Description of Clinical Academic Groups (CAGs) as part of the cooperation between the Capital Region of Denmark and the University of Copenhagen

Transcription

1 Description of Clinical Academic Groups (CAGs) as part of the cooperation between the Capital Region of Denmark and the University of Copenhagen Introduction (general facts about the closer partnership between the University of Copenhagen and the Capital Region of Denmark) Since mid-2015 the University of Copenhagen and the Capital Region of Denmark have been in the process of establishing a common foundation (vision of goals) for increasing cooperation between the two organisations, with the aim of elevating education, research and clinical work to a new level. In August 2016 the partners reached agreement on a shared vision of goals which will provide the foundation for future cooperation. In the light of the close links between the Faculty of Health and Medical Sciences at the University of Copenhagen and the Capital Region of Denmark's hospitals, the partners have decided to start by boosting cooperation in the field of health. For this purpose they have established a joint partnership structure under the name of Copenhagen Health Science Partners (CHSP). CHSP will focus on closer cooperation between education, research and clinical practice, with the goal of enhancing research and quality and coherence in the health service for the benefit of the patients. Common priorities and development will provide the momentum for chosen areas of activity and will serve to create new or greater social value creation. This common ambition can only be achieved through targeted input and a clear focus. The core element of cooperation will be a number of CAG in various fields of particular potential. Concentrating efforts via the CAGs will ensure research breakthroughs in patient care, improve international profiles and at the same time support the general transformation of the health service in the Capital Region of Denmark. What is a CAG and what is its purpose? The purpose of a CAG is to establish a strong, academic-based partnership structure that facilitates cooperation between clinicians and researchers at a hospital and researchers and teachers at a university. This cooperation will ensure the free flow of existing know-how, the collaborative development of new knowledge, and the various participants' mutual influence on each other's academic agendas. In other words, clinicians will have an impact on the researchers' agendas and the researchers at universities or hospitals can influence academic activity in the clinic. Cooperation must be two-way.

2 Collaboration within a CAG should promote the development of new knowledge, channel new knowledge into the hospitals and ensure its implementation. In this way CAGs will help to ensure that future patient care is on a high expert level, effective and innovative. The CAG structure is intended to speed up the implementation of new knowledge. Cooperation within a CAG will have an impact on research agendas, making it easier to address the need of clinics and society for new knowledge. At the same time researchers will be secured optimal access to patients, thus enhancing the quality of research. The CAG must ensure that the research is of a higher international calibre and is more relevant/easier to implement. In this sense CAGs will act as a framework and will facilitate the process of seeking funding such as through Horizon 2020, but also in a wider context. The success of the CAGs hinges on the academic knowledge and findings both new and existing being disseminated and used. Thus teaching activities are crucial to the work that goes on in a CAG, both when it comes to teaching at universities and teaching in hospitals. One of the key issues for a CAG, for example, is how to guarantee that new knowledge within a field disseminated and used by healthcare professionals in hospitals and teaching institutions. It calls for collaboration across organisational divides. In this way CAGs will ensure more practice-oriented education and training based on state-of-the art knowledge. CAGs therefore not only revolve around clinical practice and research, but also education. All three elements are part of its professional work. A CAG is thus not a partnership structure merely for the purposes of research. Professional development is obviously a key factor in the work of the CAGs; however, a CAG also devotes energy to developing clinical guidelines and ensuring that they are widely used in everyday clinical practice. More seamless cooperation between universities and the Capital Region of Denmark is essential, and cooperation between the different departments at different hospitals is crucial to whether a CAG can perform its task. One obstacle today, for example, is the lack of common administrative systems and joint prioritisation of resources across the organisational units and sectors. The involvement of external partners, e.g. other regions, universities, hospitals, private companies or international environments, can in some instances be vital to a CAG's success. Mandatory eligibility criteria for CAGs CAGs are chosen based on open notice and are selected by the CHSP Executive Committee. The detailed criteria for the individual notice for a CAG are agreed/determined on a continual basis by the parties behind the cooperation. To be eligible for a CAG (in the first phase/2017) fulfilment of the following criteria (not listed in order of priority) is evaluated: Major clinical significance for large patient groups Strong shared vision Presence of translational need for anchoring the work in a hospital

