
the two facilities.
Just Culture
“Just Culture” aims to change the
reporting atmosphere to one of trust,
where people understand that reporting
is important for the good of patients. Too
often, fear of punishment causes people
to not come forward, but human errors,
whether lack of knowledge or systems
problems, need to be reported in an
atmosphere of education. Of course, if
people are reckless, we deal with that
appropriately, but we’re changing the
culture from one of blame to one where
we can talk about mistakes and near
misses. We’ve already seen progress.
Service Excellence and Beyond
In our service excellence project we
put patient care at the center of all the
things we do. We try to treat our
patients like guests at a hotel, making
sure they’re greeted appropriately, seen
appropriately, discharged appropriately
and treated with respect. We have
trained 3,000 people and almost all of
the physicians.
Now, when we see somebody
wandering the hallway, people
automatically ask whether they can
help…. Lynne Spalding [the woman
who was found dead many days after
her disappearance] was a horrible
tragedy. About half of what was in the
newspapers was not quite accurate – but
it did make us look at our systems, and
realize we had big gaps in our policies
and procedures that needed to be fixed.
We put forth a plan of correction
and CMS (Centers for Medicare &
Medicaid Services) and TJC (The Joint
Commission) have accepted the plan as
appropriate and now we have clearer
ways to delineate patients at risk, have
new processes to monitor these patients,
changed the way the alarms in the
stairwells work and are installing
electronic bands so when a patient at
risk approaches an exit door, it says, in
their language, to turn around and go
back to their room. This doesn’t fall into
any specific initiative; it falls into all of
them and under systems improvement.
New Hospital
The new hospital – it opens in 2015 –
was a response to the Northridge
earthquake, when the state senate,
changed earthquake codes for hospitals.
We started in 2008, with a general
obligation bond, for $887.4 million –
the largest ever to go before the city –
and it passed with 84 percent approval.
It will be a state-of-the-art earthquake
resistant building with two stories
underground, seven above. We’re in the
process of doing the transition planning
for how we’ll actually move but we know
we’ll have a few more inpatient beds,
Aerial view of the new hospital construction
Sue Carlisle
an ER that’s three times as big, more
ORs, more labor and delivery, more ACE
(acute care for elders) beds. It’s going to
be beautiful, but it’s greatly increased
planning and preparation.
Responding to Reform
The San Francisco Department of Public
Health is working on becoming an ACO
(Accountable Care Organization) called
the San Francisco Health Network. It will
include all ambulatory care, as well as
SFGH and other outpatient clinics.
It will affect reimbursement and will
change programs like Healthy SF [an
access program for low-income and
indigent patients in San Francisco that
offers a menu of services and has begun
the process of putting patients in
medical homes] and SF Health Plan, the
city’s MediCal managed care plan from
which we accept payment for anything
that is non-emergent. For emergent
procedures, we receive funding from a
variety of sources, both local and federal.
The transition [to an ACO] will be
complicated partly because our
academic faculty members are paid part
time as clinicians and part time as faculty
or from their research grants; and we
could not begin to afford to pay full
salaries for all our specialists. We feel
strongly that the arrangement we have
now allows us to have a broader range
and higher level of talent than we would
have otherwise. The ACO will move us to
a kind of capitated arrangement and we
will have to find formulas to distribute
payments among different organizations.
We’re just starting to try to think through
how all of this will work.
But depending on which day you talk
to me, I’m optimistic. I tend to be a glass
half-full person and believe we’ll find our
way through this incredible maze,
especially because we can pull in smart
people to help us think about all this. Our
success matters a lot, not just to
individual patients, or to our faculty, but
to this city. We do 20 percent of the
health care in San Francisco, 30 percent
of the ambulances come to us – all the
trauma care and most psychiatric care.
San Francisco would be a different place
without us. We have to solve these
problems and we have to continue to get
better. We have to address every crisis
not as an opportunity to fail, but as an
opportunity to succeed.
