Faculty Concerns About the Activity-Based Workplace
Planned for the Mission Bay Academic Building and Beyond

UCSF faculty members are concerned about the plans for an activity-based workplace in new and remodeled space at Mission Bay and Parnassus. Please review the information listed below.

Faculty comments received as of May 8, 2013

  • Professor, SOM 2013-05-15 20:56:28
    The whole concept of the activity-based workstation is a disaster. There is no evidence that it works. I expect to just work at home on days when I am not working clinically, worsening any concept of a collaborative environment. If this goes through, I predict that the backlash will cost the chancellor her job (just one factor).
  • John Shepherd 2013-05-15 16:48:06
    ABW was summarized best by, "ABW is not for everyone and is more appropriate for a workforce that is mobile or is planning to embrace mobility with the support of its leadership team." Does this sound like a research university? Many of us already embrace mobility and are constantly looking for ways to improve our group's effectiveness. However, ABW for UCSF is cost cutting pure and simple and seems to be at the expense of effectiveness. Why not provide guidelines to faculty on creating mobility and effectiveness by the types of technology they purchase first. Currently, I receive no guidance or consultation on this. If we as faculty are taught first how to embrace mobility, then ABW will be "in statu logica" not "in eo statu bellum". Lastly, let's fix existing problems that were caused by other recent Operation Excellence cost cutting plans before launching a new problem.
  • Asst Prof DOM 2013-05-10 15:47:53
    From what I've head from the administration, there just wasn't enough money and time to create more traditional office spaces for the faculty at Mission Bay. Unfortunately, I share the perception that the proposed plan will make my life more difficult. This diversion of resources away from the faculty does not foster the perception that our work is valued. Such a perception could certainly have a negative impact on retention and recruitment.
  • Tracey Woodruff 2013-05-07 08:46:24
    I went on the workstation tour last month and I am very concerned about how the current layout and structure will affect mine and my research group’s productivity. The workstations space is too small, there is insufficient privacy or sound reduction, and there are too many stations put into one open space. This is going to particularly burdensome to research faculty and staff who are generally are in the office much more than not; I’ve worked in cubicles, and they can be tolerable; but the current configuration will not be.
  • Assistant Professor, Dept of Medicine 2013-04-26 17:03:29
    I am in support of the plans presented for the Activity-Based Workspace at the new Mission Bay Academic Building. The space as designed is visionary and reflects an institutional commitment to collaboration. It is this level of innovation that drew me to take a position at UCSF. Contrary to some of the opinions expressed here, I believe this space is likely to attract bright faculty members who are excited to be in an environment that fosters an exchange of ideas.
  • John Kornak, PhD. Department of Epidemiology and Biostatistics 2013-04-22 10:35:20
    This workspace design decision is clearly based on short-term financial desperation rather than any clear long-term view for continued excellence at UCSF. This WILL have a long-term negative impact for the prestige and quality of UCSF -- particularly for the departments forced into this one-size-fits-nobody design. We have been told that it costs too much to change the design now. This is a false economy. It will cost much more to repair and unravel the damage to UCSF after this mistake has been made. Please reconsider this decision.
  • Michael Matthay, MD, Dept Medicine and Anesthesiology and the CVRI 2013-04-07 16:09:33
    I was recently a visiting professor at Penn and described the Activity Workplace plan to several colleagues in different departments there (Medicine, Pediatrics and Surgery) and they were all astounded that such a poor top down decision could be made by the Chancellor and the Vice Chair of Research and the Dean of the School of Medicine without adequate faculty input. They all said they would never move to a Medical School with this kind of work place plan because of the negative effects on research, clinical communications, and faculty excellence. The Academic Senate must be very forthright to change these plans at all UCSF sites immediately.
  • Tiffany Chang, Pediatric Hematology Oncology 2013-04-07 15:25:54
    ABW was developed from "hoteling" "hot desking" where employees had a 2/3 mobile job. But is ABW suitable for the primary functions of UCSF? No.
    -We need to support confidentiality. We conduct patient calls, student interviews and conference calls on sensitive research. Having to constantly move to a designated "private" space to conduct these conversations would disrupt workflow.
    -We are still document bound. Even the most technologically savvy individuals carry patient records, shadow charts, books. ABW requires 100% mobile technology. Converting to 100% digital would take time and training.
    -We need areas to concentrate. I have for the past 4 years shared work space. When I needed a quiet area to focus on completing a grant or paper, I would work at the library or from home. "Focus rooms" would become congested, and absenteeism would ensue as a growing number of people would work from home.
    ABW may we well suited to certain industries, but no models have been implemented in medicine.
  • DOM 2013-04-06 21:50:56
    Now that a number of the main tenants of the MB faculty building have weighed in -- the Pediatrics Department -- faculty from all but one of the proposed Departments who will have cubicles in the space have registered thoughts - With such overwhelming negativity and with 22 months before this building will be ready for occupancy - and now this from Pediatricians who are actually getting a new hospital -- it is not reality to believe this will work -- faculty will leave, retire, work from home and be unhappy all at the same time.
    I suggest that the next step is for the Department Chairs be forced to meet with their faculty and explain to their faculty where they were when this decision was made -- and what were they thinking if they were thinking at all. The Chairs are every bit as responsible for this mess as are the planning groups. If and when you read this, forward the link to your Department Chair and hold them accountable.
  • Mignon Loh 2013-04-05 14:46:52
    After taking the virtual tour, it is hard for me to imagine a less conducive work environment. While we do thrive on collaborations and interactions with our peers, so much of the work that academic faculty perform requires a quiet and private space where focused writing and thinking can occur. Reading, reviewing, and writing grants and manuscripts, as well as a relatively quiet space to meet with a student, trainee, or colleague one on one for sensitive conversations is critical. In addition, participating on conference calls and Webexs, which are frequent occurrences in this era of national and international collaborations, will be challenging. As a faculty who prides itself on creativity and productivity, we must resist the latest business trends that suggest that these environments allow full productivity. If I were to be assigned an office here, I would likely be spending a lot more time in my house, working from home.

