MIKÄ ON YLIOPISTOSAIRAALA ? • Omasta mielestäni yliopistosairaalan tunnusmerkkejä ovat ainakin seuraavat: (1) muodollinen (juridinen) status yliopistosairaalana, (2) yliopiston osallistuminen sairaalan hallintoon, (3) viralliset ja monipuoliset sidokset sairaalan ja yliopiston välillä, (4) runsaasti yhteisiä virkoja (periaatteessa kaikilla erikoisaloilla), (5) laajaa tieteellistä tutkimustoimintaa, (6) yhteisiä opetuksen ja tutkimuksen infrastruktuuriyksiköitä, (7) yhteinen strategia tai yhteisiä toimintapolitiikoita, -suunnitelmia ja –ohjelmia. ESITYKSENI VALMISTELU • Kysyin sähköpostitse n. 20 sellaiselta henkilöltä, joilla tiesin olevan kokemusta työskentelystä yliopistollisessa sairaalassa, näkemyksiä ja kokemuksia otsikon aiheesta eli ”Mikä/millainen on yliopistollinen sairaala ?”. Puolet vastasi, kolme henkilöä erittäin perusteellisesti – kiitokset heille. • Lisäksi ”googlasin” itse eräiden sairaaloiden rakenteita ja vuosiraportteja + tutustuin uudelleen FinnPron toimesta laadittuun ”maailman johtavien sairaaloiden” selvitykseen, jonka HUS teetätti kaksi vuotta sitten • Lisäksi ”olin utelias ja kyselin” ”urbi et orbi” • Referoin ja esitän johtopäätöksiä. Viimeistely jäi ”kalkkiviivoille” – panostetaan keskusteluun. JOHTOPÄÄTÖKSIÄ 1 • Koko aineistossa, johon tutustuin, suuri enemmistö yliopistollisista sairaaloista oli KAHDEN ERI ORGANISAATION eli sairaalan ja yliopiston yhteistyöorganisaatioita. Esim. Irlannissa kahden eri ministeriön (Terveys ja Opetus) alainen valtiollinen toiminta ”kohtaa” yliopistollisessa sairaalassa, jolle on säädetty selkeä muodollinen yhteinen toimintamalli- ja organisaatio. Norjan ja Tanskan malli on samantapainen. • UK:ssa esim. ”Sheffield Teaching Hospital” on korkealle rankattu sairaalayhtymä, jolla on yhteistyösopimus 2-4 yliopiston/korkeakoulun kanssa. Sama ”toisinpäin”: UCSF UCSF Medical Center + muut sairaalat. JOHTOPÄÄTÖKSIÄ 2 • On myös ”kokonaan yliopiston hallitsemia” sairaaloita, esim. Berliinin Charite, ja toisaalta ”kokonaan sairaalan hallitsemia” tiedekuntia tai Medical schooleja, ymmärtääkseni esim. Cleveland Clinic • Hampurissa kaupungin (!) aikanaan omistama yliopistollinen sairaala on yksityistetty ja opetuksen ja tutkimuksen järjestäminen on osoittautunut hankalaksi. • (Sivuhyppäys: Ranskassa on myös sairaaloiden johtamisen ”Grand Ecole” Rennesissä, nelivuotinen korkeakoulu jo yhden tutkinnon suorittaneille, sisäänotto 60 vuodessa, V-Sshp:llä ja sitä ennen PPshp:llä oli yhteyksiä siihen.) ”TAPAUSSELOSTUKSIA” KÖLNIN YLIOPISTO SAKSA. TIEDOT ANTOI PROFESSORI KLAUS BROCKMEIER: We have a 'split' budget - one is the income from patient care and there is only scientific activity in terms of clinical studies (new drugs etc). The revenue belongs to the department in charge (overhead is 510%). Second is the budget from the government for teaching and science that is distributed by a key that is related to proportion of personel and activity. This 110 MEuros p/a are also used for the salaries of all people / material working in the preclinic medical school, maintenance, buildings etc. In fact there is a complex interaction between the faculty of medicine and the university hospital of Cologne. Last year the hospital had a positive balance of 4 MEuros and the faculty a negative of 1 ME. The dean is now providing a plan of how to stabilize the budget - rather successful. Important feature of Cologne University is the close co-operation with the faculty of math/natural sciences. There are several new facilities for research/labs and two graduate schools. New directors/ full profs are selected by a team of experts of the faculty. However, both directors of the hospital ( economic&medical) have a vote in the final decision making (also proportions of students and MDs without a professorship). Aki Linden, toimitusjohtaja 6 PADOVAN YLIOPISTO (EUROOPAN VANHIN LÄÄKETIETEELLINEN YLIOPISTO, GALILEO GALILEIN OPPITUOLI SIJAITSEE TÄÄLLÄ). TIETOJEN ANTAJA PROFESSORI ORNELLA MILANESI Our Hospital is an University Medical Institution, functioning as a tertiary pediatric care center for the entire Veneto Region, providing teaching and training opportunities at the pre- and post graduate level and conducting clinical and laboratory research. The personnel working in the hospital has or a university (named Professor) or hospital (Doctor) appointmentOnly people with university appointment can chair a class in the pre and post graduation courses , while people with a hospital appointment can cooperate with the university professor, but not chair. The duties of a university professor are three: taking care of patients, teaching and doing research, while the duty of a physician