NewFaculty
Career Faculty
Jeffrey Ghassemi,
MD, MPH
Kerry Apostolo, MD
Health Sciences Assistant
Clinical Professor
Joined Faculty July 2014
Health Sciences
Clinical Instructor
MEDICAL SCHOOL
New York Medical College
INTERNSHIP
Medicine: Kaiser Permanente
Oakland Medical Center
RESIDENCY
Jeanie Bhuller, DO
Clinical Professor
Joined Faculty June 2014
MEDICAL SCHOOL
Touro University College of
Osteophathic Medicine
INTERNSHIP
Internal Medicine
Alameda County Medical Center
RESIDENCY
Anesthesiology: Georgetown
University Hospital
FELLOWSHIP
Pediatric Anesthesiology: UCSF
PREVIOUS EMPLOYMENT
Anesthesiologist
Medical Anesthesia Consultants
Tony Chang, MD
Health Sciences Clinical
Instructor
Joined Faculty August 2014
MEDICAL SCHOOL
University of South Alabama
INTERNSHIP
Anesthesiology: UCSF
RESIDENCY
The University of Chicago,
Pritzker School of Medicine
MEDICAL SCHOOL
INTERNSHIP
University of California, Irvine
Surgery: UCSF
INTERNSHIP
RESIDENCY
Medicine: UCLA
RESIDENCY
Clinical Professor
Melissa Haehn, MD
MEDICAL SCHOOL
Instructor
INTERNSHIP
MEDICAL SCHOOL
University of Minnesota
Twin Cities Medical School
FELLOWSHIP
Critical Care Medicine: UCSF
Kate Kronish, MD
Instructor/
Liver Transplant Fellow
FELLOWSHIP
L. Stephen Long, MD
Clinical Professor
MEDICAL SCHOOL
MEDICAL SCHOOL
Georgetown University
School of Medicine
INTERNSHIP
Internal Medicine: Kaiser Permanente
Oakland Medical Center
RESIDENCIES
University of Pennsylvania
School of Medicine
Medicine: University of Pennsylvania
Neurology: University of Pennsylvania
Anesthesiology: University of
Pennsylvania
MEDICAL SCHOOL
Stanford University
School of Medicine
INTERNSHIP
Transitional: Santa Clara Valley
Medical Center
PREVIOUS EMPLOYMENT
RESIDENCY
RESIDENCY
Internal Medicine: California
Pacific Medical Center
RESIDENCY
RESIDENCY
Oregon Health and
Science University
INTERNSHIP
Anne Donovan, MD
INTERNSHIP
Vincent Lew, MD
Regional Anesthesia: UCSF
Assistant Professor
in Residence
University of Iowa Carver
College of Medicine
Ansthesiology: UCSF
FELLOWSHIP
Philip Kurien, MD
MEDICAL SCHOOL
MEDICAL SCHOOL
MPH, Health Services: UCI
Clinical Professor
Health Sciences
Clinical Instructor
ADVANCED DEGREE
Anesthesiology: UCLA; UCSF
Laura Lang, MD
Clinical Instructor and
Postdoctoral Scholar: UCSF
INTERNSHIP
RESIDENCY
FELLOWSHIP
Pediatric Anesthesia: UCSF
Jonathan Pan, MD, PhD
Assistant Professor
in Residence
ADVANCED DEGREE
PhD, Neuroscience:
Rutgers University
MEDICAL SCHOOL
Fudan University Medical Center
INTERNSHIP
Transitional Medicine:
Mercy Catholic Medical Center
RESIDENCY
Anesthesiology: University
of Pennsylvania
POSTDOCTORAL FELLOWSHIP
Andrew Schober, MD
Wei Zhou, MD, PhD
PREVIOUS EMPLOYMENT
Health Sciences
Assistant Professor
Health Sciences
Clinical Instructor/
T32 Postdoctoral Trainee
University of Pennsylvania
Clinical Instructor, NIH T32: UCSF
MEDICAL SCHOOL
Krishna Parekh, MD
Clinical Professor
MEDICAL SCHOOL
New York University School
of Medicine
ADVANCED DEGREE
INTERNSHIP
MEDICAL SCHOOL
RESIDENCY
Duke University
INTERNSHIP
Internal Medicine: Thomas Jefferson
University Hospital
RESIDENCY
Anesthesiology: Brigham and
Women’s Hospital
FELLOWSHIP
FELLOWSHIP
Scott Schulman,
MD, MHS
Clinical Professor
PhD, Neuroscience: UCSD
Peking Union Medical College,
Beijing, China
INTERNSHIP
RESIDENCY
Visiting Faculty
ADVANCED DEGREE
Jouko Jalonen, MD
MHS, Clinical Research
Training Program: Duke University
Visiting Professor
Clinical Professor
MEDICAL SCHOOL
MEDICAL SCHOOL:
George Washington University
School of Medicine
University of Turku Medical
School, Turku, Finland
MEDICAL SCHOOL
INTERNSHIP
RESIDENCY:
Nichlesh Patel, MD
SUNY Downstate
Medical Center
RESIDENCIES
Medicine: Lenox Hill Hospital
Pediatrics: UCLA
Anesthesiology: UCLA
Anesthesiology (General, Cardiac,
Cardiothoracic): Turku University
Central Hospital, Karolinska Hospital,
