Academic Health Science Systems The British Columbia Context

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1 Academic Health Science Systems The British Columbia Context

2 Presenters: Dr. Rob Liston Executive Associate Dean, UBC Faculty of Medicine Carl Roy Executive Vice President & Chief Administrative Officer PHSA

3 Academic Health Sciences Networks (AHSNs) will improve the health of Canadians and enable Canada to be a global leader in health care, education and research.

4 1. providing Canadians with timely access to advanced patient care services; 2. training the next generation of health care professionals; and 3. conducting leading-edge research and making it available to clinicians, administrators, policy makers and the public

5 1. while changing governance models in the health system are sometimes acting as a catalyst for improved integration across all three missions of the AHSC, in other instances they are creating barriers; 2. new integration mechanisms are required, both within AHSCs and between AHSCs and government, to better align plans, strategies, processes and outcomes; and 3. continued resourcing pressures, uncoordinated funding, and multiple funding sources including the different levels of government, present a significant challenge to optimize all aspects of the care-teaching-research mission.

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7 No cookie-cutter recipe Importance of a common vision Constituents taking the lead Mental Health as a catalyst

8 BC Cancer Agency BC Centre for Disease Control BC Children s Hospital & Sunny Hill Health Centre for Children BC Mental Health & Addiction Services BC Renal Agency BC Transplant BC Women s Hospital & Health Centre Cardiac Services BC Perinatal Services BC Emergency and Health Services Commission (Provincial Ambulance Service)

9 4 th largest health research organization in Canada (source: Research InfoSource 2010/11) $127.4 million in external grants 2011/12 Attracts 25% of external research funding in BC (Source: UBC) 677 researchers >1,000 research trainees 393 clinical trials, >9,000 enrolled subjects 4,000 students/year

10 Single medical school in BC with a province-wide mandate 19 Departments; 15 Research centres and institutes 4,000+ undergraduate, graduate and postgraduate students and learners 633 Full-time faculty members 4,860 Clinical faculty $292 million annually in research funding from public and private sectors (2011/12) 44 out of 149 UBC spin-off companies originating in the Faculty of Medicine Among the top 40 research universities in the world

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12 Expansion of the Faculty and affiliated health authority research institutes has allowed the foundational health sciences to grow, fuelling research growth in British Columbia Faculty (including affiliated HA research institutes) recently rated at #1 in Health and Life Sciences in Canada, and #30 in the world BC has a healthy population

13 Government Provincial Health Authorities Faculty of Medicine Affiliated Universities Community Industry..towards a common Vision

14 Healthier Population; Economic benefits

15 1. Integration of planning, strategies, processes 2. Resourcing 3. Governance

16 While we are making attempts to better align our processes, we have a ways to go UBC currently developing an Integrated Plan for Medical Education ( ) with both Ministries Health Authorities are aligning their plans with Ministry of Health s Service Plan...we need to move towards a more integrated planning process, identifying common goals and defining common success metrics

17 We are working together but not always collectively... Blending of clinical leadership (underway) Joint Advisory Councils (Faculty meeting individually with HAs) MHRPTF (most players participating; doesn t include Health Professions however) Leadership Council (Faculty not at the table) Lower Mainland CEOs (Faculty not at the table) Faculty/Deputy Ministers Meetings (HAs not at the table) Health Research BC (all HAs, research intensive universities, research institute, MSFHR) PSAC (Faculty not at the table)

18 We are reaching into the Community Delivery of primary care in a coordinated manner across the population is a prerequisite to improved health outcomes In BC we are seeing an explicit shift to focus on ambulatory care within the community during health education and training We are creating new academic environments that embrace clinical service delivery, quality improvement, and research the result is enhanced patient care and economic benefit to communities that were previously underserved

19 In BC, a new financial model must be considered or we will continue to face challenges such as Lack of Alternate Funding Plans Inability to recruit and retain leaders Inability to support and sustain essential research infrastructure Inability to compete nationally and respond in a timely way to emerging opportunities Inflexible/obsolete physical facilities Industry moving rapidly to strategically aligned partners

20 Boards/Funding organizations not always aligned and may have competing interests. Multiple Boards (UBC Board; HA Boards; RI Boards) Multiple Funding Agencies (i.e. foundations; national funding agencies) Health practitioners independent or wearing multiple hats

21 Government: Traditionally funding for universities and health authorities has been separate (AEIT support UGME; MoH supports medical infrastructure, PGME and HA s) Government is under considerable pressure to reflect accountability and there is renewed interest in examining all aspects of financial arrangements Current resourcing streams limit flexibility Flexibility / accountability dichotomy

22 1. Establish formal interorganizational structures and governance mechanisms 2. Commit to developing integrated plans and strategies 3. Establish appropriate structures, process and forums to meet on a regular basis 4. Work with respective provincial and territorial governments 5. Federal, provincial and terrirotiral governments collectively recognize AHSNs as a national resource

23 6. Ensure appropriate financial resources, mechanisms and programs are aligned 7. Ensure appropriate federal financial resources, mechanisms and programs to align with provincial and territorial government priorities 8. Create an international meeting place or annual forum to bring together global leaders committed to advancement of AHSNs

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25 One Faculty of Medicine providing medical education across the province Undergraduate Program delivered across four geographically distinct sites working in partnership with UNBC and UVIC Postgraduate education training sites distributed across clinical and community health care facilities around the province Six Provincial Health Authorities PHSA Northern Health Vancouver Island Health Authority Vancouver Coastal Health Fraser Health Services Authority Critical mass of research and teaching

26 Define the vision for leveraging our assets Reach agreement on a partnership/network model Clearly define roles, responsibilities and accountabilities Clearly define systems and processes required to support partners in effectively working together Secure enabling provincial policy and funding to accelerate progress Deliver specific projects/functions across the network

27 Thank You!!

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