anesthesianews · at new cancer, women’s and children’s hospitals, design features incorporate...

Seeking More Efficient, More Patient-Centered Perioperative Care

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AnesthesiaNewsNewsletter of the Department of Anesthesia and Perioperative Care | University of California, San Francisco

2014 | Vol. 12

For 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 ManagementDue 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

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Renee Navarro on Diversity | Pathway to Scientific Independence | Change at SFGH | Clerkships

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.

Michael Gropper, MD, PhD Professor and Interim Chair

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 under-going 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

AnesthesiaNews FROM THE INTERIM CHAIR

A Time of Change

UCSF Department of Anesthesia and Perioperative Care | Anesthesia News | 2014 | 2

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

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

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

OR, we can often improve post-operative recovery and short circuit long-term chronic pain.”

Enhanced Recovery 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, ApproachesIn 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.”

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Perioperative Care

“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)

Inpatient room mockup for the new UCSF Medical Center at Mission Bay, opening in 2015


How and why should we create a more diverse faculty, residency and staff in the Department of Anesthesia and Perioperative Care?

ASK THE EXPERT

Renee Navarro, PharmD, MD, UCSF Vice Chancellor Diversity and Outreach

The 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 team-based. 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

state and caring for them on a minute- to-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 BiasIt’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.

OutreachThe 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.

SupportGraduate 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.

AcountabilityWe are working to establish accounta-bility 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 multi-dimensional 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


Anesthesia 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

EDUCATION

Maintaining Top Clerkship Demands Innovationreceive. They are typically paired one- on-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 InnovationThe 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.


The 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 that allows our most

promising researchers to be successful and our department to grow.”

How the Program WorksThe 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

RESEARCH

Paving a Pathway to Scientific Independence

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 SupportBy 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

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 MentoringIn 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 ContinuesGiven 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.”

Claire Harmon (right), Research Admini-stration Manager in the Department of Anesthesia, guides a young researcher through the grant application process.

Judith Hellman


San 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 patient-centered 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

FACULTY PROFILE

Sue Carlisle Leads Physicians, Researchers Through Tragedy, Reform and Rebuild

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 BeyondIn 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 HospitalThe 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,

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 ReformThe 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.

Sue Carlisle

Aerial view of the new hospital construction


Laura Lang, MDHealth Sciences Clinical InstructorJoined Faculty July 2014MEDICAL SCHOOLThe University of Chicago, Pritzker School of MedicineINTERNSHIPSurgery: UCSFRESIDENCYAnsthesiology: UCSF

Vincent Lew, MDJoined Faculty July 2014Health Sciences Assistant Clinical ProfessorMEDICAL SCHOOLOregon Health and Science UniversityINTERNSHIPInternal Medicine: California Pacific Medical CenterRESIDENCYAnesthesiology: UCSFFELLOWSHIPCritical Care Medicine: UCSF

L. Stephen Long, MDHealth Sciences Assistant Clinical ProfessorJoined Faculty July 2014MEDICAL SCHOOLGeorgetown University School of MedicineINTERNSHIPInternal Medicine: Kaiser Permanente Oakland Medical CenterRESIDENCYAnesthesiology: UCSFFELLOWSHIPPediatric Anesthesia: UCSF

Jonathan Pan, MD, PhDAssistant Professor in ResidenceJoined Faculty August 2012ADVANCED DEGREEPhD, Neuroscience: Rutgers UniversityMEDICAL SCHOOLFudan University Medical CenterINTERNSHIPTransitional Medicine: Mercy Catholic Medical CenterRESIDENCYAnesthesiology: University of Pennsylvania

Career Faculty

Kerry Apostolo, MDHealth Sciences Clinical InstructorJoined Faculty July 2014MEDICAL SCHOOLNew York Medical CollegeINTERNSHIPMedicine: Kaiser Permanente Oakland Medical CenterRESIDENCYAnesthesiology: UCSF