Displaying the 10 most recent comments.
View all faculty comments received as of May 8, 2013.

Next Steps as of February 8, 2013

We are committed to ensuring that the implementation of this model serves UCSF and its faculty as best as possible. We are separating the steps by faculty groups, as follows:

  1. Mission Bay Hospital Faculty: Faculty members whose departments and/or programs must move to the Mission Bay Academic Building. For this group, we request that campus leaders conduct a rigorous study of the implementation of the activity-based workplace model, as well as give their commitment to act upon any deficiencies uncovered, including dismantling the model if necessary. We advocate that UCSF provide workspaces that support our success in research, teaching and clinical care.
  2. Faculty currently slated to electively move to the Mission Bay Academic Building: Some faculty members in this group have been recruited to move with their clinical program to the Mission Bay Hospital. Others in this group include clinical faculty who are leaving their division/department to be housed in the Academic Building. We ask that campus leaders work with these groups to determine how to best meet their needs, which may include delaying or rethinking their move to the Mission Bay Academic Building.
  3. Faculty not slated to move to the Mission Bay Academic Building: Many faculty members are slated to move into activity-based workspaces proposed for renovated or new space in the Clinical Sciences Building, University Hall, and SFGH. We recommend a moratorium on workplace planning for any of these locations until data from the requested study of the Mission Bay Academic Building have been collected and fully analyzed.
  4. Academic Senate: The Academic Senate will continue to work with faculty and campus leaders during this process via the Mission Bay Academic Building Working Group, the Committees on Academic Planning & Budget (APB), Research (COR), Clinical Affairs (CAC), Faculty Welfare (CFW) and the School Faculty Councils. David Teitel and Alan Venook have been appointed to, and will work with the Mission Bay Advisory Group. Their participation on the Advisory Group includes advocating on behalf of faculty and reporting new information to the Academic Senate.
  5. All Faculty: We have presented the background of the work environment proposed for the Mission Bay Academic Building, our concerns and the possible solutions that we have devised based on meetings of Academic Senate committees and work groups, and conversations among interested parties. We know that the faculty, as a whole, can add greatly to the process by sharing their concerns and solutions. Your participation is critical to the success of the implementation of the model, or alterations in it to meet the needs of the faculty.

