2010 Human Health Initiative
Academic Planning - Companion Document Drafted by the Health Sciences Council University of Alberta 6/30/2010
Table of Contents PART A: CONTEXT Context ....................................................................................................................................................... 3 Vision.......................................................................................................................................................... 3 Mission ....................................................................................................................................................... 3 Statement of Innovation ............................................................................................................................ 3 Anticipated outcomes ................................................................................................................................ 4 Current Challenges ..................................................................................................................................... 4 Background ................................................................................................................................................ 4 Consultation Process .................................................................................................................................. 5 Motivations for the Human Health Initiative ............................................................................................. 5 1. Recognition that all faculties contribute to health scholarship ................................................... 6 2. Opportunity provided by the formation of Alberta Health Services (AHS) .................................. 6 3. Review of Alberta health care legislation ..................................................................................... 6 4. Infrastructure designed to support interdisciplinary health scholarship ..................................... 6 5. Opportunity provided by Alberta Innovates - Health Solutions ................................................... 6 6. An emergent provincial academic health centre called the Alberta Academic Health Sciences Network......................................................................................................................................... 7 7. Institutional focus on commercializable technologies and processes .......................................... 7 Goals........................................................................................................................................................... 7 Ultimate Ambition...................................................................................................................................... 8 Objectives................................................................................................................................................... 8 1. Prevent illness and injury through screening, diagnosis, treatment and rehabilitation, promotion and protection of health ............................................................................................................... 8 2. High impact research outcomes ................................................................................................... 9 3. Partnerships with all sectors ......................................................................................................... 9 4. International networks.................................................................................................................. 9 5. Administrative structures.............................................................................................................. 9 Linkages to Cornerstones of Dare to Discover ........................................................................................... 10 Linkages to global health movements ....................................................................................................... 10 Academic health centre networks ................................................................................................ 11 Health team collaboration ............................................................................................................ 11 Patient / public engagement ......................................................................................................... 11 Technologies in health .................................................................................................................. 11 Healthy promoting universities ..................................................................................................... 12 Strengths .................................................................................................................................................... 12 Barriers and Challenges ............................................................................................................................. 13 PART B: INVITATION Mechanisms ............................................................................................................................................... 13 1. Health Sciences Education and Research Commons (HSERC) ...................................................... 14 2. Interdisciplinary Health Discovery Academy................................................................................. 14 3. Health Sciences Council Executive ................................................................................................ 15 Lead group and governance structure ....................................................................................................... 16 Measures of Success .................................................................................................................................. 16 Summary .................................................................................................................................................... 16
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PART A: CONTEXT The Human Health Initiative will facilitate university-wide health research and education that is relevant to and advances the public good. Mechanisms already exist to advance this Initiative: 1. strong, autonomous faculties and disciplines; 2. Health Sciences Council a. Health Sciences Education and Research Commons; b. Interdisciplinary Health Discovery Academy; and c. Health Sciences Council Executive. The Human Health Initiative creates a way for all faculties, centres and institutes to share existing uni-, multi- and inter-disciplinary resources that advance health and wellness. The challenges to health across the world are acknowledged to be complex. Solutions are to be found “at the fringes of the ologies� (Samarasekera, 2007), that is, in interdisciplinary health scholarship. The University of Alberta has a large number of strong health sciences disciplines with a history of working together and of collaborating with science, arts and humanities disciplines across five campuses. In addition, there is a long standing culture of partnering with important stakeholders groups, locally, nationally and globally. The Human Health Initiative will create a competitive, outcomes-focused environment where existing excellence is encouraged, expanded and focused to address health challenges. Vision All disciplines collaborate at the University of Alberta to contribute to the health of individuals, the nation and the international community.
The University of Alberta is committed to creating and sharing knowledge for the health of all people, be they students, teachers, clinicians or the public. We aspire to be a model of health at the University of Alberta. Mission The Human Health Initiative will promote interdisciplinary team scholarship and facilitate participation in inter-sectoral partnerships that: - advance knowledge for human health; - mobilize/transfer evidence-based health practices across the continuum of care; and - engage learners in systematically understanding their roles in achieving human health, as individuals and as health team members. Statement of innovation Achieving this vision will result from a balanced focus on all aspects of the determinants of human health including: clinical factors and predisposition to health conditions, social-political and economic environments, the physical environment, and the person’s individual characteristics and behaviours (www.who.int/hia/evidence/doh/en/index1.html and www.thecanadianfacts.org/The_Canadian_Facts.p df ). The academy of human health scholars, staff, students and alumni will lead in promoting and protecting their own health as well as the health of their families and communities (local / provincial / national / international). Health workforce members educated at the University of Alberta will collaborate effectively with each other, patients and their support systems, thus 3
improving quality and safety of health service for Canadians.
