Securing the Future of Canada’s AHSCs…

1. Securing the Future of Canada’s AHSCs… NATIONAL CONSULTATION FORUM Sheraton Hotel – Ottawa January 28 & 29, 2010 Dr. Nick Busing Co-chair, Steering Committee 1

2. What we Learned – Gathering the Evidence • Securing the Future of Canada’s AHSCs Environmental Scan • Securing the Future of Canada’s AHSCs A case study describing the current state and future issues

3. Goals of the Environmental Scan To identify the internal and external factors (including enablers and barriers) that need to be addressed to allow Academic Health Science Centres (AHSCs) to achieve excellence and innovation in patient care and service delivery, education and training, and research; and, To identify and understand the perspectives of AHSCs, governments and the public across Canada on the changing needs of AHSCs

4. Eight Themes to Guide the Analyses • Accessibility • Accountability • Excellence • Innovation and Knowledge Transfer • Interdependence/collaboration • Interdisciplinary • Quality • Sustainability

5. Inventory of Published Literature & Information Sources • 1000 articles, reports and websites reviewed • 170 abstracts for most relevant documents (1994-2009)

6. Internal and External Factors to achieve Excellence and Innovation in Patient Care and Service Delivery • Recruitment/Retention • Funding • Continuity of patient care • Access • Interdisciplinary approach • Demands for new technology • Capital funding • Better governance • Electronic patient record systems

7. Education and Training • Interprofessional education • Funding education • Redefine AHSC/University relationships • Clinical placements • Service/educational balance for students and teachers • Adapting to decentralized education

8. Research & Innovation Factors • Accelerate KT to clinical practice • More researchers, including clinical scientists • Protected time for clinical scientists • Impact of economic downturn in research funding • Better communication of ROI • Improve AHSCs/funding agencies relationships • Increased funding of new technology/equipment

9. Survey of AHSC Leaders & Stakeholders • 280 invitations/124 completed for a 43.5% response rate • Questions related to patient care and service delivery, education and training, research and innovation, governance • In general, academic leaders had lower satisfaction with levels of performance

10. Interviews of AHSC Leaders & Stakeholders Key observations • National approach to define the AHSC’s role • Need a well managed network of hospitals within the system • Patient centered approach, linking back to primary and secondary care • Clear definitions of different patient care responsibilities of AHSCs, community and regional centers

11. Interviews of AHSC Leaders & Stakeholders 29 Interviews • 10 institutional leaders • 13 academic leaders • 2 government representatives • 4 other stakeholders

12. Observations - Patient Care • National approach relating to HHR within AHSCs • Interdisciplinary process • Compensation system • Avoid duplication of care delivery • EHR

13. Observations - Education and Training • Integrated curricula focusing on needs of patient/population • Support of distributed education • Better Education/Health dialogue at provincial level • Enhance training in rural family medicine and core specialties • Governance accommodating community care

14. Observations - Research and Innovation • Increased funding for health research • Strategic planning for a health and biomedical research agenda • Align health research with health of population and economy • Clinician scientist support

15. Observations - Governance • Better government – AHSC relationships • Clarify role of AHSCs in regionalized and integrated health care system • Better management of AHSC/University relationship

16. Purpose of the Case Study • Describe current AHSC Models • Identify consistency and divergence - in models - in structures within which models functions - in mechanisms that deliver the mandate

17. Consultations • Over 100 interviews • Presidents and CEOs of hospital and health regions • Health Authority and health regional board chairs • Deans of Medicine/Pharmacy/Nursing • Rehabilitation Sciences • VPs of Research – Universities, Hospital • Directors of Research Institutes • Vice Presidents – professional practice, academic and provosts

18. Key Observations • Current AHSC model grounded in partnership between universities, relevant faculties and affiliated hospitals or RHAs • Health Authorities added a new dimension to mandate of care, education and research • 10 of 17 AHSCs have traditional governance models • Rest have a regionalized governance model • Regional models challenge AHSCs because of lack of formal integration or alignment

19. Key Observations • New models to address alignment issues (eg Quebec RUIS) • Changes in all three mandates - clinical care, education, research • Resource needs for patient care versus education and research • Need for cohesion across ministries • Need to recognize value of partnership between universities and health regions • Desire for new integrated models