3 Clearly measurable clinical aspects and potential socio-economic gain Excellent research and/or clinical environment Can contribute to the development of education and training within the CAG's field Well-defined, strong research management that has scientific merit and organisational skills Potential for communication and outreach Strong international network and plan for developing it Clear, documentable implementation plan Reliably feasible Potential for obtaining external funding Another criterion for the assessment of the individual tender will be whether the field in question needs the organisational boost which designation as a CAG entails. In that sense a mature, academically strong environment will not necessarily be selected as a CAG if the shared organisation as a CAG and the academic programme do not serve to significantly enhance the field for the benefit of patients and/or the proposed CAG field does not gain any significant value creation due to the designation. Incentives for entering into CAGs A well-functioning and mature CAG with a documented ability to boost cooperation and academic development will presumably be the pivotal point/core/natural impetus for major strategic priorities in the area in future. In the build-up phase individual CAGs will have access to the following: The senior management of both the University of Copenhagen and the Capital Region of Denmark (executive management and hospital senior management) in the Executive Board via the executive managers of CHSP. In other words managerial support to ensure impact and dissemination etc. Assistance to build and run the CAGs, e.g. access to support from CHSP's secretariat, management of CAG's finances, documentation of established targets, holding conferences, etc. VIP treatment priority/special access to assistance from the support functions of the Capital Region of Denmark and the University of Copenhagen (funding, legal advice, creodk, single point of access etc.). Basic funding of CAGs (minimum amount DKK 1 million for each CAG per year). This should be seen as a start-up package that is meant to stimulate managerial and organisational development and may include funding for relevant research activities in the form of PhDs or similar. Organisation of CAGs CAGs can be organised in many ways and the degree to which they are organised can vary considerably from CAG to CAG. CAG-like cooperation projects, both formal and informal, already exist today, and they should, of course, continue. Becoming a CAG under the direction of CHSP, however, requires a more official recognition of the collaboration and its importance in both organisations. One key factor is that CAGs have

4 a clearly defined professional management that is also willing to assume responsibility for the organisational aspects of the cooperation. The CAG management must be able to ensure collaboration across organisational borders and have experience in developing a palette of academic activities. Structurally, CAGs consists of a group of people who desire the cooperation and who implement a number of activities to improve research and treatment. These people join forces to tackle one or several academic issues. They must come from both the Capital Region of Denmark and the university. Typically, a CAG includes several hospitals and at least one university faculty. People from other universities and organisations can also be part of a CAG and its activities. The management consists of one or more strong experts from the university or the Capital Region of Denmark who will work closely with the director of CHSP. It is important for the CAG management to have strong international merit and legitimacy in the academic environments involved. Academic side of CAGs CAGs must be responsible for independently planning and holding its academic activities. CAGs must manage their daily activities themselves and must be dedicated to the overall development of their respective disciplines. The academic activities can be diverse in nature and include research seminars, education and training activities, the joint development of new clinical guidelines or workshops for discussing professional challenges: What does the problem involve in the everyday? What knowledge do we already have? How can we apply it? What knowledge do we lack for solving the clinical problem? Another important professional activity is to prepare joint, large-scale international applications. CAGs must document their performance and make them available to others in order to inspire a general increase in cooperation between the Capital Region of Denmark and the University of Copenhagen. The ultimate objective of a fully developed CAG is for its research, clinical practice and education to be unique and for the potential within the field to be exhausted. CAGs are responsible for identifying and implementing ideas and activities that can contribute to enhanced collaboration and these activities are prioritised based on meticulously drawn up business plans. Financing CAGs CAGs will be funded in three tiers. The first tier consists of basic funding from the University of Copenhagen and the Capital Region of Denmark. This funding primarily covers CAG management and the basic activities that will generate academic life in the CAG structure. Part of the basic funding will also comprise earmarked funds for PhD projects. In the second tier, the CAG structure is expected to attract a high level of external financing, which will drive research, education and training and clinical activities. The central team will provide support for developing the necessary funding strategy.

5 In the third tier a well-functioning and mature CAG with a documented ability to stimulate collaboration and academic development is expected to become a focal point for major strategic priorities in the future. Infrastructure and network-building organisations will be developed using CAGs as an underlying structure. The first step towards establishing a CAG In the first step towards establishing a CAG, several strong academic environments (represented by various experts strong in their field) join forces around a clear academic profile and various academic activities that are considered necessary. It is important that these environments can cope with a difficult strategic dilemma. On the one hand they need to have a clear profile and international standing. On the other it is important to generate broad support for the CAG's work preferably with representation from all relevant hospital departments. It is also important that the environments agree on the appointment of a CAG director and deputy director who can oversee the academic as well as organisational collaboration. The first task is to describe the CAG and its work in various documents that can be used in an official application process which will focus on assessing the CAG's ability to achieve the desired outlined effects. Example of a CAG A CAG could, for example, look like this in the future: A CAG management team consisting of six people have established a CAG. Four of them are clinical professors at different hospitals in the Capital Region of Denmark (one of them is also a head of department at Rigshospitalet), one is a professor and deputy head of department at one of the general departments at the University of Copenhagen Faculty of Health and Medical Sciences, and one is the chief consultant at the Capital Region of Denmark's largest hospital department in the academic field in question. Several experts have been involved in developing the CAG and its programme; however, these six people have been the main driving force. The Executive Board has appointed the clinical professor with the largest research portfolio as director of the CAG and the professor from the University of Copenhagen as its deputy director. These two CAG directors refer in this function to the director of the newly established partnership organisation CHSP. The CAG management team has involved more than 75 active experts both from the University of Copenhagen and from the Capital Region in the cooperation. The central component is an academic profile and various academic collaborative projects they want to promote through highly dedicated joint efforts. The CAG's profile and its collaboration is set out in a number of clear documents, which describe, for example, the academic activities envisaged in the first three years. A number of leading staff at the University of Copenhagen and in the Capital Region have pledged their support for these activities, thus ensuring broad organisational support for the CAG's work and professional development. The documents have also been used in the application process CHSP presided over the New Year 2016/17. This results in the CAG obtaining official approval.