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The Human Health Initiative provides momentum and synergies to change the way the University of Alberta does business. Changes in the practice of discovery, learning and service will include: - teaching and learning in teams; - using simulation to increase clinical learning experiences; - integrating patient-centred care lessons into practice; - facilitating team research; - building interdisciplinary and cross-sectoral research capacity; and - collaborating with community, government, health institutions and industry. When the Human Health Initiative is successful, the outcomes will be: - Effective connections between health disciplines and the health focused communities-of- practice. - Methods in place for all faculties, researchers, teachers, students, workforce and patients to collaborate in health related activities and wellness - More relevant disciplinary and interdisciplinary education and research to address existing and emerging health challenges. - More timely influence on health and social policies and the resulting models for health care delivery. - A greater ability to address broad issues related to population health, health sciences education and health service delivery. - Improved ability for the University to attract and retain quality researchers, educators and clinicians. - Enhanced recognition within the academy for collaborative scholarship efforts. - Enhanced profile of and increased support for the University as a recognized leader in the post-secondary system. - Positioned as a priority partner by government and the health system for new initiatives in advancing the health agenda. - Capacity to broker arrangements that connect local communities through a Community Health Research Portal.
Stronger and more competitive environment for research grant dollars. Enhanced credibility to become nationally and internationally renowned in team research and education.
Current challenges to the health status of Canadians and for the Canadian health care system are complex. Each requires interdisciplinary scholarship and cross-sectoral partnerships to improve the health of individuals and populations. Organizations such as the Canadian Institute for Health Information (www.cihi.ca) provides broad and detailed perspectives on these challenges. Alberta Health and Wellness with Alberta Health Services propose strategic directions for addressing health challenges of Albertans with threats to determinants of health, including: socioeconomic, environmental, cultural, and education. In Vision 2020: The Future of Healthcare in Alberta (www.health.alberta.ca/documents/Vision-2020Phase-1-2008.pdf ), there is a focus on sustainability pressures, patient-focused care and improvement in service delivery across the continuum of care including: primary care, public health, chronic disease management and acute, continuing and long term care. According to Alberta Health Services (www.albertahealthservices.ca/files/org-strategicdirection.pdf ), actions to support three key measurable goals for health care – quality, access and sustainability – are required (www.albertahealthservices.ca/files/org-imagestrategic-direction.pdf ). The academic community could interface with AHS clinical networks in order to contribute to these goals and priorities. Background The University of Alberta set an aggressive goal to be among a handful of the world’s best publicly funded universities. In support of achieving that goal, in 2007 the Health Sciences Council agreed to develop a model for a university-wide Human Health Initiative (formerly the Health Academy) that could serve as a foundation for the University’s leadership in health scholarship.
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Twenty years ago, the health sciences deans acknowledged the complex nature of challenges to the health of Canadians. In response they created the Health Sciences Council (HSC), working with the Provost, as a cross-cutting mechanism to facilitate interdisciplinary health sciences scholarship at the University of Alberta. The approach allows each discipline to maintain autonomy and develop unique disciplinary strengths while addressing challenges and opportunities relevant to groups of health sciences disciplines. The HSC made an early (1990) and ongoing commitment to education in health team competence for all health sciences students. An additional early commitment was to facilitate health team research using an incubation model for research centre development. In the centre incubation model, successful centres are transitioned to faculties where there is significant support for the interdisciplinary topic under study in the centre. The HSC has incubated research centres in: aging, health promotion, health ethics, the child / family / community nexus, human nutrition and qualitative methodology. All have been or are in the process of transitioning to faculties. About ten years ago (2000), the HSC created a reliable administrative platform called the HSC Secretariat to provide support for common functions (interdisciplinary or crossdisciplinary) across the health sciences faculties. Risk management planning, health communications and management of clinical placement issues (affiliation agreements, fittesting of N95 respirators, criminal record check procedures) are examples of administrative functions undertaken by the HSC executive on behalf of the health sciences faculties. Over the years, the pre-eminence of Alberta’s health scholarship, especially in the capital region, has become globally known. Like all reputations, it needs to be mindfully supported, protected and advanced. Our reputation is built on the extraordinary infrastructure centered in Edmonton – a health precinct of six major research and clinical care centres within walking distance of our north campus, a major location of training in 14 strong health disciplines and highly respected schools of engineering, business, law,
arts, science and agriculture - and on the excellent initiatives and support systems developed over time within an intricately woven partnership designed to optimize patient-centred care, student-focused education and research-based practice. Advancement of the U of A’s reputation for exemplary health scholarship would take the form of a natural evolution of the unique partnership of health sciences faculties, the provincial health authority and the university’s central research office. In this light, an iterative consultation process was initiated by the HSC in December 2007. It resulted in university-wide support for the concept of a collaborative model for health scholarship that could be a foundation for Canadian leadership. A series of 19 consultations took place among senior administration including: the Chair of the Board of Governors, the Chancellor, President, Provost, Deputy-Provost, four Vice-Presidents (Finance & Administration, Facilities & Operations, External Relations, Research), nine deans, and the director of Government Relations. Acting on this conviction, the HSC worked to develop the health team education strategy (HSERC), a resource to be shared through the Human Health Initiative. During these HSERC consultations, students, faculty, government and AHS clinicians were contacted. More recently, similar conversations with all faculties has begun to develop a shared health team research strategy. The motivation for the Human Health Initiative, a vehicle to catalyze and facilitate the contribution of all disciplines at the University of Alberta to human health, is rooted in six sources: 1. recognition that all faculties contribute to health scholarship 2. opportunity provided by the formation of Alberta Health Services (AHS) 3. review of Alberta health care legislation 4. infrastructure designed to support interdisciplinary health scholarship 5. opportunity provided by Alberta Innovates - Health Solutions 6. an emergent provincial academic health centre called the Alberta Academic Health Sciences Network