Questions and Concerns

Insufficient consultation with stakeholders: The Academic Senate is a resource for these kinds of consultations. Despite repeated efforts by the Academic Senate Clinical Affairs Committee (CAC) starting in 2007, faculty concerns about the need for faculty office space and education space in the new hospital were not addressed. CAC eventually learned that faculty offices and education space would be located in a separate building; however, the plan for the activity-based workspace was not discussed with CAC.

Meetings with faculty and departments were “information only”, not iterative consultations, and came late in the process. Regardless of the options to be implemented, this is such a crucial decision that the faculty impacted by this must be consulted early and often. As this kind of configuration is also planned for the remodeled space at Parnassus faculty consultation is and will continue to be essential. We strongly urge evaluating a pilot program before expanding activity-based workplace plans beyond the Mission Bay Academic Building.

For example, we know that there were no meetings involving the Pediatrics faculty or its leadership about this issue until it was a fait accompli, and the meetings were just for information, not input. One meeting told us about the existence of the activity-based workplace model a couple of months ago, and another meeting described its structure and function.

The faculty believe that the activity-based workplace could adversely impact the perception that UCSF is a good place to work. Some faculty have already said that this building is sort of the “last straw” for them and that UCSF is becoming an undesirable work place. One issue that does not appear to be considered is that some faculty still use books, which may not be available in electronic form. A faculty member typically stores books in her or his office. Faculty members may also store teaching materials, clinical materials, and staff may have such needs.

This may also be problematic for faculty who have functional needs to use voice recognition software.  For example, it is not uncommon for people to develop health conditions such as carpal tunnel syndrome in which accommodations such as voice recognition software would be used instead of manual typing.  Such faculty would need private space to dictate compositions.  In addition such faculty may need to dictate confidential information.

Confidentiality concerns, including HIPAA, IRB, HR and academic requirements: Patient privacy compliance is a real concern for clinicians. Clinicians are encouraged to be available to their patients for phone calls, results, advice, etc., however if the activity-based workplace makes it impossible for a provider to be working on a manuscript or grant at the work station and pause, seamlessly, to take a patient call, providers may be discouraged from responding to patients promptly. They will be more likely to have the patient leave a message – rather than leave the workstation and find a focus room.

In a recent meeting, Deborah Yano-Fong, UCSF Chief Privacy Officer assured that HIPAA compliance within the open workspace will be simple because everyone in the "neighborhood" will be HIPAA cleared. However, one of the tenets of HIPAA is for PHI to be on a need to know basis[1], so even though most people within earshot will have been trained to keep the information confidential, hardly any of them would need to know that specific information for their UCSF work. Moreover, it seems unlikely that non-UCSF people will not be present in the space and unlikely that all will be cleared for the knowledge of specific patient details. In that case, will students, applicants, vendors, etc. be barred from the space, and if so, how will this be accomplished?

Our understanding is that it is a HIPAA violation for any provider not caring for a patient to be privy to any medical information about that patient. So it is not just insuring that non-providers who are in the building don't have access to patient information, but any clinician who is working in this space and does not care for a patient, should also not have any access to his/her information unless explicitly consulted for healthcare purposes. This will be impossible to guarantee with the open cubicles.

The following types of patient information could be visible to others from many different types of devices during the course of a normal day for clinical faculty members:

  • shadow charts, medical records from outside hospitals, computer screens, PACS radiographic pictures, radiographs, etc.
  • audible information: dictations; phone conversations: with MD, family, patients; curbside consultation information.
  • This does not address confidential information exchanged between faculty and sponsors, or other types of private interactions.

Furthermore, study staff may need to store materials, including items of cash value, materials for study visits, which may be on paper. These materials may be required by funding agencies or the FDA.