Stockholm, Sweden
RESIDENCY
PREVIOUS EMPLOYMENT
PREVIOUS EMPLOYMENT:
Professor of Anesthesiology
and Pediatrics: Duke University
Medical Center
Professor, Department of
Anaesthesiology and Intensive Care
Medicine, University of Turku
Stephen Weston, MD
Thorsten Smul, MD
Clinical Instructor/Liver
Transplant Fellow
MEDICAL SCHOOL
Pediatrics: UCLA
INTERNSHIP
FELLOWSHIP
Cardiothoracic Anesthesia:
The Texas Heart Institute
Gabriel Sarah, MD
Clinical Professor
MEDICAL SCHOOL
MEDICAL SCHOOL
University of Arizona
University of California,
San Diego
RESIDENCY
INTERNSHIP
Anesthesiology:
The University of Miami/Jackson
Memorial Hospital
Medicine: UCSD
RESIDENCY
FELLOWSHIP
Pediatric Anesthesiology:
The University of Miami
Edward Yap, MD
Instructor/Regional
Anesthesia fellow
MEDICAL SCHOOL
New York Medical College
Visiting Assistant Professor
Medical School of Julius
Maximilians University,
Würzburg, Germany
RESIDENCY
Anesthesiology and Critical Care:
Julius Maximilians University
Würzburg, Germany
RESEARCH FELLOWSHIP
Myocardial Reperfusion Injury:
Julius Maximilians University
PREVIOUS EMPLOYMENT
Director of Liver Transplantation
Anesthesia Section, Department of
General Surgery, Julius Maximilians
University, Würzburg, Germany
INTERNSHIP
RESIDENCY
New Residents
CLASS OF 2017
Ashish
Agrawal
Gina
Bane
Marc
Buren
Matthew
Careskey
Josemine
Carey
Denise
Chang
Monica
Chen
Gregory
Chinn
Lusine
Danakian
Iman
Hadaya
Mellody
Hayes
Marisa HernandezMorgan
Jordan
Higgins
Nicole
Jackman
Jeffrey
Kim
Bradley
Lee
Roger
Lee
Masood
Memarzadeh
Mastoora
Nasiri
Elaine
Nguyen
Megha
Parekh
Joseph
Reza
Sara
Richards
Kyle
Sanders
Paul
Su
Allison
Thoeny
Peer Reviewed Publications
Asmussen S, Ito H, Traber DL, Lee JW, Cox RA,
Hawkins HK, McAuley DF, McKenna DH, Traber LD,
Zhou H, Wilson J, Herndon DN, Prough DS, Liu KD,
Matthay MA, Enkhbaatar P. Human mesenchymal
stem cells reduce the severity of acute lung injury
in a sheep model of bacterial pneumonia. Thorax.
2014 Sep;69(9):819-25.
Bendjilali N, Nelson J, Weinsheimer S, Sidney S,
Zaroff JG, Hetts SW, Segal M, Pawlikowska L,
McCulloch CE, Young WL, Kim H. Common
variants on 9p21.3 are associated with brain
arteriovenous malformations with accompanying
arterial aneurysms. J Neurol Neurosurg Psychiatry.
2014 Apr 28.
Braun S, Plitzko G, Bicknell L, Van Caster P, Schulz
J, Barthuber C, Preckel B, Pannen B, Bauer I.
Pretreatment with helium does not attenuate liver
injury after warm ischemia reperfusion. Shock.
2014 May;41(5):413-9.
Chen W, Choi EJ, McDougall CM, Su H. Brain
arteriovenous malformation modeling, pathogenesis, and novel therapeutic targets.
Transl Stroke Res. 2014 Jun;5(3):316-29.
Chen W, Sun Z, Han Z, Jun K, Camus M, Wankhede
M, Mao L, Arnold T, Young WL, Su H. De novo
cerebrovascular malformation in the adult mouse
after endothelial Alk1 deletion and angiogenic
stimulation. Stroke. 2014 Mar;45(3):900-2.
Choi EJ, Chen W, Jun K, Arthur HM, Young WL,
Su H. Novel brain arteriovenous malformation
mouse models for type 1 hereditary hemorrhagic
telangiectasia. PLoS One. 2014 Feb 10;9(2):e88511.
Choquet H, Nelson J, Pawlikowska L, McCulloch
CE, Akers A, Baca B, Khan Y, Hart B, Morrison L,
Kim H. Association of cardiovascular risk factors
with disease severity in cerebral cavernous
malformation type 1 subjects with the common
Hispanic mutation. Cerebrovasc Dis. 2014
37(1):57-63.
Cohen NH, Patterson AJ, Coursin DB. Time to
break down silos: alternative approaches to staffing
ICUs. Crit Care Med. 2014 Jul;42(7):e535-6.
Culley DJ, Fahy BG, Xie Z, Lekowski R, Buetler S,
Liu X, Cohen NH, Crosby G. Academic productivity
of directors of ACGME-accredited residency
programs in surgery and anesthesiology. Anesth
Analg. 2014 Jan;118(1):200-5.
Dickerson DM, Naidu RK. Preparing for the
physician payment sunshine act. Reg Anesth Pain
Med. 2014 May-Jun;39(3):185-8.