with medical appointment is to take care of patients. However most of them do an excellent research. Research projects can be funded by the University (Ministry of Education) and just University professors can apply to them, or by the Veneto Region (Ministry of Health) or by private companies, like banks (Cassa di Risparmio is a no profit bank) and both professors and doctors can apply to them. The Faculty of Medicine and Surgery of Padua is made of 8. University Departments, all with a separate budget, provided by the Ministry of Education through the Central Administration of the University. Our Department is the Department of Women and Children's health and comprises Pediatrics, Obstetrics and Gynecology Pediatric Surgery. The chair of the Department is a full professor, elected between the chairs of the three different disciplines by all the Aki Linden, toimitusjohtaja 7 University do. PADOVAN YLIOPISTO (EUROOPAN VANHIN LÄÄKETIETEELLINEN YLIOPISTO, GALILEO GALILEIN OPPITUOLI SIJAITSEE TÄÄLLÄ). TIETOJEN ANTAJA PROFESSORI ORNELLA MILANESI Overlapped to this University Department there is the Women and Children's Hospital, with a director, who can be a Professor or a Doctor, depending on and referring to the General Director of the Hospital Medical Institution. He is elected between all the directors of a Complex Unit (Pediatrics, Pediatric Cardiology, Psychiatrics, Obstetrics and Gynecology, Pediatric Cardiac Surgery, Pediatric Surgery, Metabolic Diseases are the Complex Unit) by all the people working in the Hospital. In the case of my department the chair of the University department and of the hospital is the same person, Giorgio Perilongo that you met when you came to Padova. The director of the Hospital Medical Institution, depending from the Minestry of Health and without any teaching duty or activity, is designed in agreement by the Rector of the University and the President and the Veneto region. At the moment there is no a parallel position in the University hierarchy, all the University Departments have their different administration, and their chair. The president of the school of medicine, elected between the full professors of medicine and supported by representative of the 8 Departmets, has the duty to outline the strategy of the faculty of medicine and allied faculties. The Director of the hospital medical Institution, is totally independent from the University in deciding the strategies of the hospital (employment of MD and other personnel, opening or closings of divisions etc) . In the last months I've participated in a commission aiming at outlining a more tight cooperation between the University and the hospital authority, as far as the decisions concerning the strategy of development, and the regional health policy. Aki Linden, toimitusjohtaja 8 UK, ST EVELYN HOSPITAL/KINGS COLLEGE. TIETOJEN ANTAJA PROFESSORI GURLEEN SHARLAND Our hospital is linked with King's College London. Another large hospital, King's College Hospital, is also linked to King's College the university. The hospitals and university work together under the umbrella of King's Health Partners. The hospital and university work as separate institutions with separate funding and separate managerial staff running things. All staff working in the hospital have to provide teaching for medical students as part of their contract. Clinicians that do some academic work can apply for paid sessions with the university and get an honorary contract with university. Usually nowadays one has to generate grant income to get these sessions paid for. One can also get an honorary contract with the university if one is involved in alot of teaching for the university. Clinical academics who do mainly academic work and generate alot of grant income will have their main contract with university, but can get an honorary contract with hospital for any clinical work. Funding for research projects has to be applied for through grants. Most consultants that are not academics will have only 1 hour a week allocated for research which is nothing really. Professors and academics posts are selected by the university. The hospital can support applications but the university makes the final decision. Aki Linden, toimitusjohtaja 9 LUNDIN/MALMÖN YLIOPISTOLLINEN SAIRAALA/SKÅNE UNIVERSITY RUOTSI. TIETOJEN ANTAJA KATARINA HANSÉUS (HÄN TUNTEE HELSINGIN JÄRJESTELMÄÄ): We have (had) the same system. In reality research and clinical work is rather mixed. Since the fusion of Malmö and Lund hospital to Skane University Hospital the administrations are trying to cooperate more and have a bilateral exchange system with one rep in all boards from Faculty-hospital