Jeanie Bhuller, DOHealth Sciences Assistant Clinical ProfessorJoined Faculty June 2014MEDICAL SCHOOLTouro University College of Osteophathic MedicineINTERNSHIPInternal MedicineAlameda County Medical CenterRESIDENCYAnesthesiology: Georgetown University HospitalFELLOWSHIPPediatric Anesthesiology: UCSFPREVIOUS EMPLOYMENTAnesthesiologistMedical Anesthesia Consultants

Tony Chang, MDHealth Sciences Clinical InstructorJoined Faculty August 2014MEDICAL SCHOOLUniversity of South AlabamaINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSF

Anne Donovan, MDHealth Sciences Assistant Clinical ProfessorJoined Faculty July 2014MEDICAL SCHOOLUniversity of Iowa Carver College of MedicineINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSFFELLOWSHIPCritical Care Medicine: UCSF

Jeffrey Ghassemi, MD, MPHHealth Sciences Assistant Clinical ProfessorJoined Faculty July 2014ADVANCED DEGREEMPH, Health Services: UCIMEDICAL SCHOOLUniversity of California, IrvineINTERNSHIPMedicine: UCLARESIDENCYAnesthesiology: UCLA; UCSFFELLOWSHIPRegional Anesthesia: UCSF

Melissa Haehn, MDHealth Sciences Clinical InstructorJoined Faculty August 2014MEDICAL SCHOOLUniversity of Minnesota Twin Cities Medical SchoolINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSF

Kate Kronish, MDHealth Sciences Clinical Instructor/ Liver Transplant FellowJoined Faculty August 2014MEDICAL SCHOOLUniversity of Pennsylvania School of MedicineINTERNSHIPMedicine: University of PennsylvaniaRESIDENCIESNeurology: University of PennsylvaniaAnesthesiology: University of Pennsylvania

Philip Kurien, MDAssistant Professor in ResidenceJoined Faculty August 2012MEDICAL SCHOOLStanford University School of MedicineINTERNSHIPTransitional: Santa Clara Valley Medical CenterRESIDENCYAnesthesiology: UCSFPREVIOUS EMPLOYMENTClinical Instructor and Postdoctoral Scholar: UCSF


NewFaculty

Andrew Schober, MDHealth Sciences Assistant ProfessorJoined Faculty July 2014MEDICAL SCHOOLNew York University School of MedicineINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSFFELLOWSHIPCritical Care Medicine: UCSF

Scott Schulman, MD, MHSClinical ProfessorJoined Faculty August 2014ADVANCED DEGREEMHS, Clinical Research Training Program: Duke UniversityMEDICAL SCHOOLGeorge Washington University School of MedicineINTERNSHIPPediatrics: UCLARESIDENCIESPediatrics: UCLAAnesthesiology: UCLAPREVIOUS EMPLOYMENTProfessor of Anesthesiology and Pediatrics: Duke University Medical Center

Stephen Weston, MDClinical Instructor/Liver Transplant FellowJoined Faculty July 2014MEDICAL SCHOOLUniversity of California, San DiegoINTERNSHIPMedicine: UCSDRESIDENCYAnesthesiology: UCSF

Edward Yap, MDHealth Sciences Clinical Instructor/Regional Anesthesia fellowJoined Faculty July 2014MEDICAL SCHOOLNew York Medical CollegeINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSF

POSTDOCTORAL FELLOWSHIPUniversity of PennsylvaniaPREVIOUS EMPLOYMENTClinical Instructor, NIH T32: UCSF

Krishna Parekh, MD Health Sciences Assistant Clinical ProfessorJoined Faculty August 2014MEDICAL SCHOOLDuke UniversityINTERNSHIPInternal Medicine: Thomas Jefferson University HospitalRESIDENCYAnesthesiology: Brigham and Women’s HospitalFELLOWSHIPCritical Care Medicine: UCSF