Flexman AM, Wong H, Riggs KW, Shih T, Garcia PA,
Vacas S, Talke PO. Enzyme-inducing
Anticonvulsants Increase Plasma Clearance of
Dexmedetomidine: A Pharmacokinetic and
Pharmacodynamic Study. Anesthesiology. 2014
May;120(5):1118-25.
Hetts SW, Cooke DL, Nelson J, Gupta N, Fullerton
H, Amans MR, Narvid JA, Moftakhar P, McSwain H,
Dowd CF, Higashida RT, Halbach VV, Lawton MT,
Kim H. Influence of Patient Age on Angioarchitecture of Brain Arteriovenous Malformations.
AJNR Am J Neuroradiol. 2014 Jul;35(7):1376-80.
Kim H, Al-Shahi Salman R, McCulloch CE, Stapf C,
Young WL, for the MARS Coinvestigators.
Untreated brain arteriovenous malformation: patient
level meta-analysis of hemorrhage predictors.
Neurology. 2014 Aug 12;83(7):590-7.
Lewin M, Samuel S, Wexler D, Bickler PE, Mensh B.
Early treatment with intranasal neostigmine reduces
mortality in a mouse model of Naja naja (Indian
cobra) envenomation. J. Tropical Medicine. 2014;
2014:131835.
McAuley DF, Curley GF, Hamid UI, Laffey JG, Abbott
J, McKenna DH, Fang X, Matthay MA, Lee JW.
Clinical grade allogeneic human mesenchymal
stem cells restore alveolar fluid clearance in human
lungs rejected for transplantation. Am J Physiol
Lung Cell Mol Physiol. 2014 May;306(9):L809-15.
Miller RD, Ward TA, McCulloch CE, Cohen NH.
A comparison of lidocaine and bupivacaine digital
nerve blocks on noninvasive continuous hemoglobin
monitoring in a randomized trial in volunteers.
Anesth Analg. 2014 Apr;118(4):766-71.
Mohr JP, Parides MK, Stapf C, Moquete E, Moy CS,
Overbey JR, Al-Shahi Salman R, Vicaut E, Young
WL, Houdart E, Cordonnier C, Stefani MA,
Hartmann A, von Kummer R, Biondi A, Berkefeld J,
Klijn CJ, Harkness K, Libman R, Barreau X,
Moskowitz AJ; international ARUBA investigators.
Medical management with or without interventional
therapy for unruptured brain arteriovenous
malformations (ARUBA): a multicentre, non-blinded,
randomised trial. Lancet. 2014 Feb
15;383(9917):614-21.
Potts MB, Jahangiri A, Jen M, Sneed PK,
McDermott MW, Gupta N, Hetts SW, Young WL,
Lawton MT. UCSF Brain AVM Study Project. Deep
Arteriovenous Malformations in the Basal Ganglia,
Thalamus, and Insula: Multimodality Management,
Patient Selection, and Results. World Neurosurg.
2014 Mar 19.
Rutledge WC, Ko NU, Lawton MT, Kim H.
Hemorrhage rates and risk factors in the natural
history course of brain arteriovenous malformations.
Transl Stroke Res. 2014 Oct;5(5):538-42.
Schartel SA, Kuhn C, Culley DJ, Wood M, Cohen N.
Development of the anesthesiology educational
milestones. J Grad Med Educ. 2014 Mar;6
(1 Suppl 1):12-4.
Shen F, Degos V, Chu PL, Han Z, Westbroek EM,
Choi EJ, Marchuk D, Kim H, Lawton MT, Maze M,
Young WL, Su H. Endoglin Deficiency Impairs
Stroke Recovery. Stroke. 2014 Jul;45(7):2101-6.
Sheth SA, Potts MB, Sneed PK, Young WL,
Cooke DL, Gupta N, Hetts SW. Angiographic
features help predict outcome after stereotactic
radiosurgery for the treatment of pediatric
arteriovenous malformations. Childs Nerv Syst.
2014 Feb;30(2):241-7.
Tada Y, Wada K, Shimada K, Makino H, Liang EI,
Murakami S, Kudo M, Kitazato KT, Nagahiro S,
Hashimoto T. Roles of hypertension in the rupture
of intracranial aneurysms. Stroke. 2014
Feb;45(2):579-86.
Tada Y, Wada K, Shimada K, Makino H, Liang EI,
Murakami S, Kudo M, Shikata F, Pena Silva RA,
Kitazato KT, Hasan DM, Kanematsu Y, Nagahiro S,
Hashimoto T. Estrogen protects against intracranial
aneurysm rupture in ovariectomized mice.
Hypertension. 2014 Jun;63(6):1339-44.