board Medicinska fakulteten – divisionen Avdelning för pediatrik verksamhetsledningen. A good initiative and I think it has helped at least somewhat to bridge the gaps. Aki Linden, toimitusjohtaja 10 ZÜRICHIN YLIOPISTO/YLIOPISTOLLINEN SAIRAALA SVEITSI. TIETOJEN ANTAJA PROFESSORI EMMANUELA VALSANGIAMO-BÜCHEL Here some information about the relationship Pediatric Hospital and University in Zurich: Academic activity: lectures and bedside courses in Pediatrics, tutorials and repetitoriums. Our academic staffs can participate to different working groups and initiatives of the University - this is happening more on an individual iniative The Hospital has a total of 7 Chairs (who are official paid by the University). The highest chair is the Chair of Pediatrics, position coupled with the position of medical director of the Hospital. Other chairs in the different specialities: Infectiology, Neuroloy, Immunology, Oncology, Cardiology= , Endocrinology All chairs are member of the Faculty of Medicine of the University Zurich, which have regular meetings during the year The chair of Pediatric has direct contact and exchanges with the dean and other important persons within the University. He does not currently have any higher position within the board of the University There are not any direct representatives of the university in the hospital’s governing body The University give to the Children's Hospital a certain money budget /year which is then redistributed among the different chairs. This money can be used for academic activities and research - the amount is usually enough for travel expenses, ethical fees, small other expenses. Not enough for financing a full research project - research is financed with grants from the university (application is separate) and from the national (Swiss national found for research) as well as from grants from private foundations The professors who have a university chair are elected by an election committee of the University; however the medical and administrative directors of the Hospital are in the committee ex-officio and have a large influence Aki Linden, toimitusjohtaja 11 on the choice of the candidate. UNIVERSITY MEDICAL CENTERS IN THE NETHERLANDS: WHY AND HOW Prof.dr. G.H. Blijham Chairman of the board UMC Utrecht Chairman of the Dutch Federation of UMCs (NFU) THE UNIVERSITY SYSTEM IN THE NETHERLANDS • 13 semipublic universities • 8 with a faculty of medicine • Faculty of medicine: – ± 20% of university budget – ± 25% of the professors – undergraduate (bio)medical teaching – preclinical and clinical research THE HEALTHCARE SYSTEM IN THE NETHERLANDS • Private providers (not-for-profit) • Private insurers (not-for-profit) • Tight regulation of: – Patient selection – Premium – Budgets • Currently changes in insurance and budget system aiming at more competition HOSPITALS IN THE NETHERLANDS • 100 hospitals (16 million inhabitants) • 20 ‘large’ hospitals (>500 beds, teaching facilities) • 8 academic hospitals (associated with university) • Few ‘commercial’ out-patient clinics (<5% of care) Ministry of Education University Academic Hospital Board of trustees Board of trustees Executive board Executive board Faculties (deans) Departments (chiefs) – students – teachers – researchers – – – – students teachers researchers patients Ministry of Education University Academic Hospital Board of trustees Board of trustees Executive board accountability Executive board for R&E Dean medical faculty Medical faculty membership Departments merger UNIVERSITY MEDICAL CENTERS: ACCOUNTABILITY • Various models depending on local situations • Allocation of money for research, teaching and patient care to divisions/departments • Integration of money flow at the division/department level • Contract model with departments based on performance • Integrated annual budget and report UNIVERSITY MEDICAL CENTERS: INTERNAL ORGANIZATION • Various models depending on local situations • Integration of research, teaching and patient care in divisions/departments • Management team of division/department is responsible for all functions • 60% of executive board members of UMCs has a background as professor UNIVERSITY MEDICAL CENTER UTRECHT: ORGANIZATION • Executive Board: 3 members (prof. of medicine, prof. of neurosciences, economist) • Central facilities (HRM, Finances, ICT) • 12 Divisions lead by 1 or 2 professors, 1 nursing and 1 operating manager. • Clinical departments, research groups etc with integrated budget responsibility University Medical Centers in the Netherlands • Mergers of academic hospitals and medical faculties • New organisations in 7 of 8 locations • 60.000 employees, • Total