west moreton hospital and health service research and ... · strategy 2015–20 (turning research...

Turning research into excellent care

West Moreton Hospital and Health Service

Research and innovation strategy2015–20

West Moreton Hospital and Health Service

ContentsA message from Dr Mary Corbett, Chair, West Moreton Hospital and Health Board.........................2A message from Ms Sue McKee, Chief Executive, West Moreton Hospital and Health Service .........3

Executive summary ______________________________________________________ 4

Background ____________________________________________________________ 5The value of research and innovation in health care ......................................................................5The platform for fostering a culture of research and innovation in West Moreton HHS ....................6

Research and Innovation Strategy 2015–20 __________________________________ 8Turning research into excellent care ..............................................................................................8Our research expertise ..................................................................................................................8Our vision .....................................................................................................................................8Our strategic goals .......................................................................................................................8

Strategic goal 1: Invest in research _________________________________________ 9

Strategic goal 2: Support knowledge translation _____________________________ 10

Strategic goal 3: Establish research governance excellence _____________________11

Strategic goal 4: Maximise research capability ______________________________ 12

Strategic goal 5: Build research partnerships _________________________________13

References ____________________________________________________________ 14

Appendices _____________________________________________________________15Appendix 1: Consultation log ...................................................................................................... 15Appendix 2: SWOT analysis ......................................................................................................... 16

2015014 | 07/08/2015 | Images: http://www.freeimages.com

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Research and innovation strategy 2015–20 | 1

The increasing prevalence of chronic disease and the growing healthcare demand across West Moreton presents the Hospital and Health Service with a monumental challenge. However, this challenge also brings an opportunity for WMHHS to develop and strengthen its involvement in research and innovation. A strong research culture, that enables continuous quality improvement and the delivery of evidence-based care, is essential in achieving excellence in the quality and safety of our services. A strong research culture will enhance our reputation as a world class organisation whilst attracting and retaining quality staff.

In West Moreton, the value of research to human health and patient care is fully acknowledged. We recognise the role of research in new and innovative treatments and procedures, which lead to prevention, eradication and effective management of many medical conditions. With the launch of the Research and Innovation Strategy 2015–20 (Turning Research into Excellent Care), I am pleased to announce the establishment of the Centre for Research and Innovation. This establishment is accompanied by the appointment of Dr Raymond Chan, Director of Research and Innovation.

To achieve world-class excellence in research and innovation, and health improvements for our community, the centre will have a key role in creating research capacity and meaningful partnerships with our university and tertiary partners.

Research and Innovation has been a topic of much discussion and interest for the Board since its inception in 2012. We commenced our journey in 2013 with the commitment of $500,000 funding for innovative projects which improve our patient’s experience. This was continued in 2014, and has formed the nucleus for our broader Research and Innovation Strategy.

Over the coming five years, the Board is placing greater emphasis on research which will improve our community’s health and well-being, while providing opportunities for staff to engage and participate in relevant projects.

I look forward to seeing our research efforts grow over the life of the strategy.

Dr Mary Corbett Chair West Moreton Hospital and Health Board

A message from Dr Mary Corbett Chair West Moreton Hospital and Health Board

2 | Research and innovation strategy 2015–20

Our new Strategic Plan, Path to Excellence 2015-19 confirms our commitment to achieving excellence in service delivery through innovation, research and lifelong learning. Our Research and Innovation Strategy 2015-20 further cements this commitment and provides us with a clear research direction by articulating our vision, recognising key areas of expertise for development and outlining strategic goals and associated outcomes.

West Moreton’s diverse demographic creates rich research opportunities - the opportunity to be known as a leader in key areas of clinical research, the opportunity to develop targeted research and innovation partnerships and the opportunity to create a true learning organisation that is focused on local needs.

Better and safer care is achieved through the translation of research into clinical practice. Our research and innovation agenda will focus on enhancing health outcomes and improving the quality of care provided in areas that are considered as a priority for our demographic. These areas include chronic diseases and their consequences (especially obesity), health services research and system improvement, health promotion and prevention, pregnancy and early childhood disease and mental health.

Our research and innovation agenda will include a specific focus on creating a learning organisation by cultivating a culture that supports continuous improvement and best practice. We will ensure our team is provided with the opportunity, environment, tools and resources to incubate and test ideas that drives change and improves the care we provide. Our clinicians will be developed and supported to be active contributors in improving the way they provide care to the community through research and evidence-based practice.