Takayanagi T, Crawford KJ, Kobayashi T,
Obama T, Tsuji T, Elliott KJ, Hashimoto T, Rizzo V,
Eguchi S. Caveolin 1 is critical for abdominal aortic
aneurysm formation induced by angiotensin II
and inhibition of lysyl oxidase. Clin Sci (Lond).
2014 Jun;126(11):785-94.
Talke PO, Sharma D, Heyer EJ, Bergese SD,
Blackham KA, Stevens RD. Society for
Neuroscience in Anesthesiology and Critical Care
Expert consensus statement: anesthetic
management of endovascular treatment for acute
ischemic stroke*: endorsed by the Society of
NeuroInterventional Surgery and the Neurocritical
Care Society. J Neurosurg Anesthesiol. 2014
Apr;26(2):95-108.
Wada K, Makino H, Shimada K, Shikata F,
Kuwabara A, Hashimoto T. Translational research
using a mouse model of intracranial aneurysm.
Transl Stroke Res. 2014 Apr;5(2):248-51.
Ware LB, Landeck M, Koyama T, Zhao Z, Singer J,
Kern R, Neidlinger N, Nguyen J, Johnson E, Janz
DR, Bernard GR, Lee JW, Matthay MA; California
Transplant Donor Network. A randomized trial of the
effects of nebulized albuterol on pulmonary edema
in brain-dead organ donors. Am J Transplant.
2014 Mar;14(3):621-8.
Wilhelmsen K, Khakpour S, Tran A, Sheehan K,
Schumacher M, Xu F, Hellman J. The
Endocannabinoid/Endovanilloid N-Arachidonoyl
Dopamine (NADA) and Synthetic Cannabinoid
WIN55,212-2 Abate the Inflammatory Activation
of Human Endothelial Cells. J Biol Chem.
2014 May 9;289(19):13079-100.
Yeh DD, Tang JF, Chang Y. The use of furosemide in
critically ill trauma patients: A retrospective review.
J Emerg Trauma Shock. 2014 Apr;7(2):83-7.
Zhu YG, Feng XM, Abbott J, Fang XH, Hao Q,
Monsel A, Qu JM, Matthay MA, Lee JW.
Human mesenchymal stem cell microvesicles for
treatment of Escherichia coli endotoxin-induced
acute lung injury in mice. Stem Cells. 2014
Jan;32(1):116-25.
Active Research Grants
Jon Matthew Aldrich
Catherine Chen
Principal Investigator
UC Office of the President
CHQI/QERM, Individual Grant,
1/1/2014–12/31/2015
Advanced Resuscitation
Training (ART)
$113,599
Foundation for Anesthesia
Education and Research,
Research Career Award,
7/1/2013–6/30/2015
Roland Bainton
Unnecessary Preoperative
Testing in Medicare Patients
Undergoing Cataract Surgery
$75,000
Lee-lynn Chen
Anesthesia Dept, Individual
Grant, 7/1/2014–6/30/2015
Anesthesia Department
Research Award
$70,800
NIH/NIEHS, Individual Grant,
5/25/2012–4/30/2015
Mt. Zion Health Fund, Individual
Grant, 4/1/2014–6/30/2015
Implementation Barriers to
the Colorectal ERAS
Pathways at Mount Zion
$30,000
A platform for rapid
characterization of
metabolic disrupters in
whole animals
$420,240
Helene Choquet
Contribution of
Cardiovascular Risk Factors
and Inflammation to Familial
CCM1 Disease Severity
$94,000
NIH/NINDS, Individual Grant,
2/1/2013–1/31/2015
Discovering fundamental
metabolic control processes
of the blood brain barrier
$430,002
Philip Bickler
Various Industry Sponsors,
Clinical Trial, 7/1/2013–Ongoing
Accuracy of pulse oximeters
with profound hypoxia
$731,917
Coviden, Contract,
1/21/2014–4/4/2015
Controlled Desaturation for
Cerebral Oximetry
$164,064.02
Marek Brzezinski
Alzheimer’s Drug Discovery
Foundation, Individual Grant,
10/1/2011–5/31/2015
Effects of brain beta amyloid
on postoperative cognition
$300,000
Grant, 7/1/2014–6/30/2015
Research Award
$70,800
American Heart Association,
Fellowship,
7/1/2014–6/30/2016
Jeffrey Ghassemi
Grant, 7/1/2014–6/30/2015
Clinical Research Award
$19,994
Michael Gropper
Johns Hopkins University,
Subcontract-Research,
10/1/2012–9/30/2014
Acute Care/ICU Multi-Center
Feasibility Study
$250,000
Gordon and Betty Moore
6/1/2013–9/30/2014
Project EMERGE Planning
Grant at UCSF
$1,397,844
10/1/2014–9/30/2015
Implementation Grant
for EMERGE at
University of California,
San Francisco
$4,000,000
Fellowship Grant,
1/1/2014–12/31/2014
2014 Medical Student
Anesthesia Research
Fellowship Program
$6,200
Zhonghui Guan
NIH/NINDS, Research Career
Award, 9/30/2012–8/31/2017
Epigenetic regulation in
neuropathic pain
$947,160