budget 4.400 x 106 • Integration of care, education and research at all levels UNIVERSITY MEDICAL CENTERS: IS 8 ENOUGH? • 340 first year medical students per UMC: that´s a lot • For teaching each UMC needs 5-10 other hospitals • Geographic spread for specialized and tertiary care is needed • Less UMCs than in the USA or Switzerland on population basis • Competition fosters quality, in particular in research • Increased awareness of the necessity to concentrate some functions 8 UMCs in the Netherlands: research and development • 7.500 papers in peer-reviewed scientific journals per year • One-third of total scientific output of the country • 100.000 citations per year, 40% over world average • High quality of clinical research • Strong national and international cooperation • 2000 new clinical research protocols per year • Active human technology assessment departments 8 UMCs in the Netherlands: teaching and education • Medical students (15.000) • Bachelor and master programs in biomedical and health sciences (1500 students) • Ph.D. programs (3500 students) • Training for medical specialist (2500 residents) • Training for specialized nursing (3000 students) • New professionals: physician assistants en nurse practitioners • Postgraduate teaching 8 UMCs in the Netherlands: patient care • 800.000 new patients/year • 60% tertiary/licensed care • 80% of tertiary and 50% of licensed specialized care in the country • 10% of secondary care in the country 8 UMCs in the Netherlands: health care funding • • • • Regular budget € 1.900 licensed specialized care € 400 Last resort tertiary care € 400 Healthcare R&D € 200 € 2.900 x 106 8 UMCs in the Netherlands: research and education funding • Bachelor and master programs € 400 (tax money) • Post initial medical & nursing training € 200 (insurers) • (Bio) medical research € 400 (tax money) • Third party money € 1.500 x 106 € 500 University Medical Centers: merging academic hospital and faculty of medicine PROs • • • • Strategic synergy Bench-to-bedside alignment Improved accountability Less bureaucracy University Medical Centers: merging academic hospital and faculty of medicine CONs • “Research will suffer, patient care will dominate” • “Patient care will pay for preclinical research” • Loss of interaction with other academic disciplines • A step toward separate medical universities Complexity Phenomenology of hospital care Tertiary care Elective highly specialized care Basic general care Elective simple care Predictability Complexity University Medical Centres UMC’s and large general hospitals Community hospitals Focussed factories Predictability University Complexity R&D T&E Disease oriented Process oriented Symptom oriented Process oriented Chain Primary care Self-care Predictability R&D T&E Access for R&D and T&E UMC’s and large general hospitals Community hospitals Focussed factories UMCs: ambitions • The motor of research and development in health, disease and healthcare • The breeding site of the health care work force • The provider of tertiary care in the health care system UMCs: challenges • How to maintain research and development (R&D) • How to provide teaching and education (T&E) • How to guarantee tertiary care for complex and ‘orphan’ patients (TC) in a money- market- driven system 22.6.2015 40 22.6.2015 41 22.6.2015 42 22.6.2015 43 22.6.2015 44 22.6.2015 45 22.6.2015 46 22.6.2015 47 22.6.2015 48 22.6.2015 49 22.6.2015 50 22.6.2015 51 22.6.2015 52 22.6.2015 53 22.6.2015 54 22.6.2015 55 22.6.2015 56 22.6.2015 57 22.6.2015 58 22.6.2015 59 http://issuu.com/ucsfmedicalcenter/docs/2014_annual_report_ucsf_medical_cen 22.6.2015 60 COLLEGE OF MEDICINE AT QATAR UNIVERSITY MAKING HMC THE QATAR UNIVERSITY HOSPITAL DISCUSSION PAPER AND WORKING DOCUMENT 23rd of March, 2015 BUILDING UPON THE EXPERIENCE OF HMC, THE COLLABORATION WILL BRING ALONG SUBSTANTIAL ADVANTAGES FOR BOTH PARTIES Previous education and research achievements of HMC • Originator of Qatar’s academic health system (AHS) initiative with 8 health education and research partners, 2011 • Establishment of comprehensive teaching activities for medical students in collaboration with – Qatar University Health Sciences and Pharmacy – WCMC-Q – Calgary nursing • As only 2nd healthcare provider outside the US, HMC received US accreditation (ACGME I) for 7 residency programs • High commitment to and profound experiences in research activities – During 2013, research investigators at Hamad received 11 grants – In 2013, more than QR 3,000,000 was awarded through internal research grants for 143 research proposals Mutual advantages of the collaboration Advantages for CMED • Comprehensive service scope with a