Steno Diabetes Center Aspiration Strategy Translating. Research Prevention

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1 Steno Diabetes Center Aspiration Strategy 2020 Translating Research INTO Superior Care And Prevention

2 Aspiration strategy 2020 Our vision is to become leaders in diabetes care and translational research with focus on early disease and prevention John Nolan, CEO and Head, Steno Diabetes Center Superior quality of care We will excel in clinical care through our clinics, the use of modern technologies, and improved methods for patient education. Full-cycle care and prevention We will develop solutions for both care and prevention of diabetes through research in health promotion, understanding of early disease, complications and novel approaches to clinical care. Addressing the global diabetes epidemic The challenges posed by pandemic diabetes, pandemic obesity and the related health care costs are well established and constitute a major public health crisis. To address the global diabetes epidemic, the 2020 strategy for Steno Diabetes Center strengthens its focus on the prevention and care of diabetes. Our vision is to become global leaders in translational diabetes research and clinical care. We will focus on early disease and prevention to find solutions that will make a real difference for people with diabetes and those who are at risk. Global presence and recognition We will extend Steno s educational message through local Steno hubs in high-prevalence countries, as well as through web-based approaches and through international research partnerships. People and organisational development We will develop Steno s organisation through leadership, attraction and retention of talent and a culture marked by the joy of high performance. 2 3

3 Translational research, care and prevention We want to build on the historic tradition of Steno by establishing a renewed focus on patient care, translational research and disease prevention. By translational we mean: Translation of knowledge from basic laboratory research, through physiology into new approaches in the clinic for diagnosis, treatment and prevention. Translation of scientific advances into improved treatment and prevention in real-life settings such as in general practice, the family home, the workplace or the school. Excellent historic examples of translational research, care and prevention from Steno Diabetes Center are: The Steno 2 study The Steno 2 study is a landmark study that immediately led to new international guidelines for the treatment of type 2 diabetes. The study translated a clinical care concept simultaneous treatment of lipids, blood pressure, blood glucose and intensive patient education from research into clinical practice. Diabetic kidney disease Diabetes is the leading cause of end-stage kidney disease. Steno researchers showed that early detection and treatment of blood pressure among patients with kidney complications could prolong lifespan by 14 years. Eye screening: low cost - major impact Diabetes is the leading cause of blindness. Steno Diabetes Center, in partnership with Glostrup Hospital and the Capital Region of Copenhagen, has implemented a network-based retinal screening programme to prevent eye complications and blindness. The low-cost screening in the clinic has made blindness rare and today it affects less than 1% of our patients. Hagedorn and river trout Hans Christian Hagedorn was one of the founders of the Steno. It was in the 1930s that Hagedorn added protamine from river trout to insulin to stabilise the proteins and prolong the effect of injected insulin in the body. As a consequence, the world s first long-acting insulin (NPH) was discovered and first translated into better care at Steno. 4 5

4 Superior quality of care Our clinical mission is to offer people with diabetes a life expectancy and quality of life equal to that of people without diabetes Leadership in standards of care Claiming leadership in diabetes care requires that Steno meets or improves on national and international standards in patient care. This is a major goal for Steno and fundamental to our clinical mission: To offer people with diabetes a life expectancy and quality of life equal to that of people without diabetes. TOWARDS 2020, we want to meet the highest standards of care by translating new models for patient education, screening and treatment into clinical practice. Personalised care in specialised clinics With a better understanding of disease progression, the treatment of chronic conditions like diabetes will increasingly involve personalised care rather than a one size fits all approach. Consequently, Steno will increasingly focus its clinical care within specialised clinics offering tailor-made and individualised treatments. TOWARDS 2020, we plan to develop personalised diabetes care at Steno, in close partnership with the Capital Region of Copenhagen. This could involve a focus on more specialised clinics, such as: Insulin Pump clinic Steno already has the largest insulin pump clinic in Scandinavia, with 500 patients currently enrolled. We will build on our expertise in this specialised treatment to improve the quality of life and long term health of patients on pump therapy. International clinic Many immigrants are at higher risk of diabetes for a number of reasons, including ethnic predisposition as well as the lifestyle effects of migration itself. An international diabetes clinic at Steno could provide tailored care both for foreign nationals and for immigrants who live in Denmark. Clinic for young people with Type 1 diabetes We will place special emphasis on these young patients and develop new methods in education to increase their compliance, self-care and quality of life. Clinic for women with former Gestational Diabetes Mellitus (GDM) GDM is a high risk condition for the development of diabetes later in life. A new clinic for women with this high risk profile could focus care and research in the prevention of type 2 diabetes in these women. 6 7