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7. institutional focus on commercializable technologies and processes 1: Recognition that all faculties contribute to health scholarship A survey conducted in 2008 indicated that all disciplines at the University of Alberta contribute to the body of health scholarship directed at solving complex health challenges (Summary responses – Academic Health Centre at S:\HSC\External Relations\Academic Health Centres\FINAL CONSOLIDATED DOCUMENT). Evidence showed interdisciplinary and joint UAAHS scholarly engagement in: • teaching / learning (clinical placements, health-related work placements, summer schools and program, joint graduate degrees); • research (research institutes, joint research chairs, joint clinical trials, joint commercialization projects and international research partnerships); • Research infrastructure consisting of the state-of-the-art equipment, buildings, laboratories and databases required to conduct research (cumulative total of CFI funding for 333 projects from 1997 to 2010 is over $212 million); and • citizenship / service (for example, Alberta Rehabilitation Network, Special group on Aging, Healthy Alberta Communities, Primary Health Care Initiative, Community University Partnership for Study of Children, Youth and Families). 2: Opportunity provided by the formation of Alberta Health Services (AHS) In 2008, the province of Alberta moved to create a single provincial health delivery system. A health care system that is not only affordable and sustainable for the future, but also safe, effective, high quality, evidence-based, and state-of-the-art, is the impetus behind the reorganization of Alberta’s health services. While this innovation has had some implementation challenges and may be disruptive to the earlier relations between the University of Alberta and former regional health authorities, it creates an opportunity for decision-maker-toscholar partnerships focused on the health needs of the province’s populations, including rural,
aboriginal, immigrant, northern and at-risk / vulnerable populations. Through such partnerships, human health scholarship can be contextualized early in the knowledge development and mobilization processes. 3: Review of Alberta health care legislation The Alberta Health Act is under revision and includes a significant public consultation process. The full report of the Minister’s Advisory Committee on Health will be issued in the fall of 2010. An interim version is available at the website below. The four primary recommendations of the MACH are: 1) a set of principles will be articulated that will be sustained and maintained throughout Alberta’s health system; 2) legislate the Health Act including a patient charter; 3) ensure ongoing citizen engagement; and 4) develop clear directions to guide legislative, regulatory, policy and program delivery changes across the health system. (www.yourhealthact.alberta.ca) 4: Infrastructure designed to support interdisciplinary health scholarship The Edmonton Clinic was developed by a tripartite partnership between the Government of Alberta (H&W and AE&I), the University of Alberta and Alberta Health Services. The infrastructure consists of an ambulatory care facility and an academic facility. The vision developed by the partners was that the Edmonton Clinic will be a leading, state-of-the-art enabler of integrated, patient-centred health care, education and research. Twenty-five innovations were described by the partners that can be categorized in the following way: - partnerships internally and externally, and most importantly with the patient; - health team learning, teaching, research and citizenship; - wellness of all constituents (students, patients, faculty and staff); - state-of-the-art information and learning technology 5: Opportunity provided by Alberta InnovatesHealth Solutions Alberta Innovates – Health Solutions, launched January 1, 2010, will strategically align and integrate provincial research and innovation 6
(http://www.albertainnovates.ca/health/introduct ion). Under this banner of Alberta Innovates, the new corporation will work with key innovation support agencies, publicly funded post-secondary institutions, health care institutions, industry and government to further research and innovation in the province and to develop Alberta’s competitiveness in the global economy. The University of Alberta has an opportunity to actively participate in discussions with Alberta Innovates and the other affiliated stakeholders to develop and contribute to its strategic plan as well as play a key role in innovative health research across all sectors. This fits well with the HHI vision and goals. 6: An emergent provincial academic health centre called the Alberta Academic Health Sciences Network There is a world-wide move to fully integrate research and education with health service through the formation of academic health centre networks. The National Task Force on the Future of Canada’s Academic Health Sciences Centres (www.ahsc-ntf.org/docs/AHSCs/ NTF%20Report/Draft%205%20for%20Public%20C onsultation/AHSCNTFDraftFinalJanuary132010.pdf ) propose that central to this is focusing on: - translation of evidence to best practice in health environments; - fostering interprofessional and collaborative models of care; - pursuing a wide spectrum of health sciences research and innovation; - maintaining capacity to address emerging national issues related to the health of the nation; - creating forums for local, provincial and territorial, national and international participation in health system transformation; and - promoting wellness, preventing illness and enabling self-care. Formation of AHS leads the University of Alberta to advocate for an active role in the development of an academic health centre partnership between the academy and AHS. The university brings to such collaboration its roles as educator of the health workforce and producer of evidence-based health practices. In recent months, Alberta Health