Nichlesh Patel, MDHealth Sciences Assistant Clinical ProfessorJoined Faculty August 2014MEDICAL SCHOOLSUNY Downstate Medical CenterINTERNSHIPMedicine: Lenox Hill HospitalRESIDENCYAnesthesiology: UCSFFELLOWSHIPCardiothoracic Anesthesia: The Texas Heart Institute

Gabriel Sarah, MDHealth Sciences Assistant Clinical ProfessorJoined Faculty August 2014MEDICAL SCHOOLUniversity of ArizonaRESIDENCYAnesthesiology:The University of Miami/Jackson Memorial HospitalFELLOWSHIPPediatric Anesthesiology:The University of Miami

Wei Zhou, MD, PhDHealth Sciences Clinical Instructor/ T32 Postdoctoral TraineeJoined Faculty July 2014ADVANCED DEGREEPhD, Neuroscience: UCSDMEDICAL SCHOOLPeking Union Medical College, Beijing, ChinaINTERNSHIPAnesthesiology: UCSFRESIDENCYAnesthesiology: UCSF

Visiting Faculty

Jouko Jalonen, MDVisiting ProfessorJoined Faculty August 2014MEDICAL SCHOOL:University of Turku Medical School, Turku, FinlandRESIDENCY:Anesthesiology (General, Cardiac, Cardiothoracic): Turku University Central Hospital, Karolinska Hospital, Stockholm, SwedenPREVIOUS EMPLOYMENT:Professor, Department of Anaesthesiology and Intensive Care Medicine, University of Turku

Thorsten Smul, MDVisiting Assistant ProfessorJoined Faculty August 2014MEDICAL SCHOOLMedical School of Julius Maximilians University, Würzburg, GermanyRESIDENCYAnesthesiology and Critical Care: Julius Maximilians UniversityWürzburg, GermanyRESEARCH FELLOWSHIPMyocardial Reperfusion Injury: Julius Maximilians UniversityPREVIOUS EMPLOYMENTDirector of Liver Transplantation Anesthesia Section, Department of General Surgery, Julius Maximilians University, Würzburg, Germany


New ResidentsCLASS OF 2017

Ashish Agrawal

Gina Bane

Marc Buren

Matthew Careskey

Josemine Carey

Denise Chang

Monica Chen

Jeffrey Kim

Bradley Lee

Roger Lee

Masood Memarzadeh

Mastoora Nasiri

Elaine Nguyen

Megha Parekh

Gregory Chinn

Lusine Danakian

Iman Hadaya

Mellody Hayes

Marisa Hernandez-Morgan

Jordan Higgins

Nicole Jackman

Joseph Reza

Sara Richards

Kyle Sanders

Paul Su

Allison Thoeny



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, patho-genesis, 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.

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.

Peer Reviewed PublicationsHetts 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 Angio-architecture 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


Jon Matthew AldrichPrincipal InvestigatorUC Office of the President CHQI/QERM, Individual Grant, 1/1/2014–12/31/2015Advanced Resuscitation Training (ART) $113,599

Roland BaintonPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,800

Principal InvestigatorNIH/NIEHS, Individual Grant, 5/25/2012–4/30/2015A platform for rapid characterization of metabolic disrupters in whole animals$420,240

Principal InvestigatorNIH/NINDS, Individual Grant, 2/1/2013–1/31/2015Discovering fundamental metabolic control processes of the blood brain barrier$430,002

Philip BicklerPrincipal InvestigatorVarious Industry Sponsors, Clinical Trial, 7/1/2013–OngoingAccuracy of pulse oximeters with profound hypoxia$731,917

Principal InvestigatorCoviden, Contract, 1/21/2014–4/4/2015Controlled Desaturation for Cerebral Oximetry$164,064.02

Marek BrzezinskiPrincipal InvestigatorAlzheimer’s Drug Discovery Foundation, Individual Grant, 10/1/2011–5/31/2015Effects of brain beta amyloid on postoperative cognition$300,000

Principal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,800

Catherine ChenPrincipal InvestigatorFoundation for Anesthesia Education and Research, Research Career Award, 7/1/2013–6/30/2015Unnecessary Preoperative Testing in Medicare Patients Undergoing Cataract Surgery $75,000