wide range of specialties • Health care provider with joint interests in education and research • Profound teaching experience including existing infrastructure and staff • Access to research infrastructure and staff Advantages for HMC • University status as catalyzer for future development strengthening research and educational activities TODAY’S MEETING FOLLOWS A FOUR STEP APPROACH Task Focus of today’s meeting: 1 2 Definition of affiliation archetype • Scope Benchmarking of university hospital requirements • Establishment of a long-term collaboration towards shared education and research objectives Ensuring a collaboration model on ‘equal footage’ • • Assessment of international examples for structural criteria of a university hospital Derivation of responsibilities of both parties 3 Proposed university hospital framework • • Proposed criteria catalogue for HMC University Hospital Proposed governance structure 4 Proposed roadmap • Derivation of action plan to implement the CMED-HMC affiliation and • derivation of timelines towards the formal affiliation THE FRAMEWORK FOR BECOMING THE CMED UNIVERSITY HOSPITAL NEEDS TO DEFINE CRITERIA ON FIVE MAIN AREAS Strategy • • Agreement on core collaboration areas and joint branding Full strategic alignment of core areas including development of a long-term education and research strategy Universit y hospitals Teaching hospitals Teaching Research • Min. department size / max. program size • Staff qualification • Protected time for teaching • Research is not a priority (for staff hiring or for promotion) • Crossrepresentation • Installation of teaching coordinators and mentors • Significant teaching commitment, e.g.: • Appointments • Evaluation • Academic teaching • Min. research output for new appointments • Protected time for research • Joint committees and decision making • Installment of research coordinators • Crossappointments best practice High quality of patient care based in international • • Organization & governance HMC to be responsible to ensure highest quality of patient care and continuous improvements HMC to provide transparency about quality of care in terms of standardized external evaluation processes WITHIN THIS FRAMEWORK, CMED AND HMC AGREE ON A JOINT STRATEGY FOR THE UNIVERSITY HOSPITAL WHILE REMAINING AUTONOMOUS IN THEIR PARTICULAR CORE COMPETENCIES Joint areas of the University Hospital CMED • • Full responsibility for development of the curriculum Full responsibility for academics (incl. e.g., staffing, operational requirements at the medical faculty) • Development of a joint long-term vision • Agreement on a joint branding / name of the affiliate • Full responsibility for clinical care at HMC • Development of a clinical education and research strategy • Full responsibility for high quality of patient care • Responsibility for formulation of proposed clinical education program in line with curriculum • Agreement on clinical education program • Joint application for 3rd party funding • Joint decision making regarding operational requirements of the education and research program (incl. e.g., teaching and research staff, investments) HMC INTERNATIONAL AFFILIATION AGREEMENTS CONTAIN DETAILED PREMISES REGARDING TEACHING QUALITY AND FACILITIES Criteria: German y Requirements: Department size: • • > 4 full-time specialists per department, < 0.5 student placements per full-time specialist 10-15 beds per student placement, > 60 inpatient beds in internal medicine / surgery Staff qualification: • • PhD of Department Head, higher education qualification of staff members > 1 central teaching coordinator by faculty • Formulated teaching curriculum incl. > 90 min classes / week, demonstrations, case conferences Compliance with Logbook and formulated structured evaluation of teaching success Clinical teaching plan: • • Staff qualification: • Austria • Clinical teaching plan: • • Staff qualification: UK Impact on CMED HMC • Clinical teaching plan:• • • • • Provision of a teaching coordinator at the hospital and subject coordinator on specialty level Minimum qualification: specialists, participation at training programs of the medical faculty obligate Provision of case conferences and radiological demonstrations as well as further trainings Nomination of mentors on departmental level Biweekly assessments, feedback sessions at the end of each block, support of the final examination Significant teaching commitment, defined as the installment of a non-executive director appointed from a university with medical / dental school > 1 practice placement per department Minimum department size in alignment with expected student numbers? Higher education of all