Tomoki Hashimoto
3/15/2011–2/29/2016
Intracranial aneurysm
pathogenesis–roles of
vascular remodeling and
inflammation
$1,674,637
Grant, 7/1/2014–6/30/2015
Research Award
$100,000
9/1/2013–5/31/2018
UCSF REAC, Individual Grant,
7/1/2013–6/30/2015
Cannabinoid Receptor
Modulation of the
Endothelial Toll-like
Receptor-Dependent
Inflammatory Response
$30,000
Jan Hirsch
Richard Fidler
VA Office of Academic Affairs,
Fellowship, 7/1/2013–Ongoing
VA Advanced
Fellowship Program
in Simulation
$300,000
Irfan Kathiriya
Grant, 7/1/2014–6/30/2015
Research Award
$70,800
7/1/2013–6/30/2015
Gene regulation during
cardiac differentiation
$175,000
Helen Kim
7/1/2013–6/30/2018
Predictors of spontaneous
cerebral AVM hemorrhage
$2,335,649
Jens Krombach
The Role of Mast Cells in
the Pathophysiology of
Intracranial Aneurysm
$1,726,306
Judith Hellman
Development and
Implementation of a
Comprehensive
Anesthesia Checklist
App for Routine and
Emergency Procedures
$111,401
Grant, 7/1/2014–6/30/2015
Research Award
$100,000
GBMF Libretto
Consortium–UCSF
$305,000
Program Director
2/1/2014–1/31/2015
Prescription Loss Prevention
Program, Individual Grant,
7/1/2013–6/30/2015
NIH/NIGMS, Training Grant,
7/1/2012–6/30/2017
Comprehensive Anesthesia
Research Training
$1,079,916
Philip Kurien
Grant, 7/1/2014–6/30/2015
Research Award
$37,400
Michael Lawton
Program Director
NIH/NINDS, Multicenter Project
Grant, 9/30/2009–6/30/2015
Brain Vascular Malformation
Consortium: Predictors of
Clinical Course
$6,036,945
Chanhung Lee
Grant, 7/1/2014–6/30/2015
Research Award
$3,300
Jae-Woo Lee
NIH/NHLBI, Individual Grant,
5/1/2012–4/30/2017
Human mesenchymal stem
cell microvesicles for the
treatment of acute lung
injury
$1,904,985
Grant, 7/1/2014–6/30/2015
Research Award
$100,000
UCSF Academic Senate,
Individual Grant,
2/1/2014–1/31/2015
Therapeutic Use of
Microvesicles for Breast
Cancer with Lung
Metastases
$30,000
Susan M. Lee
Grant, 7/1/2014–6/30/2015
Research Award
$18,569
Jacqueline Leung
Jennifer Lucero
Mervyn Maze
Jeffrey Sall
Steven Takemoto
Pathophysiology of
postoperative delirium in
older patients
$2,067,530
Research Award
$20,520
Providing good sleep for
ICU sedation
$232,987
Research Award
$70,576
James Marks
Volatile anesthetic alteration
of neural precursor cell
cycle and fate decisions
$478,440
NIH/NIA, Individual Grant,
9/15/2009–7/31/2015
CHQI/QERM, Individual Grant,
7/1/2013–6/30/2015
Project to Eradicate PostOperative Delirium in highrisk patients (PEPOD)
$167,000
Bin Liu
NIH/NCI, Individual Grant,
3/1/2010–12/31/2014
Grant, 7/1/2014–6/30/2015
UC Irvine, SubcontractResearch,
5/1/2009–4/30/2015
Evolving Diagnostic
Antibodies for Botulinum
Neurotoxins
$1,294,897
Xoma Corporation,
12/20/2011–7/31/2015
Masimo Corporation, Clinical
Trial, 6/1/2011–12/31/2014
Trial, 6/1/2011–12/31/2014
Evaluation of sleep:
PSG vs. Sedline
$168,500
NIH/NIGMS, Individual Grant,
9/1/2013–8/31/2017
Inflammation resolving
mechanism dysregulation in
postoperative cognitive decline
$1,212,399
Identifying antigens bound
by novel scFvs targeting all
subtypes of mesothelioma
$1,249,880
Development of
Therapeutics for Biodefense
$1,668,357
Mervyn Maze
Jacqueline Leung
NIH/NIAID, Individual Grant,
2/1/2013–1/31/2018
Trial, 6/1/2011–12/31/2014
6/8/2011–3/31/2015
Mapping a clinically
significant internalizing
tumor epitope space
$904,004
8/6/2012–7/31/2017
Internalizing human
antibody-targeted nanosized
siRNA therapeutics
$1,616,928
UCSF Stephen and Nancy
Grand Multiple Myeloma
Translational Initiative,
Individual Grant,
4/15/2013–4/30/2015
Generation of therapeutic
antibodies for serotype F
botulism
$5,448,316
CA Dept of Public Health,
Unfunded Research
Collaboration,
10/15/2012–10/14/2016
Identification of monoclonal
antibody combinations that
neutralize variant botulinum
neurotoxins
Merrimack Pharmaceuticals,
Unfunded Research
Collaboration,
3/1/2010–2/28/2016
Novel human antibody drug
conjugates targeting
multiple myeloma
$60,000
Bispecific antibodies