Lee-lynn ChenPrincipal InvestigatorMt. Zion Health Fund, Individual Grant, 4/1/2014–6/30/2015Implementation Barriers to the Colorectal ERAS Pathways at Mount Zion$30,000

Helene ChoquetPrincipal InvestigatorAmerican Heart Association, Fellowship, 7/1/2014–6/30/2016Contribution of Cardiovascular Risk Factors and Inflammation to Familial CCM1 Disease Severity$94,000

Jeffrey GhassemiPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Clinical Research Award$19,994

Michael GropperPrincipal InvestigatorJohns Hopkins University, Subcontract-Research, 10/1/2012–9/30/2014Acute Care/ICU Multi-Center Feasibility Study $250,000

Principal InvestigatorGordon and Betty Moore Foundation, Individual Grant, 6/1/2013–9/30/2014Project EMERGE Planning Grant at UCSF $1,397,844

Principal InvestigatorGordon and Betty Moore Foundation, Individual Grant, 2/1/2014–1/31/2015GBMF Libretto Consortium–UCSF$305,000

Principal InvestigatorGordon and Betty Moore Foundation, Individual Grant, 10/1/2014–9/30/2015Implementation Grant for EMERGE at University of California, San Francisco$4,000,000

Principal InvestigatorFoundation for Anesthesia Education and Research, Fellowship Grant, 1/1/2014–12/31/20142014 Medical Student Anesthesia Research Fellowship Program$6,200

Zhonghui GuanPrincipal InvestigatorNIH/NINDS, Research Career Award, 9/30/2012–8/31/2017Epigenetic regulation in neuropathic pain$947,160

Tomoki HashimotoPrincipal InvestigatorNIH/NINDS, Individual Grant, 3/15/2011–2/29/2016Intracranial aneurysm pathogenesis–roles of vascular remodeling and inflammation$1,674,637


Principal InvestigatorNIH/NINDS, Individual Grant, 9/1/2013–5/31/2018The Role of Mast Cells in the Pathophysiology of Intracranial Aneurysm$1,726,306

Judith HellmanPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$100,000

Program DirectorNIH/NIGMS, Training Grant, 7/1/2012–6/30/2017Comprehensive Anesthesia Research Training$1,079,916

Principal InvestigatorUCSF REAC, Individual Grant, 7/1/2013–6/30/2015Cannabinoid Receptor Modulation of the Endothelial Toll-like Receptor-Dependent Inflammatory Response$30,000

Jan Hirsch Richard FidlerPrincipal InvestigatorVA Office of Academic Affairs, Fellowship, 7/1/2013–OngoingVA Advanced Fellowship Program in Simulation$300,000

Irfan KathiriyaPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,800

Principal InvestigatorFoundation for Anesthesia Education and Research, Research Career Award, 7/1/2013–6/30/2015Gene regulation during cardiac differentiation$175,000

Helen KimPrincipal InvestigatorNIH/NINDS, Individual Grant, 7/1/2013–6/30/2018Predictors of spontaneous cerebral AVM hemorrhage$2,335,649

Jens KrombachPrincipal InvestigatorUC Office of the President Prescription Loss Prevention Program, Individual Grant, 7/1/2013–6/30/2015Development and Implementation of a Comprehensive Anesthesia Checklist App for Routine and Emergency Procedures$111,401

Philip KurienPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$37,400

Michael Lawton Program DirectorNIH/NINDS, Multicenter Project Grant, 9/30/2009–6/30/2015Brain Vascular Malformation Consortium: Predictors of Clinical Course$6,036,945

Chanhung LeePrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$3,300

Jae-Woo LeePrincipal InvestigatorNIH/NHLBI, Individual Grant, 5/1/2012–4/30/2017Human mesenchymal stem cell microvesicles for the treatment of acute lung injury$1,904,985