We are fortunate to host high calibre national and international research programs led by individual clinicians and research groups throughout our health service. For the most part, however, this activity is not reliably captured and is not visible to our workforce, community or stakeholders. This strategy places a strong emphasis on increasing the profile of the research that we do and positioning our health service as a leader in clinical research. We will recognise and celebrate our existing clinical researchers as leaders in promoting our desired learning culture and reward and showcase our quality improvements and ability to deliver healthcare in an innovative way.

Ms Sue McKee Chief Executive West Moreton Hospital and Health Service

A message from Ms Sue McKee Chief Executive West Moreton Hospital and Health Service


Executive summaryThe West Moreton Research and Innovation strategy aligns with the WMHHS Strategic Plan, Path to Excellence, and recognises the existing depth of skill, enthusiasm, and motivation of our staff, stakeholders, and community in the delivery of excellent health care.

A strong research and innovation presence has a number of advantages for WMHHS. First and foremost, research and innovation is important in improving the quality of patient care, as part of meeting our triple aim: better care, better health, and better value. By focusing research and innovation on the needs of our population, in particular the burden of chronic disease, this research and innovation strategy has a key role in improving health outcomes. Achieving excellence in research will also attract a high quality workforce, which will further contribute to building the self-sufficiency of WMHHS.

The scope of this strategy covers a spectrum of activities including small scale quality improvement projects to multi-site large research collaborations. However, our point of difference will be a strong focus on innovation. It is anticipated that West Moreton researchers will also be engaged in translational research (bench-to-bedside and beyond), health services research and quality improvement activities.

Our mission through this strategy is to:

• Position WMHHS as a leader in key areas of clinical research

• Create a visible and viable research programme that supports high quality clinical research and quality improvement with the aim of improving patient care

• Develop and sustain strong relationships with our research partners.


BackgroundThe value of research and innovation in health careHealth research is defined as a collection of activities that contribute to the development of knowledge surrounding health care service and delivery (NSW Ministry for Health, 2011). The Strategic Review of Health and Medical Research in Australia Final Report (McKeon, 2013) identified several economic benefits of healthcare organisations having a visible and active research program, including:

• Better and safer care is achieved through the translation of research into clinical practice;

• Clinicians are often the initial identifiers and drivers of improving the way care is provided;

• Accessible, evidence-based, innovative practice allows organisations to adapt swiftly, guaranteeing system sustainability;

• The profile of organisations as research leaders attracts and retains high calibre clinical staff;

• External revenue opportunities are enhanced and can be reinvested in improving workforce and system capability (NSW Ministry of Health, 2011). The Australian Society for Medical Research (2008) indicates that there is a powerful return on investment with every dollar spent on research estimated to bring an average health benefit of 117 per cent.


The platform for fostering a culture of research and innovation in West Moreton HHSThe West Moreton demographic profile is diverse, representing multiple aspects of the Australian community; including a mixture of urban and rural living, wealth and poverty, a strong cultural heritage with a large community of Aboriginal and Torres Strait Islander peoples, and a growing migrant population. This diversity creates rich research opportunities, and by focusing on local needs we can both improve the care we provide to our community and contribute to the national agenda of health and healthcare improvement.

1. Clinician, partner, and community engagementExtensive consultation with our clinical researchers, administrators, research partners and experts occurred throughout 2014, with a combination of one-on-one and focus group interviews (See Appendix 1). The main aim was to understand the current strengths and challenges associated with conducting research in West Moreton, and to inform the development of the strategic priorities and actions. The feedback has been summarised as a SWOT analysis of the key ‘clinical researcher’, ‘organisational’, and ‘partnering’ themes identified and summarised in Appendix 2.

2. The profile of research in West Moreton HHS This plan seeks to increase the profile of research at West Moreton HHS. We currently have pockets of high calibre national and international research led by individual clinicians and research groups in the areas of mental health; cardiology, maternal health, emergency medicine, community health and allied health. The research activity (inputs and outputs) of our researchers however is not reliably captured outside of the Queensland Centre for Mental Health Research (QCMHR) and therefore not visible to our workforce, community, or stakeholders.

3. The current health care environment West Moreton has recognised that the healthcare environment is rapidly changing and there is an urgent need to close the gap between new knowledge generation and health service delivery. Knowledge translation activities using effective implementation strategies in clinical settings will improve quality of care and access to services, and enable clinicians and patients to change behaviours considered critical in improving health outcomes and quality of life.