targeting basal breast
cancers
DNA 2.0 Inc., Unfunded
Research Collaboration,
2/5/2013–2/5/2018
UCSF Prostate Cancer
Research Program, Individual
Grant, 1/1/2014–12/31/2014
Novel Antibody Drug
Conjugates Targeting
Prostate Cancer Bone
Metastasis
$50,000
Martin London
Grant, 7/1/2014–6/30/2015
Research Award
$9,350
Improve the CHO expression
of a scFv fragment that is
moving towards the clinic by
optimizing the DNA
sequence of the scFv and/or
leader sequence
NIH/NIAID, Individual Grant,
6/20/2014–5/31/2017
Trispecific Monoclonal
Antibody for Botulinum
Neurotoxin Intoxication
Therapy
$1,336,571
NIH/NIGMS, Research Career
Award, 2/1/2010–1/31/2015
SmartTots, Individual Grant,
8/1/2013–7/31/2015
Recognition memory
following early
childhood anesthesia
$200,000
Grant, 7/1/2014–6/30/2015
Pekka Talke
Masimo Corporation, ContractClinical Services,
8/14/2013–12/31/2014
Mark Schumacher
Noninvasive hemoglobin
(SpHb) measured with Pulse
CO-Oximetry technology
$42,266
Susana Vacas
Grant, 7/1/2014–6/30/2015
Research Award
$70,800
Society of Anesthesia and
Sleep Medicine, Individual
Grant, 11/1/2013–10/31/2014
Obstructive Sleep Apnea and
Postoperative Cognitive Decline
$10,000
David Shimabukuro
Michael Gropper
Detecting sleep hygiene with
SEDline monitor
$191,040
Co-Principal Investigator
Vanderbilt University,
8/15/2012–6/30/2017
Claus Niemann
The MENDS II Study
$243,048.07
Improved Fluid Management
in Abdominal Surgery
$23,000
HRSA, Individual Grant,
9/1/2011–8/31/2015
The effect of therapeutic
hypothermia on deceased
donor
$2,001,108
James Sonner
Grant, 7/1/2014–6/30/2015
Jonathan Pan
Research Award
$91,958
Hua Su
7/1/2014–6/30/2016
Dexmedetomidine Renders
Neuroprotection via
Modulation of Systemic and
Local Immune Responses
Following Rodent Spinal
Cord Injury
$175,000
Arun Prakash Budde
Grant, 7/1/2014–6/30/2015
Research Award
$70,800
1/1/2014–12/31/2018
Hemodynamics of Cerebral
Arteriovenous Malformation
$1,562,940
4/15/2014–3/31/2016
Soluble VEGF Receptor
Therapy for Brain
Arteriovenous Malformation
$790,313
UCSF REAC, Individual Grant,
1/1/2014–12/31/2014
Mouse AVM Models for
Mechanistic Study and
Therapeutic Test
$30,000
C. Spencer Yost
Mt. Zion Health Fund, Individual
Grant, 4/1/2014–6/30/2015
Xiaobing Yu
7/1/2013–6/30/2015
Treating neuropathic pain
with spinal cord transplants
of genetically modified
human pluripotent stem
cell-derived GABAergic
inhibitory neurons
$175,000
Grant, 7/1/2013–6/30/2015
Research Award
$50,000
Eunice Zhou
Merrimack Pharmaceuticals,
Contract,
1/10/2013–12/31/2014
Development of human
mAbs to CXCR1 and CXCR2
$199,755
Honors, Awards & News
Faculty Honors, Awards
and Appointments
Matt Aldrich, MD
Wei Zhou, MD, PhD
CAMPUS AWARD
Medical Student Teaching Award
Interim Director, Critical Care Medicine
Trainee Honors, Awards
and Appointments
Claire Brett, MD
Erika Brinson, MD
CAMPUS AWARD
CAMPUS AWARD
Career Achievement Award
UCSF Graduate Medical Education
CAMPUS APPOINTMENT
Emily Chanan, MD
Kristine Breyer, MD
CAMPUS AWARD
CAMPUS AWARD
The UCSF Haile T. Debas Academy of
Medical Educators
Excellence in Teaching Award, 2014
Catherine Chen, MD
Christopher Choukalas, MD
CAMPUS AWARD
Medical Educators
Adrian Gelb, MB, ChB
EXTRAMURAL HONOR
Inaugural Lecturer, William Young
Memorial Lecture, EuroNeuro 2014
CAMPUS APPOINTMENT
Interim Chair, Department of Anesthesia
and Perioperative Care
Mark Rollins, MD, PhD
EXTRAMURAL AWARD
Society of Obstetric Anesthesia and
Perinatology, Teacher of the Year, 2013
CAMPUS AWARDS
Ronald Miller Award for Excellence in
Resident Mentoring, Department of
Anesthesia and Perioperative Care, 2013
Clinical Faculty Teaching Award, School
of Medicine, 2014
CAMPUS APPOINTMENT
Sol M. Shnider Endowed Chair for
Anesthesia Education, 2014
Karin Sinavsky, MD
CAMPUS AWARD
EXTRAMURAL AWARD
1st Place and Best in Category, Poster
Presentation in System and Practice
Based Projects
Prevalence And Cost To Medicare Of
Unnecessary Preoperative Medical
Testing Prior To Cataract Surgery.