Principal InvestigatorUCSF Academic Senate, Individual Grant, 2/1/2014–1/31/2015Therapeutic Use of Microvesicles for Breast Cancer with Lung Metastases$30,000

Susan M. LeePrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$18,569

Active Research Grants


Jacqueline LeungPrincipal InvestigatorNIH/NIA, Individual Grant, 9/15/2009–7/31/2015Pathophysiology of postoperative delirium in older patients$2,067,530

Principal InvestigatorUC Office of the President CHQI/QERM, Individual Grant, 7/1/2013–6/30/2015Project to Eradicate Post-Operative Delirium in high-risk patients (PEPOD)$167,000

Bin LiuPrincipal InvestigatorNIH/NCI, Individual Grant, 3/1/2010–12/31/2014Identifying antigens bound by novel scFvs targeting all subtypes of mesothelioma$1,249,880

Principal InvestigatorNIH/NCI, Individual Grant, 6/8/2011–3/31/2015Mapping a clinically significant internalizing tumor epitope space$904,004

Principal InvestigatorNIH/NCI, Individual Grant, 8/6/2012–7/31/2017Internalizing human antibody-targeted nanosized siRNA therapeutics$1,616,928

Principal InvestigatorUCSF Stephen and Nancy Grand Multiple Myeloma Translational Initiative, Individual Grant, 4/15/2013–4/30/2015Novel human antibody drug conjugates targeting multiple myeloma$60,000

Principal InvestigatorUCSF Prostate Cancer Research Program, Individual Grant, 1/1/2014–12/31/2014Novel Antibody Drug Conjugates Targeting Prostate Cancer Bone Metastasis$50,000

Martin LondonPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$9,350

Jennifer LuceroPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$20,520

James MarksPrincipal InvestigatorUC Irvine, Subcontract-Research, 5/1/2009–4/30/2015Evolving Diagnostic Antibodies for Botulinum Neurotoxins$1,294,897

Principal InvestigatorXoma Corporation, Subcontract-Research, 12/20/2011–7/31/2015Development of Therapeutics for Biodefense$1,668,357

Principal InvestigatorNIH/NIAID, Individual Grant, 2/1/2013–1/31/2018Generation of therapeutic antibodies for serotype F botulism$5,448,316

Principal InvestigatorCA Dept of Public Health, Unfunded Research Collaboration, 10/15/2012–10/14/2016Identification of monoclonal antibody combinations that neutralize variant botulinum neurotoxins

Principal InvestigatorMerrimack Pharmaceuticals, Unfunded Research Collaboration, 3/1/2010–2/28/2016Bispecific antibodies targeting basal breast cancers

Principal InvestigatorDNA 2.0 Inc., Unfunded Research Collaboration, 2/5/2013–2/5/2018Improve 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

Principal InvestigatorNIH/NIAID, Individual Grant, 6/20/2014–5/31/2017Trispecific Monoclonal Antibody for Botulinum Neurotoxin Intoxication Therapy$1,336,571

Mervyn MazePrincipal InvestigatorMasimo Corporation, Clinical Trial, 6/1/2011–12/31/2014Providing good sleep for ICU sedation$232,987

Principal InvestigatorMasimo Corporation, Clinical Trial, 6/1/2011–12/31/2014Evaluation of sleep: PSG vs. Sedline$168,500

Principal InvestigatorNIH/NIGMS, Individual Grant, 9/1/2013–8/31/2017Inflammation resolving mechanism dysregulation in postoperative cognitive decline$1,212,399

Mervyn Maze Jacqueline LeungPrincipal InvestigatorMasimo Corporation, Clinical Trial, 6/1/2011–12/31/2014Detecting sleep hygiene with SEDline monitor$191,040

Claus NiemannPrincipal InvestigatorHRSA, Individual Grant, 9/1/2011–8/31/2015The effect of therapeutic hypothermia on deceased donor$2,001,108

Jonathan PanPrincipal InvestigatorFoundation for Anesthesia Education and Research, Research Career Award, 7/1/2014–6/30/2016Dexmedetomidine Renders Neuroprotection via Modulation of Systemic and Local Immune Responses Following Rodent Spinal Cord Injury$175,000

