Photo: Majed

One major component of the upcoming restructuring is the creation of a CTSI Clinical Research Center (CCRC). This Center will be comprised of three existing research centers: the San Francisco General Hospital; the UCSF Long/Moffitt Hospital; and the UCSF Children's Hospital, with a subunit at the Children's Hospital and Research Center in Oakland. Over the course of the next few years, several new units throughout the Bay Area will be added to this, including locations at the San Francisco Veterans Affairs Medical Center, a clinic in the Tenderloin, and UCSF-sponsored clinics in Fresno, Salinas, and Walnut Creek.

The goal is to create a clinical research center "without walls," so that UCSF investigators can have greater access to the research and facilities offered at these centers.

The university's current clinical research centers (CRCs) support a broad range of cutting-edge clinical and translational research projects, involving both inpatients and outpatients. More than 500 investigators working on 404 protocols use the facilities. These centers are also host to dozens of medical students, residents, postdoctoral students, and junior faculty each year.

But having three highly successful but separate research centers has not allowed for maximal efficiency for UCSF researchers. Furthermore, the rules imposed on the CRCs by the NIH prevented them from reaching their full potential to assist UCSF researchers in their T1 (bench to bedside) and T2 (bedside to community) research.

The new CCRC will be a key focus of clinical and translational research within CTSI. Its creation will streamline the current facilities and logistics, reduce operating costs, and expand the facilities and expertise into the surrounding communities. "Clinical research can no longer be conducted only in academic settings," says Joel Palefsky, MD, professor of medicine at UCSF. "Today, efficient clinical investigation needs to be done in a variety of settings, ranging from research units at academic medical centers to sites right in the communities, where patients receive care and where investigators are actually located."

That means that infrastructure needs to be created that can support research in a wider variety of settings. It also means that this clinical research infrastructure needs to be available 24/7, as is the case for the current CRCs. "Potential research participants often work or go to school full time," Palefsky says. "And clinical research often involves acutely ill participants or pregnant women, whose medical status does not necessarily fit within a standard workweek. Clinical research facilities need to be open at night and on the weekends."