4. Research themesThe following overarching research themes were identified as West Moreton priorities during the consultation process:

• Chronic diseases and their consequences – especially obesity

• Health services research– system improvement

• Health promotion and prevention of disease

• Pregnancy and early childhood disease

• Mental Health

SummaryIn summary, the West Moreton HHS seeks to support clinicians to be active contributors in improving the way they provide care to our community through research and evidence-based practice.


The West Moreton research principles underpinning the strategic goals, objectives and actions are outlined in the table below.

Table 1. West Moreton’s Research Principles

Research principles

Desired outcomes

Building a research culture requires a long-term perspective

This plan seeks to build capability and capacity systematically and progressively, acknowledging that the foundations need to be strong and sustainable.

We value and seek to develop our existing research strengths and partnerships

This plan recognises and celebrates our existing clinical researchers as leaders in promoting the desired culture of research. We also recognise our existing relationships with research partners which we value and seek to retain.

Dedicated financial investment will result in optimal research performance and patient outcomes

Nationally, the benchmarked research expenditure by health services is recommended to be between 3 and 4 per cent of a total health service budget (McKeon et al., 2013). This plan focuses on establishing the infrastructure and investment strategy to increase research activity.

We will harness the latent research capacity in our clinical workforce

Health professionals are highly trained clinicians with skills of critical reasoning, synthesis and interpretation of information, implementation of theoretical knowledge, and evaluation of outcomes. This plan will focus on maximising these skills within a research environment.

Our point of difference will be around service evaluation of transformed models of care

West Moreton has been recognised as a leader in transforming models of care. This plan promotes rigorous evaluation of innovations to improve patient safety, quality of care and the experience of care.

We will focus our research efforts on local priorities

A targeted approach with corresponding level of investment and support can result in significant overall health benefits to the community. This plan will focus on establishing the critical mass to drive locally determined research priorities.

Celebrating our research performance recognises the value of continuous improvement

This plan will focus on incentivising, rewarding, and showcasing our research and quality improvement activity and performance.

We will access the commitment of our people to make a difference

This plan will invest in our people to drive change in their daily practice and directly influence the provision of care.

Capability will develop by focussing on proximal research (helping patients now) as well as strategic research (improving treatments)

We want our clinicians to know that service improvement is a daily continuous process and support them to be constantly searching for ways to improve the care they provide through maximising “bench to bedside” practices.

Improving our research performance will be maximised by partnering with established research stakeholders

This plan acknowledges that the strategic partnerships with larger HHSs and university / research institute partners (who have recognised established research agendas) are pivotal to improving WMMHS research capability.


Invest in research

Maximise research

capability

Support knowledge translation

Establish research

governance excellence

Build research

partnerships

Research and Innovation Strategy 2015–20Turning research into excellent careThis strategy aims to provide WMHHS with a clear research direction by

1. recognising the areas of expertise for development

2. articulating the vision

3. developing strategic goals and associated outcomes.

Our research expertiseWMHHS will develop expertise in:

• Translational research (bench-to-bedside and beyond): “effective translation of the new knowledge, mechanisms, and techniques generated by advances in basic science research into new approaches for prevention, diagnosis, and treatment of disease is essential for improving health” (Fontanarosa & DeAngelis, 2002);

• Health services research: “provides unbiased, scientific evidence to influence health services policy at all levels so as to improve the health of the public. It is not a scientific discipline but draws on and uses a wide range of methods from several disciplines including sociology, statistics, economics, epidemiology, psychology, and history. It also requires input from and an understanding of biology, medicine, nursing, and other clinical areas” (Black, 1997).

• Quality improvement: Introducing the best innovative practice and evaluating its patient and system outcomes. One common and effective methodology is clinical audit, which many of our staff are required to complete as part of their clinical training.

Our visionEmpowering clinicians to deliver world-class, evidence-based, innovative care for the West Moreton community.