Services, the University of Alberta, and the University of Calgary in partnership with the Government of Alberta (H&W and AE&I) have joined in discussions to create the Alberta Academic Health Sciences Network. 7: Institutional focus on commercializable technologies and processes Cross-disciplinary health research is an excellent source of novel technologies. In all cases, effective technological solutions require a balance of inspired technological creativity, and careful definition of the clinical or educational need and context in which the technology is to be deployed. The outcome of commercialization is the integration of new technologies into the health care system, which benefits the overall wellbeing of the population. Successful commercial development requires a responsive, specialist commercialization “pipeline” to guide the technology through the maze of challenges so that it can be strategically positioned for commercialization by an established industry partner, or in a few cases spun off to form a new company. Through ongoing commercialization discussions with health scholars, the university can maximize the value of health research initiatives through the translation of research innovations into new products and services. The Human Health Initiative is building on these drivers and participating in the creation of a powerful interdisciplinary scholarly environment to tackle Canada’s most pressing human health priorities. The goals include: 1. Enabling graduates, faculty, and staff to prevent illness and injury through more effective screening, diagnosis, treatment and rehabilitation; and to enhance the promotion and protection of their own health, the health of others and the health of populations. 2. Stimulating a learning community of health team scholars that systematically addresses challenges to human health by generating high quality high impact research outcomes. 3. Facilitating partnerships with all sectors that contribute to solutions for challenges to human health (i.e., education, health, 7
social services, community development, agriculture, environment, information technology, aboriginal). 4. Building strategic international networks of interdisciplinary health team scholars focused on solving significant challenges to human health. 5. Providing administrative structures with accompanying policies and practices that support cross discipline / cross faculty scholarship. Human Health Initiative goals will be accomplished through delivery of the following objectives:
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vi. 1: Enabling graduates, faculty, and staff to prevent illness and injury through more effective screening, diagnosis, treatment and rehabilitation; and to enhance the promotion and protection of their own health, the health of others and the health of populations. i. All University of Alberta graduates have a wellness orientation, are advocates for their own health and are informed health consumers.
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Graduates who work in the health sector demonstrate people-centred and health team competencies. Graduates who work in the health care system use evidence based practices of screening, diagnosis, treatment, rehabilitation, health promotion and population health. Resources for interdisciplinary student initiatives and forums that address challenges to health are available and adequate. Students, faculty and staff are provided supports to maintain regain and promote their health. Robust student organizations create engaged alumni who contribute to the health of their communities. Scholarships that attract talented undergraduate and graduate students to engage in study with interdisciplinary teams to address challenges to human health. Students have interdisciplinary learning experiences in communities where human health is challenged by geography,
The ultimate ambition of the Human Health Initiative is to create and transfer knowledge for the health of all people.
The University aspires to be a model of health by creating the supports people need to “practice what we preach.� This means asking, understanding, teaching and living what health is, how to achieve it, and how to protect it; how to diagnose and treat injury and illness; and how to rehabilitate after injury, illness or disease.
This means creating spaces that encourage physical activity, providing campus food options that promote health and prevent disease, and creating venues - like green spaces and walking or biking trails - which support overall wellness.
This means setting differences aside and welcoming all perspectives to the table to ask questions, solve problems, and to share our discoveries so that we all will benefit through healthier lives. 8
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poverty, environmental issues, culture, climate, industry, and politics. Plan for, provide and operate infrastructure that supports wellness and interdisciplinary health scholarship.
2: Stimulating a learning community of health team scholars that systematically addresses challenges to human health by generating high quality, high impact research outcomes. i. Develop research facilitation models that support success in Tri-Council funding for interdisciplinary health research teams, including the centres of excellence model. ii. Identify and partner with local, provincial, national and international health decisionmakers and patient / public advocates that join interdisciplinary health research teams and provide knowledge transfer / mobilization context. iii. Establish a distinguished visitor program of highly capable interdisciplinary team mentors who catalyze development of targeted areas of team research. iv. Resource studentships for contributing to established interdisciplinary research teams. v. Provide funding and support for Human Health Initiative graduate and postdoctoral training. vi. Provide funding and support for Human Health Initiative Research Chairs focused on challenges to health that both complement existing strengths at the University of Alberta and catalyze developing strengths. vii. Create interdisciplinary scholar-to-scholar and scholar-to-decision-maker exchange programs / internships with local, provincial, national and international partners to increase capacity for health team research and understanding of the contexts of knowledge transfer / mobilization. 3: Facilitating partnerships with all sectors that contribute to solutions for challenges to human health (i.e., education, health, social services, community development, agriculture, environment, information technology, aboriginal).
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Create a clearinghouse of partnerships involving human health scholars and teams of scholars at the University of Alberta with the view to hasten development of novel partnerships for human health scholarship. Promote and support the attitude that participation, at the institution level and at the individual level, in health research will lead to healthier populations. Link interdisciplinary health scholarship capacity at the University of Alberta to the developing Alberta Academic Health Sciences Network. Build on relations within Campus Alberta to build mechanisms to achieve the vision of the Human Health Initiative. Focus interdisciplinary health team scholarship on strategic human health needs of local, provincial, national and international stakeholders. Create capacity within the Human Health Initiative community of scholars for timely responsiveness to partner needs for health evidence and testing for best human health practices.