5 Full-cycle care and prevention Better health and economic outcomes for diabetes patients depend on research in the full-cycle of care and prevention. This means: Taking account of the whole life situation of the patient with an integrated approach by all involved in care (family doctor, nurse, specialist, dietician, exercise therapist, physiotherapist, podiatrist, ophthalmologist, cardiologist etc) Looking at interventions at all stages of diabetes progression right from prevention and early detection to late stage diabetes with complications Using this approach, Steno is embarking on a wide range of new initiatives including: Research in diabetes complications Steno is a world leader in research in diabetes complications, particularly the mechanisms underlying the progression of diabetic kidney disease. We will continue to develop complications research, and will be leading the new EUfunded PRIORITY consortium investigating the potential to prevent very early diabetic kidney complications. TOWARDS 2020, we will have significantly advanced knowledge on the identification and treatment of very early diabetic kidney disease, and will have extended the scope and impact of research in diabetes-related micro- and macrovascular complications. 8 9

6 Health promotion research The research will focus on empowering people to live a healthy life. Schools, local communities, the workplace and the family will be key settings. Steno researchers have developed the new concept of super-settings. The concept targets a specific local area and directs focus at improving the interaction between the structural setting and various educational initiatives. TOWARDS 2020, we will have several health promotion research activities running both nationally and internationally, and will have extended this super-setting concept to other countries. Research in prediabetes and diabetes prevention The area of prevention covers large and smallscale intervention projects focusing on prediabetes and how to support people at risk in preventing or delaying the development of diabetes. TOWARDS 2020, we will have developed research projects leading to new intervention approaches, suitable for real life settings such as general practice, the community and the workplace. Research in patient education and support Steno will combine different research disciplines and conduct research projects both in the clinic and in municipalities. This approach aims to develop new models and methods for patient education. TOWARDS 2020, we will report on a number of improvements in the quality of patient education based on new approaches and interactions with patients and families. Online patient engagement Steno has had an electronic medical record for 10 years. The next step will be to engage patients online by exchanging data and facilitating dialogue and personalised care. TOWARDS 2020, we will have a fully integrated electronic network supporting and promoting self-care. The system will embrace Steno, family doctors, other hospitals, municipalities as well as our patients

7 New technologies for type 1 diabetes Closed-loop insulin therapy adjusts the rate of insulin infusion from an insulin pump, using the data from a glucose sensor. This new technology could offer patients major improvements in metabolic control, convenience and quality of life with markedly reduced risk of hypoglycaemia. TOWARDS 2020, we are perfectly poised to translate closed-loop approaches into clinical care, by focusing on both our young type 1 diabetes clinic and our pump clinic. Genetics in patient care Steno s diabetes genetics service is currently provided in collaboration with specialists based at the University of Copenhagen. To develop this service, we will remain engaged in molecular diagnostics and care for rare genetic forms of diabetes. TOWARDS 2020, we will through collaborations and the development of Steno s own competencies improve the clinical care of patients with genetically confirmed variants of diabetes. Transplantation and stem cell therapy Type 1 diabetes is one of the medical conditions for which stem cell therapy holds the possibility of long-term cure. This field is early stage but rapidly developing. Steno will first focus on building strong strategic collaborations. TOWARDS 2020, we will have established partnerships in the area of stem cell therapy for diabetes, including the new Centre for Stem Cell Research at the University of Copenhagen and the stem cell research group at the Hagedorn Research Institute. Research in pathophysiology The treatment of disease is ideally based on an understanding of the underlying pathophysiology as well as treatment mechanisms. Steno will lead the DEXLIFE EU project which is expected to provide a wide range of new biomarkers for early detection of type 2 diabetes and disease progression. TOWARDS 2020, we will have established a diabetes pathophysiology research group, with close collaboration locally with the University of Copenhagen, and internationally with leading clinical and basic researchers in this field