Our strategic goals


Invest in research

Strategic goal 1: Invest in research

Objectives OutcomesIn order to achieve this goal, we will ensure that

• Research activity is aligned with the WMHHS organisational priorities through the development of local research priorities

• Our community reference groups and local research partners are involved in informing the research agenda

• The current direct and indirect investment in research in West Moreton is acknowledged

• The Annual Research and Innovation Symposium will be successfully held

• Locally focussed pilot studies and clinician-led research will be incentivised

• Clinical research careers will be promoted

We know we will have achieved our goal when

• West Moreton has a recurrent budget dedicated to research with associated performance targets

• Internal seed research grants will be made available for staff

• Staff will be supported to apply for external competitive grants to conduct research

• A robust prioritisation matrix is used to allocate seed research funding

• Senior clinicians with research portfolios have been supported with protected time for research

• Joint appointments with universities are established

• Success in research and quality improvement activity are celebrated and rewarded


Support knowledge translation

Strategic goal 2: Support knowledge translation


• A priority list for translational research opportunities and practice gaps will be developed

• Service level targets for research activity will be developed

• There will be an increase in awareness by our community and workforce that West Moreton provides evidence-based health services

• Researchers receive training on knowledge translation and implementation science


• Research and quality improvement targets are contained in 100% of annual service plans

• The number of clinical guideline/evidence-based policies has progressively increased

• The number of translation of evidence into practice activities has progressively increased

• Evidence-based practice workshops for health professionals has been introduced and evaluated

• The West Moreton Centre for Research and Innovation webpage is commissioned

• Each division has identified at least 1 senior clinician in each professional stream with research experience who has participated in annual service planning and evaluation

• Role descriptions for senior level clinician positions contain KPIs for research and quality improvement


Establish research

governance excellence

Strategic goal 3: Establish research governance excellence


• The West Moreton research governance and support structure is established

• The approval process for research applications will be standardised and streamlined

• The WMHHS Human Ethics and Research Committee is enhanced and maintained

• The Library is rebranded and transformed into the West Moreton Centre for Research and Innovation

• A reliable mechanism for annual research reporting is established


• Funding revenue is accessible and both expenditure and outputs are monitored

• WM Human Ethics & Research Committee is NHMRC certified to approve multi-site projects

• 100% research approval timelines for Human Ethics & Research Committee and site specific approvals are within benchmarks and best standards

• Staff have access to specialist research skills and support

• The West Moreton Library service has transformed into the Centre for Research and Innovation, with librarians actively support the research agenda

• Production of a WMHHS Annual Research Report


Maximise research

capability

Strategic goal 4: Maximise research capability


• We will collect reliable data on current research activities to establish a baseline, to inform measurable performance targets

• The workforce is stimulated to conduct research and quality improvement through the formation of clinical research networks and over time recognised clinical research groups/units

• The workforce are organisationally supported at each stage of the research journey through the formation of the WM Centre for Research and Innovation

• An annual research training calendar in collaboration with our partners will be developed

• Research opportunities and achievements of our researchers will be actively marketed


• The annual research skills training series and regular research methods clinic have been launched

• There has been a progressive increase in research projects

• There has been a progressive annual increase in publications in peer reviewed journals

• There has been a progressive annual increase in conference presentations

• At least 1 West Moreton led multi-site project has been funded and commenced

• There is an increase in funding from external competitive grants

• Annual West Moreton awards ceremony has been held to recognise research achievements of novice/expert researchers


Build research

partnerships

Strategic goal 5: Build research partnerships


• There will be an increase of academic presence by formalising partnerships with Universities across the organisation, to access expertise and share research resources and infrastructure

• The opportunities to partner with Hospital and Health Services with established research presence to share research expertise and resources are explored

• A program for university-clinical research fellows in the organisation will be developed

• Formal partnerships with research institutes are established to promote the conduct of translational research (bench-to-bedside and beyond)


• The number of collaborative partnerships has increased across all professional streams

• The number of staff engaged in research higher degrees has progressively increased on a yearly basis

• The number of research projects that are collaborative and/or inter-professional has increased

• Formal partnerships with Universities / research institutes have been established to enable the conduct of basic science research and translational research in key identified research themes


References1. Black, N. Health Services Research. The Lancet. 1997;349:1834-36

2. Fontanarosa PB, DeAngelis CD. Basic science and translational research in JAMA. JAMA. 2002;287(13):1728

3. McKeon, S., Alexander, E., Brodarty, H., Ferris, B., Frazer, I., & Little, M. (2013). Strategic Review of Health and Medical Research in Australia – Better Health Through Research, Full Report, Commonwealth of Australia Department of Health and Ageing, Canberra.

4. NSW Ministry of Health (2011). NSW Health and Medical Research Strategic Review. Discussion Paper. NSW Ministry of Health, North Sydney.