Arun Prakash BuddePrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,800

Jeffrey SallPrincipal InvestigatorNIH/NIGMS, Research Career Award, 2/1/2010–1/31/2015Volatile anesthetic alteration of neural precursor cell cycle and fate decisions$478,440

Principal InvestigatorSmartTots, Individual Grant, 8/1/2013–7/31/2015Recognition memory following early childhood anesthesia$200,000

Mark SchumacherPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,800

David Shimabukuro Michael GropperCo-Principal InvestigatorVanderbilt University, Subcontract-Research, 8/15/2012–6/30/2017The MENDS II Study$243,048.07

James SonnerPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$91,958

Hua SuPrincipal InvestigatorNIH/NINDS, Individual Grant, 1/1/2014–12/31/2018Hemodynamics of Cerebral Arteriovenous Malformation$1,562,940

Principal InvestigatorNIH/NINDS, Individual Grant, 4/15/2014–3/31/2016Soluble VEGF Receptor Therapy for Brain Arteriovenous Malformation$790,313

Principal InvestigatorUCSF REAC, Individual Grant, 1/1/2014–12/31/2014Mouse AVM Models for Mechanistic Study and Therapeutic Test$30,000

Steven TakemotoPrincipal InvestigatorAnesthesia Dept, Individual Grant, 7/1/2014–6/30/2015Anesthesia Department Research Award$70,576

Pekka TalkePrincipal InvestigatorMasimo Corporation, Contract-Clinical Services, 8/14/2013–12/31/2014Noninvasive hemoglobin (SpHb) measured with Pulse CO-Oximetry technology$42,266

Susana VacasPrincipal InvestigatorSociety of Anesthesia and Sleep Medicine, Individual Grant, 11/1/2013–10/31/2014Obstructive Sleep Apnea and Postoperative Cognitive Decline$10,000

C. Spencer YostPrincipal InvestigatorMt. Zion Health Fund, Individual Grant, 4/1/2014–6/30/2015Improved Fluid Management in Abdominal Surgery$23,000

Xiaobing YuPrincipal InvestigatorFoundation for Anesthesia Education and Research, Research Career Award, 7/1/2013–6/30/2015Treating neuropathic pain with spinal cord transplants of genetically modified human pluripotent stem cell-derived GABAergic inhibitory neurons$175,000


Eunice ZhouPrincipal InvestigatorMerrimack Pharmaceuticals, Contract, 1/10/2013–12/31/2014Development of human mAbs to CXCR1 and CXCR2$199,755


Honors, Awards & NewsFaculty Honors, Awards and Appointments

Matt Aldrich, MDCAMPUS APPOINTMENTInterim Director, Critical Care Medicine

Claire Brett, MDCAMPUS AWARDCareer Achievement AwardUCSF Graduate Medical Education

Kristine Breyer, MDCAMPUS AWARDThe UCSF Haile T. Debas Academy of Medical EducatorsExcellence in Teaching Award, 2014

Christopher Choukalas, MDCAMPUS AWARDThe UCSF Haile T. Debas Academy of Medical EducatorsExcellence in Teaching Award, 2014

Adrian Gelb, MB, ChBEXTRAMURAL HONORInaugural Lecturer, William Young Memorial Lecture, EuroNeuro 2014

Michael Gropper, MD, PhDCAMPUS APPOINTMENTInterim Chair, Department of Anesthesia and Perioperative Care

Mark Rollins, MD, PhDEXTRAMURAL AWARDSociety of Obstetric Anesthesia and Perinatology, Teacher of the Year, 2013CAMPUS AWARDSRonald Miller Award for Excellence in Resident Mentoring, Department of Anesthesia and Perioperative Care, 2013Clinical Faculty Teaching Award, School of Medicine, 2014CAMPUS APPOINTMENTSol M. Shnider Endowed Chair for Anesthesia Education, 2014