4: Building strategic international networks of interdisciplinary health team scholars focused on solving significant challenges to human health. i. Build reputation for timely knowledge-toaction concerning human health knowledge developed by the University of Alberta community of scholars and associated partners. ii. Develop and implement strategic decisions regarding when the University of Alberta and its partners will join and when they will lead on international networks of health team scholars. iii. Develop reliable operational support for leading international networks of health team scholars. 5: Providing administrative structures with accompanying policies and practices that support cross discipline / cross faculty scholarship. i. Implement incentives / recognition systems to engage in collaborative human health scholarship.
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Build a structure that supports interdisciplinary health graduate student opportunities. Use university resources responsibly by reducing administrative and academic duplication. Create structures to support development and implementation of collaborative interdisciplinary research and health team learning Develop capacity within administrative units to implement policies and practices supportive of interdisciplinary scholarship. Monitor the strengths and challenges of the Human Health Initiative at the University of Alberta.
Linkages to Cornerstones of Dare to Discover Talented People The Human Health Initiative will support scholars who are creative and solutions-driven. Solutions to problems are recognized to be uni- multi- or interdisciplinary. The Human Health Initiative welcomes all approaches, and endeavours to provide additional support to those who choose interdisciplinary approaches. Interdisciplinary research is one of the foundations of a vibrant research culture. An environment of creative collaboration, such as that facilitated with the Human Health Initiative, invites linch-pin roles from all members of the academy. Learning Discovery and Citizenship The Human Health Initiative will cultivate and expand Discovery Learning through a number of key activities and mechanisms. For example, health team competencies provide a framework for teachers and learners who are participating in discovery learning in a health care and wellness context. The Human Health Initiative will provide faculty development opportunities so that teachers and clinicians can incorporate discovery learning in ways that are appropriate to the discipline and interprofessional health team competencies. There will be continued delivery of the ACCESS funded Interprofessional Health Education Partnership to allow teachers and learners from four Edmonton post-secondary institutions to actively learn with each other in simulation experiences (using mannequins, standardized patients and virtual worlds). The
Human Health Initiative also supports the continued development of HSERC as a physical space and governance structure that integrates teaching, learning, research and the use of technology in the interprofessional health scholarship context. An example of the Human Health Initiative’s focus on supporting engaged students is through distribution of TD Bank Studentships ($10,000 per year) for students to participate in collaborative health research and discovery. The Human Health Initiative will also support student-run interdisciplinary health service delivery projects (eg: SHINE) and the transfer of lessons-learned from students to their peers nationally and internationally. Connecting Communities The Human Health Initiative provides an enhanced mechanism through which the University of Alberta can connect with communities of people who wish to make a meaningful impact on health system challenges through nourishing trust based relationships with other post-secondary institutions and health service providers. This initiative demands multiple perspectives at the table and recognizes the significance of individuals and communities in health promotion, disease prevention and the treatment of illness and injury. The Human Health Initiative also places increasing focus on patient-centred care and research and public engagement in health scholarship. Transformative Organization and Support There is broad recognition of the need for substantive organizational change to facilitate and support interdisciplinary scholarship. The Human Health Initiative has identified key areas within which to support and shepherd processes and policies that will give credit where credit is due, and to create an open-door for those disciplines that have not traditionally been part of the health precinct. These changes vary from supporting refreshed faculty evaluation standards to creating mechanisms for staff cross-training and secondment across the Human Health Initiative. Linkages to global human health movements The efforts of the Human Health Initiative align with and support the following twenty-first century global movements: - academic health centre networks; 10
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health team collaboration; patient / public engagement; technologies in health; and health promoting universities.