5. Meehan, T., Bowers, A., Mitchell G., & Costello, G. (2014) West Moreton Hospital and Health Service Research Plan (2014-2019) (Draft). West Moreton Hospital and Health Service.

6. Queensland Centre for Mental Health Learning (2014). About QCMHL, Department of Health, accessed 10 February 2015 www.health.qld.gov.au/qcmhl/

7. Queensland Centre for Mental Health Research (2013). About QCMHR, University of Queensland accessed 10 February 2015 http://qcmhr.uq.edu.au/about/


AppendicesAppendix 1: Consultation log

Name Representing Clinician / partner

Lisa Van den Burg Queensland Medical Research Fund Partner

Professor Debra Hoepner Ipswich Hospital Foundation Research Group Chair Partner

Clinicians Focus group:

Assoc Prof Tony Stanton, Cardiologist

Dr Kassam Mahomed, Obstetrician

Dr Lloyd Jones, Intern

Dr Kylie Baker, Emergency Department Physician

Mr Scott Jen, Podiatrist

Assoc Prof Tom Meehan, The Park

WMHHS Clinicians

Partners Focus group: Partners

• Professor Sonj Hall WMHHS Board

• Adj Assoc Professor Julie Hulcombe Allied Health Professions Office of Queensland

• Professor Nick Graves Australian Centre for Health Services Innovation

• Ms Megan Campbell Australian Centre for Health Services Innovation

• Mr Tom Yates Ipswich Hospital Foundation

• Assoc Professor Jennifer Kelly University of Southern Queensland

• Dr Stephen Brierley UQ Ipswich Medical School

Professor Geoffrey Mitchell UQ Ipswich Medical School Partner

Dr Alison Cutler and Dr Lucy Daikin, Geriatricians

WMHHS Clinician

Professor Liz Ward, Speech Pathologist Metro South HHS / UQ Partner

Professor John McGrath Director of QCMHR Partner

WMHHS Lead Clinicians Group WMHHS Clinician

Dr Terry Stedman, Director of Clinical Services, Mental Health and Specialised Services

WMHHS Clinician and Administrator


Appendix 2: SWOT analysisSWOT analysis of clinical researcher and partner feedback from the consultation process to inform the research strategic plan

Clinical researcher themes

Organisational themes

Partnering themes

Str

engt

hs

• Pockets of nationally and internationally recognised research

• QCMHR is hosted by WMHHS

• Existing annual WMHHS Research Day for last 5 years

• Existing WMHHS Innovation Fund to support small projects

• There are existing funding sources that support current research activity

• Existing research partnerships with UQ School of Medicine and Ipswich Hospital Foundation should continue

Wea

knes

ses

• Research leadership is condition / area specific

• Knowledge of research expertise is not easily accessible

• Limited access to technology and technical assistance at all levels of the organisation

• Researchers tend to do research in own time

• Poor understanding of the current level of research activity

• Lack of strategic research leadership

• Clinical, corporate, and operational governance processes are not coordinated to efficiently facilitate the research process

• No centralised coordination of funding with minimal revenue entering WMHHS

• WMHHS Ethics committee not NHMRC certified for single ethical review of multi-centre studies

• Partnerships are not well supported at an organisational level and tend to be individually led which is not sustainable or to the benefit of WMHHS

Opp

ortu

niti

es

• Latent workforce research capacity

• Existing clinical research champions are motivated to support the research agenda

• Start small by focussing on quality improvement at a team based level

• Establish research requirements in role descriptions and performance planning and appraisal

• Establishing research communities of practice and/or clinical research units to pair experienced and early career researchers, and enhance access by higher degree students to conduct research in WMHHS

• Encouraging applications for innovation fund that focus on local quality improvement activities

• Establish joint appointments

• Partner with other HHS with established research offices or other research agencies to assist with improving capability and capacity

• Establish formal partnerships with university resources e.g. library, technological support, storage

• Access the research expertise of our partners regarding the research process

Thre

ats

Organisational commitment to protected time for researchers

Lack of internal incentives for researchers

Lack of ongoing training and education of the components of research to improve capability

Lack of robust internal support structure to manage research agenda

Lack of identified local research priorities by WMHHS

Lack of visible research culture and dedicated space for research

Lack of dedicated funding to support range of research activities

• Competing with larger Hospital and Health Services with already established research partnerships


www.westmoreton.health.qld.gov.au

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