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