We would appreciate a written document explaining the steps the faculty will be taking to avoid each of these potential HIPAA exposures, with the reality that the neighborhood will not be assuredly free of outsiders. Furthermore, given that faculty are at risk for substantial personal fines for HIPAA violations, the faculty would like to know what protection they will be provided from the Medical Center should a HIPAA violation be cited as a result of exposure in the open space e.g. who pays the fine? Who will respond to JCAHO concerns?

The UCSF IRB needs to be consulted regarding space for storage of confidential research documents, such as consent forms. The standard UCSF language is that all identifying materials will be kept locked in cabinets accessible only to study staff, within a locked office also accessible only to study staff. Researchers may need to conduct confidential conversations to recruit or engage with study participants.

Supervisors need audio privacy as well to meet with the staff they supervise. Research staff also need to be able to interview or converse with study participants in space that enables sound privacy. Sound privacy might also be an issue for some interactions with students. The only space being configured this way is space used by clinicians, educators, clinical researchers. The new labs all have private and sizable offices with space for support staff in proximity. This gives the impression that these groups of faculty and scientists are second class citizens at UCSF.

Voice access: How will occupants of the building make phone calls? Will everyone receive a cell phone so they can easily transition to a separate space for private phone conversations? If yes, does the building include plans to boost cell phone reception so that users will not drop calls?

Inefficient use of space: There is concern about the inefficiency of having to move repeatedly between the assigned workspace and the “focus rooms” to take patient calls (including asking patients to hold while we look for a room), to meet with trainees for feedback session which are supposed to be confidential, to hold other confidential discussions with faculty and staff colleagues. Will there be enough private and/or meeting space for peak demand hours?

Quiet, private space to de-stress: Clinicians, in particular, have very busy days in clinical practice. There is a need for peace and quiet when the opportunity arises. Surgeons who work in the very stressful OR environment all day need a place to go at the end of the day where they can, literally, put their feet up, doze for a few minutes, unwind in privacy, make calls, etc. As many of the clinicians in some of the “neighborhoods” are surgeons, they may all descend on the building at the end of the day and not find enough focus/huddle rooms. In addition, there is concern about the noise level between phone calls, music, noise from online training or CME.

Educational needs: How will UCSF’s education mission be met if some individuals are excluded from shared space due to privacy and confidentiality concerns?

Loss of community: There is concern that people will just go home early and work from there, come in late, or work from home entirely. This will be counterproductive in terms of our ability to collaborate. Will faculty use the shared workspace? Will they disappear from UCSF once their clinics and meetings are over?

Loss of faculty: Will faculty leave UCSF because of the new space plan?

Faculty recruitment: Several have voiced concerns about the ability to recruit excellent candidates if we can’t offer them an office. Will it become more difficult to recruit faculty to UCSF with the new space plan? Faculty come to UCSF for the environment with colleagues and this workspace model is would not help an already difficult environment due to decreasing funding, increasing cost of living and a changing clinical landscape.

Fundraising: How will faculty feel about inviting potential donors to come visit us at our cubicles?

Application of an activity-based workspace in an academic health sciences institution: We can find no evidence of this being tried anywhere for any academic or medical setting. This needs to be evaluated within the context of our peer institutions, i.e. the top five academic medical centers in the nation, not in comparison to the information technology or media industries. With no prior history of using such a model in an academic medical campus, do we really want to go ahead without prior evaluation?

Generation gap? The assumption from administration is that there is a generational gap and that junior faculty would be willing to work in the activity-based workplace. Not all junior faculty agree. When competing with our peer institutions for recruitment, we would need a much stronger set of evidence that offering cubicles instead of offices will be viewed as a strong plus by potential recruits.

Chancellor’s example? We heard that the Chancellor will move her offices to the Mission Bay Academic Building. The nature of her work is more focused on meeting with others whereas the faculty need focused quiet time to write grants, etc. In the case of our clinical faculty, they need confined space to look at private patient information and receive/send phone calls that are sensitive without a need to pack up, go to a quiet room, re-log-on to sensitive information. Also, there is skepticism that this well-intentioned gesture by the Chancellor will be permanent.