8 Global presence and recognition Steno hubs in high prevalence regions Steno s international role will be significantly enhanced by the creation of Steno hubs in regions of high diabetes prevalence. Steno s unique combination of diabetes care, research, education and prevention can make an important and sustained contribution to local diabetes communities. TOWARDS 2020, the first Steno hub in China will have been established and will be fully operational. Based on the experiences from the first hub, this new model will have been developed and implemented in hubs in other parts of the world. Improved website and new web-education programme Steno will focus on new cost-effective ways to disseminate knowledge. A key focus will be the Steno website to increase its capacity for interaction and web-based education both for health care professionals and for people with diabetes. TOWARDS 2020, Steno will have established a new online platform including website, social media and a certified web-education programme. Partnerships, conferences and publications Steno will develop and focus its scientific output and its programme of conferences and lectures. This will include hosting Steno Rounds, a monthly guest lecture by an expert within a relevant professional field. The EU projects DEXLIFE and PRIORITY will provide opportunities for increased international dialogue and partnerships. TOWARDS 2020, Steno will have developed a fully integrated global stakeholder platform and established new international collaborations around translational research. 14

9 People and organisational development Lead the change The strategy 2020 and the focus on translational research will foster and accelerate change, and the development of Steno Diabetes Center. We must ensure that our leaders have the capabilities and mindset to drive change and that our employees are developed continuously to support our strategic goals. We will succeed through our ability to work across functional and professional borders. Attract and retain talents Diabetes research and care is a highly competitive field. We need to attract and retain the best employees to ensure and establish a position as preferred employer within the field. We will develop Steno as an organisation by illustrating career paths, establishing a strong talent pipeline and pathway for succession. Perform and develop We will place special focus on performance management. This will ensure a strong link between the strategic initiatives and the individual goals for leaders as well as employees. Focused development of the individual will be centred on discussion of goals, competencies and motivation. TOWARDS 2020, we will build on our leadership platform to implement the 2020 strategy. We will create a culture marked by the joy of high performance by applying a structured approach to performance management and development. We will make talent identification and succession planning integral parts of the leadership agenda. 16

10 Highlights from 2011 Superior quality of care The Patient Care Center has been accredited by the Danish Health Care Quality Programme Steno opened a Day Hospital for closer monitoring of our patients Steno Patient Panel was established to strengthen the involvement of patients in their own care and their representation within the Steno community 97.5% of patients were very happy and happy with the care at Steno Diabetes Center according to an official patient satisfaction survey among 400 patients Global presence and recognition Steno has implemented the Steno Quality Assurance Tool with doctors in India to build capacity and improve quality of care Steno has established partnerships in Colombia and Kenya with special focus on prevention and care of gestational diabetes and on health promotion in schools Steno has provided a range of educational courses for health professionals in Asia and the Middle East through the STAR programme funded by the Novo Nordisk Foundation The Steno Symposium 2011, focusing on diabetes complications, was attended by 160 doctors from 26 countries Steno researchers have published more than 100 scientific articles in international journals in the past year Full-cycle care and prevention Steno has received funding to lead two EU Framework projects focusing on early detection and prevention of type 2 diabetes (DEXLIFE) and early detection and prevention of renal disease (PRIORITY) Together with Danish partners, Steno is applying the concept of supersettings in a prevention project on the island of Bornholm. The project is funded by the Nordea Foundation Several research projects have been established at Steno and with other partners to develop new and innovative models for patient education Results from the Addition study were published in The Lancet. The study focuses on intensive treatment of screen detected diabetes in primary care People and organisational development The Steno strategy 2020 has been updated and approved by the board The talent programme Action Lab has been established to develop and engage talents in the future development of Steno Steno Update, a monthly newsletter, has been developed to update the organisation across functional areas The Steno Health Promotion Center has been made fully operational with close to 30 employees From left: Allan Arp, Head of Business Support, Trine Nielsen, Head of Human Resources, Bjarne Bruun Jensen, Head of the Health Promotion Center, Thomas Almdal, Head of the Patient Care Center, Peter Rossing, Head of the Research Center and John Nolan, CEO and Head of Steno Diabetes Center. Steno is organised in four centers In addition to core business support functions, Steno Diabetes Center is organised in four centers that work closely together around the unifying focus of translational research, care and prevention: The PATIENT Care Center The center is headed by Thomas Almdal. Around 6200 patients with type 1 and type 2 diabetes are treated in the outpatient clinic. The Research Center The center is headed by Peter Rossing and is organised in four research groups: Complications, Epidemiology, Patophysiology and Clinical Research. The Health Promotion Center The center is headed by Bjarne Bruun Jensen and is organised in three units: Patient Education, Health Promotion and Prevention. The Education Center The center is recruiting a new leader (and currently headed by Ulla Bjerre-Christensen) and is running a wide range of educational activities nationally and internationally

11 Steno Diabetes Center is a world leading institution within diabetes care and prevention. Steno is owned by Novo Nordisk A/S and is a not for profit organisation working in partnership with the Danish healthcare system. Steno treats around 6200 people with diabetes.