52nd Annual Western Anesthesia
Residents’ Conference, May 2-4, 2014
Bradley Cohn, MD
CAMPUS AWARD
Exceptional Physician Award, 2014
Shin-e Lin, MD
CAMPUS AWARD
EXTRAMURAL AWARD
Presentation in Pediatric Anesthesia
The Role Of Intraoperative IV
Acetaminophen In Postoperative Pain
Management In Patients Undergoing
Cleft Lip Surgery.
Maxwell Thompson, MD
CAMPUS AWARD
Jed Wolpaw, MD
CAMPUS AWARD
EXTRAMURAL AWARD
1st Place, Best Oral Presentation, Saturday
The Usefulness of a Cognitive Screening
Tool in Predicting Postoperative Delirium
1st Place and Best in Category,
Poster Presentation in Acute Pain and
Regional Anesthesia
Subdural Spread of Local Anesthetic
Mimicking Cerebrovascular Accident.
Janice Man, MD
EXTRAMURAL AWARD
Presentation in Intensive Care
Higher MELD scores are associated with
higher intraoperative lactate levels in
patients with end-stage liver disease
undergoing orthotopic liver or combined
liver and kidney transplants.
Paul Riegelhaupt, MD, PhD
Kristina Sullivan, MD
1st Place, Best Oral Presentation, Sunday
TREK1 background potassium channels:
Temperature sensors, stretch receptors,
anesthetic targets! Alanine scanning muta-
Medical Educators, 2014
Jina Sinskey, MD
EXTRAMURAL AWARD
Medical Educators
CAMPUS APPOINTMENT
genesis studies of TREK1 provide clues
to understand the structural basis for the
behavior of this molecular signal integrator.
EXTRAMURAL AWARD
Faculty Retirements
Claire Brett and Chico Cauldwell will
both be retiring from the Department
of Anesthesia and Perioperative Care.
They each have had long, distinguished
careers in pediatric anesthesia, and
have made extraordinary contributions
to the specialty and to the Department
in all of our missions. Fortunately,
both will be a regular presence in the
Department as recall faculty members,
continuing as outstanding clinicians,
educators and mentors.
AnesthesiaNews
2014 | Vol. 12
Upcoming
Events
The Changing Practice of Anesthesia
September 18 – September 21, 2014
UCSF Department of Anesthesia and Perioperative Care Simulation Center
COURSE CHAIRS
Christina Inglis-Arkell, MD
Assistant Professor, Department of Anesthesia and Perioperative Care
Merlin Larson, MD
Professor Emeritus, Department of Anesthesia and Perioperative Care
John Turnbull, MD
Assistant Professor, Department of Anesthesia and Perioperative Care
C. Spencer Yost, MD
Professor, Department of Anesthesia and Perioperative Care
For more information or to register, please visit:
http://www.ucsfcme.com/2015/MAN15001/info.html
Anesthesia Research Day
Friday, September 26, 2014
UCSF Millberry Union Conference Center
Golden Gate and City Lights Rooms
Maintenance of Certification in
Anesthesiology (MOCA®)
UCSF Department of Anesthesia and Perioperative Care Simulation Center
COURSE CHAIR
Adam Collins, MD
Professor of Anesthesia, Director,
UCSF Anesthesia Simulation Center
UPCOMING COURSE DATES (Friday):
Sept. 12, Nov. 7, December 5, 2014
Feb. 27, Mar. 13, May 22, 2015
For more information or to register, please visit: http://tinyurl.com/mocasim

2014 Volume 12 - UCSF Department of Anesthesia and

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