Academic health centre networks The Association of Academic Health Centres (www.aahcdc.org/) is a global association that leads by educating policymakers, opinion leaders, and the public about the value and contributions of the academic health center enterprise to the nation. Accordingly, academic health centers: are vital to the national interest; are engines of the 21st century knowledge economy; are leaders in research and technology; are the essential core of the health system; invest in people; promote the integration of ideas and services across multiple sectors of the economy; and foster collaboration with the public and private sectors. The National Task Force on the Future of Canada’s Academic Health Sciences Centres (www.ahscntf.org/?reports) has defined the network concept as: a set of formal partnerships created by health sciences universities, academic health care organizations and other provider organizations with the goal of improving patient and population health outcomes through mechanisms and structures that develop, implement and advance integrated health services delivery, professional education, and research and innovation. The proposed Alberta Academic Health Sciences Network concept takes advantage of the emergence of new health care organizations with broad regional responsibilities, as well as emerging trends in academic health involving several venues including eLearning and interprofessional models of care. Health team collaboration The World Health Organization in the Framework for Action on Interprofessional Education and Collaborative Practice (www.who.int/hrh/resources/framework_action/ en/index.html ) recognizes that many health systems throughout the world are fragmented and struggle to manage unmet health needs. Present and future health workforces are tasked with providing health-services in the face of increasingly complex health issues. A collaborative practice-ready workforce understands how to optimize the skills of health team members, share
case management and provide better health services to patients and communities. The resulting strengthened health system leads to improved health outcomes for the population. The University of Alberta is a member of the Interprofessional Health Collaborative of Alberta (a part of the Health Workforce Action Plan www.health.alberta.ca/documents/WorkforceAction-Plan-2007.pdf ) where the Alberta Government (H&W and AE&T), other representatives from Campus Alberta, Alberta Health Services and health professions regulators will develop a framework for team education as a means of advancing health team collaboration. Patient / public engagement It is globally recognized that important components of improving quality and safety in health practices are patient preference and patient experience. It follows that quality, efficacy and safety of healthcare will be improved if patients are included as full partners in reform initiatives (www.who.int/patientsafety/patients_for_patient /statement/en/index.html ). Patient / public engagement is therefore an essential component of patient- or people-focused health scholarship. Across the Canadian provinces, there are differences in the incorporation of patient or people-centred care and scholarship. The impact is measurable in terms of access, effectiveness and equity of healthcare delivery and outcomes – the charted results indicate the need for reform (www.chsrf.ca/documents/Chartbook/CHARTBOO K%20Eng_Feb23.pdf ). This requires that patients and the public are actively and meaningfully involved in human health education, research and practice / service planning and decision-making. Technologies in health The European Union document on Telemedicine for the benefit of patients, healthcare systems and society highlights the global need for the use of technologies for remote monitoring to improve the quality of life of chronically ill patients and reduce hospital stays (http://ec.europa.eu/information_society/activitie s/health/docs/policy/telemedicine/telemedecineswp_sec-2009-943.pdf ). There is an assumption that providing e-consultation through virtual worlds (such as Second Life) can help shorten 11
waiting lists, optimise the use of resources and enable productivity gains. Another major consideration identified is the need for patient acceptance of remote healthcare technologies and their ability to satisfy healthcare needs. Telehealth gives Albertans living in rural and remote areas better access to health care services without having to travel great distances. Acceptance by patients depends crucially on acceptance by their health care providers. There is a need to build the evidence base for patients, health providers and students to truly trust and effectively use remote healthcare technologies in a workforce where new technologies are the norm. Alberta is leading Canada in the successful implementation of a single, province-wide Electronic Health Record (EHR). Alberta Netcare (www.albertanetcare.ca/default.htm) is a program that encompasses all the projects, processes, products, and services that work together to make Alberta's EHR a reality. Developed by Alberta Health and Wellness (AHW) in cooperation and partnership with Alberta Health Services, and many other partners including the health professional colleges and associations, Alberta Netcare will be an important tool for health care providers to access up-to-date information on patients. This will improve patient care at the point of care and reduce unnecessary duplication in tests, support treatment decisions and improve patient safety. In the future, a system-to-system interactive process will be set up between pharmacists, physicians and others. Alberta Health and Wellness has also set up an Interactive Health Data Application that will provide information on health status and determinants of health (www.ahw.gov.ab.ca/IHDA_Retrieval/). Health indicators are part of his site, and can be of significance to users of this type of information in research or health care. Health promoting universities The concept of health promoting universities and institutions of higher education is based on the work, experience and learnings of the Healthy Cities, Workplaces and Schools movements and the European Network of Health Promoting
Universities. In October 2005, the University of Alberta in Edmonton, Alberta, Canada hosted the second international conference in the Pan American Region, where delegates were asked to participate in development of a Charter. (see http://www.virtualwellness.ualberta.ca/docs/VW/ CharterHealthPromoting.pdf )This Charter is intended to be a “living” document that will continue to evolve through continued networking and ongoing dialogue between partner institutions. http://www.euro.who.int/__data/assets/pdf_file/ 0012/101640/E60163.pdf Strengths / barriers Strengths - The University of Alberta’s Health Sciences Council has been in existence for nearly 20 years to promote interdisciplinary research and education in Health Sciences. It was at the time, and it remains today, a unique model in Canada. - The provincial government has invested significantly in new purpose-built interdisciplinary infrastructure (ECN and CCIS). - The University of Alberta has existing strengths and resources in many disciplines directly and indirectly contributing to health scholarship. - There is no interdisciplinary strength without disciplinary strength. The University of Alberta thus has created a context where faculties maintain autonomy and build their own strength of discipline(s). - Many faculties, whether large or small, build multiple connections to stakeholder communities and develop real voices locally and internationally. - There is a strong connection to rural Alberta via a rural campus (ie: Augustana) that is situated in a rural region with a health demographic different from the urban health demographic. - The Human Health Initiative can capitalize on a major Canadian “health science campus” with six health research, education and clinical facilities within walking distance of each other on the North campus. 12
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The Human Health Initiative will strengthen interdisciplinary health scholarship collaboration and integration across the University and build partnerships with other institutions, governments, Alberta Health Services and others concerned with sustainable, individual, environmental and community health and wellness. The Human Health Initiative provides unique opportunities for smaller faculties and specialty areas of interest to link to broader health-related undertakings. There will be uptake from a cadre of earlyadapters (staff and students) who are committed to the principles of interdisciplinarity and are eager to leverage opportunities that are made available to them.
