Research Development - Strategic Plan

Priority #1

“Structure the organization to pursue excellence in Patient Care, Education and Research.”

Strategic Goal #1.3

"Develop Research Strategy"

RESEARCH STATEGIC GOALS

1. Establish research at Kingston General Hospital as an integral and indispensable part of patient care.
2. Enhance the culture at Kingston General Hospital to ensure a supportive and optimal environment for research.
3. Retain and recruit excellent researchers to Kingston General Hospital.
4. Increase the number of hospital staff participating in research.
5. Increase the number of projects and the amount of funding for research at Kingston General Hospital.
6. Utilize the established and potentially unique strengths of Kingston General Hospital, its partners and the region itself, to establish and determine directional foci.
7. Prioritize and enhance research which bears directly on patient and hospital management issues, to develop and ensure best practise models.
8. Enhance appropriate commercial development of research ideas.
9. Identify and remove barriers to research.
   1. Enhance and optimize space for research
   2. Increase funds available for research
   3. Provide an organizational structure for research that will help eliminate bureaucratic barriers.
10. Identify further potential research resources.

Strategic Action Plan

1. Identify current research resources.
   1. Establish a complete research inventory at Kingston General Hospital
      
      The need for up-to-date on-going accurate figures as to the whole range of research activities is obvious. The implications for Hospital resources are enormous, and the ethical and legal implications resulting from lack of this knowledge are self-evident. Although data exists in different areas, such as the University Research Services Office for some, the Research Ethic Board for others, there has been no consistent database at Kingston General Hospital.
      
      Status: This database has been created and is working. It covers Kingston General Hospital, as well as the Faculty of Health Sciences, Providence Continuing Care Centre and Hotel Dieu Hospital. It requires further refinement which will be addressed, and is a continuing project.
   2. Establish a space inventory

      Space at the moment is at a premium, and one of the potential bottlenecks for the conduct of research. A complete space inventory is at present being carried out by the Planning Office, and will include the research component.

      Status: The inventory has been completed in its first phase. We will now try to address actual usage of this space which will give us the opportunity to develop space distribution changes based on need and justification. Angada 4 changes allow for significant opportunities (see below).

2. Establish a listing of the prioritized research directions in the hospital.

   (This will be done taking into consideration the strategic directions of our partners. Work is in progress.)

3. Provide a research organizational structure at Kingston General Hospital with its partners to manage and enhance research activities.
   1. Provide a structure to enhance Clinical Research within the Hospital.

      This requires an increase in the number of people doing clinical research, an intensification of the quality and types of clinical research being carried out, and an enhancement of the atmosphere and culture in the Hospital, both to facilitate the current research and to enhance the environment to bring more people in.

      A critical element in starting this process is the unification and clustering of people involved in similar research in locations that permit optimal utilization of intellectual and physical resources, and permits common resource acquisition and hiring facilities.

      Plan: The creation of an effective Clinical Research Unit or Centre, in which researchers with expertise in the management, acquisition and development of large clinical research trials will be brought together geographically, and will help them begin to use and share common resources. Enhancement of this Unit will have a trickle down effect on clinical research and trials throughout the rest of the institution. This will also provide a resource for assistance in others beginning trials or research, and who may be lacking the necessary experience to do so on their own.

      Status: The availability of space on Angada 4 created by the move of the Radiation Oncology Research Unit to the new Cancer Centre early next year will provide an opportunity to bring together five or six key Clinical Research groups, at present working in different locations in the Hospital. This will hopefully be accomplished in the next year and will bring together shared expertise, physical facilities, and the opportunity to hire new experienced personnel for the greatest effect. Discussions and plans have begun. This will be done in consultation with the Department of Community Health and Epidemiology for mutual benefit.

   1. Provide a structure to enhance research administration.
      The previous incumbent in this position, Dr. Geoff Flynn, had a strategic retreat and a draft form of this was put out in May 2001 (included in previous mailing). This included suggestions for the formation of a Clinical Research Unit. This document contains many good and interesting suggestions although directions may have changed in the interval. It was not finalized, and not instituted.

      In the meantime, after my appointment to this position, I was asked to look at the integration of policies and procedures for doing research between the three Hospitals and the University. A realization has emerged that the creation of an appropriate Administration Unit covering all three Hospitals is probably the most desirable solution (?Virtual centre/institute).

      To create an organizational structure for research at Kingston General Hospital, in partnership with the other Hospitals and the University, that will

      1. facilitate research
      2. harmonize procedures and policies
      3. draw up common principles for the conduct of clinical research
      4. enable rational planning for assessing the impact of research programs on Hospital staff and resources, including space and overhead policies.

      Items for discussion for this policy under this strategic initiative will revolve around the structure of the Unit, the necessity for formal or informal designation of the structure, and the relationship between the University and the Hospitals.

      Status: A committee has been formed and I have spent considerable time looking at other institutions, as well as the local facilities and opportunities. It is anticipated that a proposal will be put to the committee in the next few months.

4. Enhance Research Directions that relate to patient care and hospital management issues.

   Important new opportunities for clinical research in the Hospital will arise at the interface between patient care, quality assurance, and clinical research. Research into patient management is likely to prove to be one of the fastest growing areas for research growth in many institutions. The clustering of expertise, will enable hospital physicians to take advantage of this opportunity and to engage in research in areas of great importance to patient outcome and to hospital management. The opportunity for funding this research through both the Hospital and outside sources becomes very attractive. An important example is the emerging emphasis on patient safety and medical error which has attracted enormous attention in the United states and is growing in Canada.

   Action Plan: The Research Development office, in consultation with internal and external experts, will propose some specific areas for clinical research, and will request proposals from individuals or groups of physicians to undertake this kind of research. These will initially be focused, (examples of these could be safety issues in the ICU, emergency department or coronary care units). Funding for this research will be provided by a combination of internal (hospital sources) and external grant sources (Health Canada, MOH, etc.). A close link to other Units, such as the Health Policy Unit and the Department of Community Health and Epidemiology at Queen’s will be established for these as well.

   The environment provided by these initiatives will be very supportive for future efforts in providing clinical research education and training for prospective researchers.

5. Provide and structure an educational program for staff and trainees to enhance research capacity.

   Education in research of medical, nursing and other hospital personnel is a vital component of the mission of the Health Sciences Centre and the Hospital. The Research Development Office as currently constituted, provides both proposal support and biostatistical support for residents and other staff members.

   Plan: The research education program will be greatly enhanced for trainees. A mechanism to provide an educational training program for residents has been devised with the assistance of numerous departments and the Research Development Office. This consists of both didactic and hands-on management of clinical research.

   Status: Two proposals for funding of this program using the facilities provided for Clinical Research in the Hospital have already gone to outside agencies. If successful they will be extended not only to health professional trainees, but will be expanded to faculty and other health professionals as well. The proposed centralization of the Clinical Research Centre expertise will also provide a focus for enhancement of clinical training.

6. Identify funds for research

   This is always a major challenge. The formation of an inter-institutional virtual centre with centralization of policies will enable us to compete to become preferred sites for outside agencies both in the public sector and in the private sector.

   Status:

   1. Work with the Development Office has begun as a search for external funding. Sources for potential fund attraction have been identified and are being contacted.
   2. An application for preferred status with one of the major pharmaceutical companies has been submitted, and although this program has been put on hold because of changes in the company, partial funds have been given to the Research Development Office for assistance in the enhancement of the clinical research endeavour.
7. Establish criteria for assessing outcomes.
   1. Increased funding.
   2. Increased numbers of projects
   3. Increased numbers of active researchers
   4. Greater satisfaction by researchers with the hospital research environment.