teaching staff, each department / specialty to be headed by PhD? Implementation of shared appointment at CMED for all teaching staff members? Minimum guidance for HMC to formulate a clinical teaching plan? SOURCES: CMED team; German Society of Medical Education: Quality management of clinical-practice instruction, 2014 / Medizinsche Universität Wien: Kriterien für die Akkreditierun als Lehr-Krankenhaus der MedUni Wien, 2013 / Association of UK University Hospitals – University Hospital Trusts, 2014; NHS Act 2006 – Definition of University Hospital Status AFFILIATIONS INSTITUTIONS ADDITIONALLY REQUIRE TO SHOW EVIDENCE OF SIGNIFICANT RESEARCH ACTIVITY WITHIN THE HOSPITAL Criteria: UK Impact on CMED HMC Requirements: Staff requirements: • A core number of university principal investigators (minimum of ten university staff) to be based on site Research output: • Research output to be Research Excellence Framework • • • 1) returnable Minimum number and qualification of research staff? Definition of share of protected time for research? Research output: • Definition of minimum quantitative output per research staff and year? • Definition of minimum qualitative output (e.g., impact, number of citations)? 1) The Research Excellence Framework is a process of expert review assessing the quality of research in the UK; Criteria are output (in terms of originality, significance, rigor), impact (in terms of effect on / change of economy, society, culture or health), and environment (in terms of strategy, resources and infrastructure that supports research) SOURCES: Association of UK University Hospitals – University Hospital Trusts, 2014; NHS Act 2006 – Definition of University Hospital Status ENSURES SUCCESSFUL AND SUSTAINABLE IMPLEMENTATION OF AN AF THE JOINT GOVERNANCE STRUCTURE AND ORGANIZATION MODEL FILIATION MODEL Criteria: Organization: Austria UK Impact on CMED HMC Requirements: • Nomination of a teaching and subject coordinators at the hospital by the medical school • Governance structure: • • Joint evaluation of teaching success, e.g. through joint final examination at the medical faculty Participation of teaching staff of the hospital at teaching programs of the medical faculty Feedback sessions between staff of the medical faculty and mentors at the hospital Organization Shared appointments of researchers at the university hospital and the medical faculty • • Governance structure: • • • • • University representation on hospital boards (e.g., Trust’s Local Awards Committee, Trust’s Advisory Appointments Committees Nomination of teaching and research coordinators at the hospital by the medical school? Appointment of clerkship directors involved in clinical services and supporting clinical students? Definition of joint committees (incl. chairs, attendees, meeting cycle and responsibilities) and proposed cross-representation on committee level of partner entity? Definition of reporting and decision making processes? Definition of publication guidelines including definition of intellectual property? SOURCES: Medizinsche Universität Wien: Kriterien für die Akkreditierun als Lehr-Krankenhaus der MedUni Wien, 2013 / Association of UK University Hospitals – University Hospital Trusts, 2014; NHS Act 2006 – Definition of University Hospital Status BASED ON INTERNATIONAL STANDARDS, AN INITIAL FRAMEWORK HAS BEEN DEVELOPED TO BUILD BASE FOR THE COLLABORATION CMED – HMC (1/2) Responsibilities of HMC Category Criteria Comment Strategy • Aligned strategic plans in core areas (except patient care) and agreement on KPIs • Joint responsibility for KPIs • Alignment about types of academic accreditation sought (e.g., ACGME standards shared between MD and postgraduate programs) • HMC needs to have postgraduate training programs Based on internal discussions Teaching • Minimum department size: • 4 full-time specialists per department, maximum of 0.5 student placement per full-time specialist • Provision of adequate number of workstations • Provision of access to clinic infrastructure (e.g. staff changing) • Access to library and internet • Shared training facilities (e.g. skills lab) • Minimum staff qualification: • Higher graduating level within each specialty: e.g, min. of 1 professor • Joint professional development activities • Graduating level of teaching staff members: M.D. • Teaching staff ideally appointed as adjunct lecturer / faculty at CMED • Teaching program: • Formulated teaching program based on the CMED curriculum and rotation program • Monthly demonstrations in pathology and case conferences • Minimum of 90 min structured classes per week Based on international benchmarks, selected most detailed criteria