Barriers and Challenges - Lack of reward system for interdisciplinary collaboration in teaching; - Uneven reward system for interdisciplinary collaboration in research; - Administrative and financial systems are not equipped to deal with grants or funds that don’t have a single PI; - Variable commitment to resourcing to the changes necessary to launch a Human Health Initiative; - Lack of a model for following through on existing partnership agreements and MOUs; - A new provincial health services environment creates some uncertainty and may limit the development and growth of a formal Human Health Initiative; and - The global economic climate limits the ability to raise philanthropic funds and inhibits the public granting agencies (eg: CIHR). - Faculties that are strong and independent may not see the Human Health Initiative as an opportunity for advancement and thus not participate.
PART B: UNIVERSITY-WIDE INVITATION TO JOIN IN The mechanisms It is proposed that the spatial, budgetary and administrative resources of current and future mechanisms designed to support human health scholarship at the University of Alberta be developed in concert and actively shared across the disciplines. To that end, the Health Sciences Council is refocusing its resources on facilitating achievement of the goals of the Human Health Initiative on behalf of all disciplines at the University of Alberta. The academic planning process will see other faculties, centres and institutes share existing mechanisms, develop new mechanisms or partner with others, including the Health Sciences Council, to support the goals of the HHI. The following principles of interdisciplinarity will be used within the Health Sciences Council (HSC) mechanisms to guide priority setting and project adjudication: - have competitive peer review and clear metrics to define success; - be interdisciplinary and cross faculty; - create solutions and contribute to the reduction in human health challenges; - mobilize human health knowledge and contribute to health policy; - reduce the burden of disease and improve human health; - leverage existing strengths, partnerships and resources; - build communities of human health scholars; - contribute to the University of Alberta’s academic outcomes; and - match the capacity of the Health Sciences Council secretariat to successfully provide support. Three mechanisms offered by the HSC to support the Human Health Initiative include: 1. Health Sciences Education and Research Commons 2. Interdisciplinary Health Discovery Academy 3. Health Sciences Council Executive
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1) Health Sciences Education and Research Commons (HSERC) Vision HSERC’s vision is of a future where “health professionals collaborate to promote and deliver quality and safe care.” This vision is achieved by pioneering team-based health science educational approaches that empower individuals to flourish in an ever-evolving health system. Specifically, HSERC prepares professionals to deliver quality and safe care using team-based health science education, establishes best practices in health sciences education and disseminates them widely and makes a meaningful contribution to the health of Alberta communities. Advisory Committee HSERC is advised by the Interdisciplinary Health Education and Practice Group (IHEPG). This advisory committee is the guiding coalition committed to developing and implementing interdisciplinary education and practice opportunities and integration of simulation experiences at the University of Alberta. The committee is comprised of Associate Deans (Academic) from all health sciences faculties and representatives from Alberta Health Services, Alberta Health and Wellness (Workforce Division), Federation of Regulated Professions and Health Science Student Association. Programming HSERC and its partners’ goal is that every health science student graduates with a core set of health team competencies. These competencies are integrated into existing educational experiences and are documented by means of a Learning Pathway. HSERC works with faculties to develop, deliver and evaluate educational experiences in simulation learning environments, both single discipline and team-based. Infrastructure HSERC will be located in 15,000 square feet or 1,500 square meters, in the Edmonton Clinic Health Academy, offering immersive learning experiences in health to the University. This infrastructure also provides a unique opportunity for researchers to develop and test health and teaching technologies.
Outcomes HSERC is finalizing its Strategic Plan for the first five years in the Health Academy. The following are some of the key outcomes expected at the end of that time period: - All health sciences students graduate with a core set of team competencies that are achieved through the Interprofessional Learning Pathway, thus providing recognized unique experiences for each student. - A certificate in Health Team Development is provided to students who pursue additional curricular and co-curricular experiences. - A certificate in simulation education is offered to educators with a commitment to creating, implementing and evaluating learning experiences in single discipline or team-based simulation environments. - Leading and participating in educational research projects as outlined in the HSERC research plan, including participating in at least two research projects related to the use of health technologies. 2) Interdisciplinary Health Discovery Academy (IHDA) Vision The purpose of the Interdisciplinary Health Discovery Academy is to support cross-faculty interdisciplinary health team research guided by priority health issues and challenges of the 21st century. Advisory Committee The Interdisciplinary Health Research Advisory Committee (IHRAC) provides guidance for the planning and implementation of programming implemented by the Interdisciplinary Health Discovery Academy. This committee is co-chaired by the Vice Provost (HSC) and an Associate Vice President – Research. They report to the HSC. Committee members include Associate Deans of Research from all University of Alberta faculties. Programming It is expected that programming in the Interdisciplinary Health Discovery Academy will be responsive to current health challenges, partners’ needs for scholarship and emerging best practices in team support. The Health Sciences Council 14