Karin Sinavsky, MDCAMPUS AWARDThe UCSF Haile T. Debas Academy of Medical EducatorsExcellence in Teaching Award, 2014

Kristina Sullivan, MDCAMPUS APPOINTMENTThe UCSF Haile T. Debas Academy of Medical Educators, 2014

Wei Zhou, MD, PhDCAMPUS AWARDMedical Student Teaching Award

Trainee Honors, Awards and Appointments

Erika Brinson, MDCAMPUS AWARDMedical Student Teaching Award

Emily Chanan, MDCAMPUS AWARDMedical Student Teaching Award

Catherine Chen, MDEXTRAMURAL AWARD1st Place and Best in Category, Poster Presentation in System and Practice Based ProjectsPrevalence 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, MDCAMPUS AWARDExceptional Physician Award, 2014

Shin-e Lin, MDEXTRAMURAL AWARD1st Place and Best in Category, Poster Presentation in Acute Pain and Regional AnesthesiaSubdural Spread of Local Anesthetic Mimicking Cerebrovascular Accident.52nd Annual Western Anesthesia Residents’ Conference, May 2-4, 2014

Janice Man, MDEXTRAMURAL AWARD1st Place and Best in Category, Poster Presentation in Intensive CareHigher 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.52nd Annual Western Anesthesia Residents’ Conference, May 2-4, 2014

Paul Riegelhaupt, MD, PhDEXTRAMURAL AWARD1st Place, Best Oral Presentation, SundayTREK1 background potassium channels: Temperature sensors, stretch receptors, anesthetic targets! Alanine scanning muta-

genesis studies of TREK1 provide clues to understand the structural basis for the behavior of this molecular signal integrator.52nd Annual Western Anesthesia Residents’ Conference, May 2-4, 2014

Jina Sinskey, MDCAMPUS AWARDMedical Student Teaching AwardEXTRAMURAL AWARD1st Place and Best in Category, Poster Presentation in Pediatric AnesthesiaThe Role Of Intraoperative IV Acetaminophen In Postoperative Pain Management In Patients Undergoing Cleft Lip Surgery.52nd Annual Western Anesthesia Residents’ Conference, May 2-4, 2014

Maxwell Thompson, MDCAMPUS AWARDMedical Student Teaching Award

Jed Wolpaw, MDCAMPUS AWARDMedical Student Teaching AwardEXTRAMURAL AWARD1st Place, Best Oral Presentation, SaturdayThe Usefulness of a Cognitive Screening Tool in Predicting Postoperative Delirium52nd Annual Western Anesthesia Residents’ Conference, May 2-4, 2014

Faculty RetirementsClaire 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.

AnesthesiaNews2014 | Vol. 12

Upcoming Events

The Changing Practice of AnesthesiaSeptember 18 – September 21, 2014UCSF Department of Anesthesia and Perioperative Care Simulation Center

COURSE CHAIRSChristina Inglis-Arkell, MDAssistant Professor, Department of Anesthesia and Perioperative Care

Merlin Larson, MDProfessor Emeritus, Department of Anesthesia and Perioperative Care

John Turnbull, MDAssistant Professor, Department of Anesthesia and Perioperative Care

C. Spencer Yost, MDProfessor, Department of Anesthesia and Perioperative Care

For more information or to register, please visit: http://www.ucsfcme.com/2015/MAN15001/info.html

Anesthesia Research DayFriday, September 26, 2014UCSF Millberry Union Conference CenterGolden Gate and City Lights Rooms

Maintenance of Certification in Anesthesiology (MOCA®)UCSF Department of Anesthesia and Perioperative Care Simulation Center

COURSE CHAIR

Adam Collins, MDProfessor of Anesthesia, Director, UCSF Anesthesia Simulation Center

UPCOMING COURSE DATES (Friday):Sept. 12, Nov. 7, December 5, 2014Feb. 27, Mar. 13, May 22, 2015

For more information or to register, please visit: http://tinyurl.com/mocasim

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