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How do WE improve Clinical Research In Ireland?
Austin G. StackProfessor and Chair of Medicine,
University Hospital Limerick, Graduate Entry Medical School, University of Limerick
Oct 13 2015
Vision.
To be a world-class health system
Enable world-class health research (support, facilitate, enable)
Mission of Healthcare Institution
Support
Research
Clinical Care
Medical Education
Research-Active hospitals benefit …UHL Patients Better care
UHL Staff Better staff
Attractive element Better doctor and better students Expanded revenue sources
UL Medical School
Training ground
University of Limerick
Expanded research network Access to patient populations Clinical Research Facility
Local industry Commerce
County hospitals Service delivery only
No research support services
No research programmes
No critical mass
No protected time
No incentives for research
Little prospects of career progression
University Hospitals Research activity & Programmes Academic scholarship Critical mass Protected research time Incentivise research Rewards research activities Career Progression National & international profile
County Hospital vs University Hospital
Ingredients for a Successful Hospital (Healthcare Institution)
Links to a University Medical, Nursing, Pharmacy, Schools Research Programmes Clinical Research Centre (CRC) Strong Academic Leadership Interdependence, Symbiosis Academic Health Centre's: clusters of hospitals
How do WE improve Clinical Research In Ireland?
=What are the CHALLENGES of
conducting Research?
Challenges in Conducting Research
Research workforce
Organisational Framework
2008Changing Systems & Structures (HSE)
Funding Stream
Ineffective governance
Poor Guidance and support
Resources
Don’t have the right people
Question 1: Is it important?Where is Research on the Hospital Executive Agenda?How often does it come up in discussion?Daily Trolley CountOPD Wait ListsCancer care and diagnosticsSurgery list cancellationsNursing shortageNCHD EWTDQuality Improvement
Question 2: Is there a clear roadmap?2008
Question 3: Is there a strong regulatory framework in place?
HRI
Office CAO
HRICRSU
University of Limerick
UL Hospitals/ Primary Care /Public Health
Oversight committee
UL/UL Hospitals CRU
CRU Management Board
Collaborator?
Recruitment group?
Legislation?
Sponsorship?
CRF?
Ethics approval?
Trial registration?Randomisation?
Access to participants?Study follow up?
Regulatory approval?
Access to reports?Phlebotomy services?
Insurance?
Study documentation?
Question 4: Is the Infrastructure in Place
Case Study:
National Kidney Disease Surveillance System
Getting Sign off from the Stakeholders
OrganisationContactsMeetings
Lots of Time
1. Academic Partners (UCC, U of M)2. State Agencies CSO, Health Intelligence3. Data Protection Office4. Data Controllers5. Ethics Committee Approval6. HSE Approval7. UL Approval8. Data Coordination Centre (DCC)
Company Name: National Kidney Disease Surveillance System
Ref Number: 13551/A
Reg Type: DP
Company Address: Graduate Entry Medical School (GEMS) University of Limerick
Contact: Maria Connolly
Purpose:
Continuation Due Date:
13/03/2016
Description:
Disclosees:
Transfers Abroad: None
Registry Details for 'National Kidney Disease Surveillance System'
Landscape has changed…
UL Hospitals & University of Limerick
3 Counties – Limerick, Clare and North Tipperary387,000 population
A New Medical School….
With Benefits…
1. New Academic appointments and research personnel
2. Strengthened relationships
3. Substantial Investment
4. “University Hospital” status
5. Expanded hospital network
6. Expanded Primary care network
Our Graduates…
Projected cost: €218m
Kappavilla Student Village €35mWorld Music & Dance €21mNew Facility for ICO € 4mKemmy Business School €11mLanguages Building €12mLiving Bridge €15mBoathouse € 4.3mMedical School
on campus €19moff campus €11m
Extension to Sports Arena €18mSports Training Pitches €17.4mIndustrial Enterprise Centre €11mUpgrade to Phys Ed building €11mLibrary Extension €29m
Recent/On-Going Physical Developments
Improving Clinical Infrastructure…
Clinical Education & Research Centre (CERC)
Size: 3,442 sq.m.Cost: €13 m
Completion Date: Sept ‘16
THIRD FLOOR: - Research Area
Real Opportunities Research Strategy for the UHL
connectivity Compete for Research funding
Increase Academic Appointments
Increase Programme Competitiveness
Enable growth and development
Working together for our future
Innovation through Partnership
UL Hospitals Research Symposium 2015
Health Research Institute (HRI)“Leading on Health Research”
Oct 13th 2015
Thematic Focus
Biostatistics & Epidemiology
Administrative Core, Regulatory and Legal Core
Technology and Health Health ServicesLifestyle and Health
Health Economics (HTA) Health Informatics
Health Relevance Expertise, Synergies, Collaborations, INTERNAL and EXTERNAL
HRI to succeed
CAPACITY
Lecturer in Medicine 1998-2001
CRITICAL MASS
CAPABILITY
2008
RELEVANCE
COLLABORATION
CREDIBILITY
How to improve Clinical Research?
1. Escalate research up the Executive Agenda
2. Build a clear roadmap
3. Get alignment of stakeholders
4. Embed and strengthen governance
5. Invest locally (% of annual budget)
6. Remove Obstacles, Empower & Facilitate
7. Use research to improve the health system
Benefitso Me, You, Department, Hospital, Universityo Improve health care delivery & outcomes (Patients)o Smarter workforce: Attracting and Retainingo Team & departmental expansion (critical mass)o Revenue Generation: Funding opportunities and revenueo Nurture the Clinical and Science interfaceo National and international recognition
HRI: Strategic Collaborations