proposes that programming is not limited by but is likely to include: facilitating success in cross-faculty interdisciplinary health research team proposals; catalyzing national and international centres of excellence that support the development of successful interdisciplinary health research teams; building capacity related to all aspects of successful interdisciplinary health research; supporting the development of effective knowledge-to-practice models; auditing progress of interdisciplinary research projects to ensure timely and accurate production and dissemination of research evidence; and tracking successful research partnerships established by interdisciplinary health research teams. Infrastructure 18,000 square feet or 1,800 square meters of space, in the Edmonton Clinic Health Academy, are assigned to the Health Sciences Council for interdisciplinary health team incubation. This space will be used to support the programming of the Interdisciplinary Health Discovery Academy. Outcomes Upon completion of strategic planning for the health discovery entity, it is expected that first year outcomes will include: - 20% success rate for cross-faculty interdisciplinary health research teams grants submitted - Monthly research team capacity building workshops - 20% increase in interdisciplinary health team research funding - Clearing house established for Joint UAExternal health research partnerships - Every health team develops a knowledge translation plan for their research. - Health research is patient-oriented and considers patient engagement in development, implementation and knowledge-to-action
3) Health Sciences Council Executive Vision All disciplines at the University of Alberta contributing to the health of the nation and the international community. Composition and Advisory Groups The Executive to the Health Sciences Council includes: the Vice-Provost - HSC, the Chair (HSC), three Associate Directors (Administration, Research, External Relations), a Strategic Communications Manager, and an Administrative Coordinator. The executive takes advice from the Health Sciences Council and the Provost’s team. Teaching and Learning, Research Engagement, and Citizenship are areas supported by solid administration and operations as well as a robust internal and external relations campaign. The Executive works to address each of these activities as follows: Teaching and Learning: develop interdisciplinary education to advance teamwork in health care Research Engagement: facilitate successful interdisciplinary health sciences research networks, relationships and resources; facilitate knowledge to action in interdisciplinary health education, practice and policies. Citizenship: create a physical presence to embody an interdisciplinary health sciences identity; lead collective U of A health sciences policies and positions on interdisciplinary issues. Administration/Operations: provide common support for interdisciplinary functions Internal and External Relations: support enhanced attitude toward, value of and support for interdisciplinary scholarship; develop relationships and mechanisms that support interdisciplinary health scholarship. Programming The Executive will provide administrative support for interdisciplinary health scholarship in the areas of learning, discovery and citizenship. Administrative support will include but is not limited to: HR and budgeting advice; communications strategy to enhance attitudes 15
toward, value of and support for interdisciplinary health scholarship; linkages to robust internal and external relations building; facilitation of intersectoral partnership development and knowledge-to-action planning, development of a physical presence to embody interdisciplinary health scholarship identity; lead on developing policies and positions that support interdisciplinary health scholarship; provide support for common interdisciplinary functions; and provision of assessments and evaluation of outcomes from the Human Health Initiative. The Executive will use the principles identified by the HSC to select interdisciplinary health initiatives that will be given priority for support. Partnerships with other academic units are being developed to build the capacity to expand support for interdisciplinary health initiatives. Infrastructure The Executive is housed in 300 Campus Towers, and will move to space on the third floor of the Edmonton Clinic Health Academy. Outcomes - Three approaches are implemented to develop interdisciplinary administrative capacity within all units. - Timely and coordinated response to broad health sector policy questions and issues management requests. - Administrative processes developed that implement and support the vision of Edmonton Clinic Health Academy for the long term. - Balanced score card developed and long term monitoring approaches implemented for the Human Health Initiative. - Health team messaging and branding that leads to more and trustworthy internal and external conversation about interdisciplinary health scholarship - Efforts required for interdisciplinary scholarship are rewarded - Increase resources for interdisciplinary scholarship Lead group, and governance structure The Health Sciences Council will lead on the implementation of the HHI. The Council consists of
eight deans (faculties of Medicine & Dentistry; Nursing; Pharmacy and Pharmaceutical Sciences; Rehabilitation Medicine; Physical Education & Recreation; Agricultural, Life & Environmental Sciences; School of Public Health; and Augustana Campus), department chair – Dentistry, and Associate Vice President – Research, University of Calgary - Social Work and two representatives from Alberta Health Services. The HSC is chaired by a health sciences dean. The Vice-Provost (Health Sciences Council) is the Chair or Co-chair of the Advisory Committees of HSERC,IHDA and the HSC Executive and reports directly to the Health Sciences Council on the activity of these mechanisms. The following considerations would form part of the measures of success of the HHI: - Impact on individual and population health - Impact on health policy and health practice - Innovation in health scholarship and health care delivery - Ability to attract internationally recognized faculty members and researchers - Creation, publication and application of new knowledge - Recognition and support by national and international philanthropic foundations, government and the private sector - National and international media coverage - Recognition by members/participants for innovation and achievement - Awards received by the Academy and / or its members / participants In summary, the HHI will develop a balanced health scholarship directed at solving challenges to human health. Activity is directed at developing an academy of human health scholars, a cohort of faculty, staff, students and alumni who will lead in promoting and protecting their own health as well as the health of their families and communities. Finally, health workforce members educated at the University of Alberta will collaborate effectively with each other, the patients and their support systems, thus improving the quality and safety of the delivery of health services for Canadians.
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