SOURCE: CMED team BASED ON INTERNATIONAL STANDARDS, AN INITIAL FRAMEWORK HAS BEEN DEVELOPED TO BUILD BASE FOR THE COLLABORATION CMED – HMC (2/2) Responsibilities of HMC Category Criteria Comment Research • Minimum number of researchers on site and minimum staff qualification • Minimum qualification for new appointments (e.g. Academic Medical Center Helsinki: minimum of 20 publications as first, second, second last or last publisher) • Reasonable research output (to be frequently assessed by Joint Steering Committee) • Publications to be marked as affiliated with QU CMED (ideally all papers) • Joint PhD program • Joint research projects • Joint application for 3rd party funding • Shared research facilities (e.g. biostatistics) Based on UK benchmark and discussion with Dr. Anne Organization & governance • Representation of HMC in CMED Steering Committee • Collaboration with teaching respectively research coordinator through CMED Based on international benchmarks, selected most detailed criteria SOURCE: CMED team ADDITIONALLY, CMED WILL PROVIDE THE ADMINISTRATIVE SUPPORT TO ENSURE HIGH QUALITY OF CLINICAL EDUCATION Responsibilities of CMED Category Criteria Strategy • Development of an overarching strategic plan for CMED as baseline for joint activities with the University Hospital Teaching • Appointment of clerkship directors involved in clinical services and supporting clinical students (12-15 in total) • At least one clerkship director for each phase of clinical clerkships (10 clerkships planned) • 20%-50% patient care • 50% teaching • 0-30% research involvement • Establishment of master programs for developing clinical staff at HMC Research • Nomination of at least one research coordinators per major department in the hospital (12-15 in total) • Research support group within the hospital to support development of research projects, connect with researchers at QU, and provide methodological support (e.g. statistics) Organization & governance • Establishment of a Joint Steering Committee • Representation of the CMED on HMC board level • Abdullatif appointment SOURCE: CMED team Comment Based on input management team meeting FIRST PRIORITY IS TO INSTALL THE COLLABORATION ON RESEARCH ACTIVITIES WHILE IMPLEMENTING THE TEACHING FACILITIES Today Teaching Agreement on activities affiliation model Assessment of current state To be defined Implementation of criteria for teaching hospitals Development of research program Research activities Milestones Winter 2015 Start of implementatio n process SOURCE: CMED team Gap analysis and implementatio n plan HMC to become designated university hospital of CMED Feb. 2019 To be defined Start of clinical education/ Final implementation of teaching requirements Start of joint research activities First batch of students to start clerkship Re-assessment of university status in “steady state” after 3 – 5 years NEXT STEPS • • • • Internal discussion of criteria catalogue and incorporation of feedback – Review trough management team, meeting planned on Monday, 23rd of March 2015 Alignment with EMC Discussion and alignment with HMC Preparation of assessment of current status CLEVELAND CLINIC 22.6.2015 78 CLEVELAND CLINIC 22.6.2015 79 CLEVELAND CLINIC 22.6.2015 80 STRATEGINEN ALLIANSSI • • • • Strateginen allianssi tarkoittaa molempien (tai useampien) osapuolten tärkeänä pitämää yhteenliittymää, joka perustuu yhteiseen strategiseen näkemykseen ja ainakin osin yhteisiin rakenteisiinkin. HUS-näkökulma: olemme jo strategisessa allianssissa HY:n ja sen lääketieteellisen tiedekunnan kanssa, mutta meidän pitää mennä yhdessä eteenpäin: yhteinen toimintasuunnitelma (tutkimusstrategia on hyvä, mutta ei riittävä), ja lisää yhteisiä rakenteita. Nostettava vakavasti esille UMS –vaihtoehto ! Tiedostettava myös haasteet: yliopistosairaalalla on kalliimpi drgpisteen hinta kuin muilla sairaaloilla ! HYKS 741 €, Muut HUSsairaalat 618 € - 671 €. Myös THL:n Benchmarkig osoittaa tämän. VALTAKUNNALLINEN YHTEISTYÖ UUDELLE TASOLLE ! • • Vaikka kilpailu potilaista ja tertiääritason keskuksista on todellista, ovat yliopistosairaaloiden yhteiset intressit suuremmat. Yhteistyö tulee nostaa uudelle tasolle. Muutamia vuosia sitten oli puhetta yhteisestä organisaatiosta/resurssista, tähän tulisi palata. Sote-lain tämän hetkinen valmistelu osoittaa, että yliopistosairaaloiden asemaa ei ymmärretä ja ne nähdään jopa ”mustina aukkoina”, jotka edustavat hallitsematonta medikalisaatiota. On toki itsekin oltava kriittinen omaan toimintaan nähden, mutta väärät uskomukset on päättäväisesti korjattava ja lisättävä lobbausta ja tiedonvälitystä kaikilla tasoilla.
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