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A Voyage of Discovery
BUILDING ACADEMIC HEALTH CENTER INFRASTRUCTURE WORLDWIDE
In Search of the U.S. Academic Health Center Model
Peter Noble, MBA, director of health development, dean’s office, faculty of medicine and health, University of Leeds
Edward Hillhouse, BSC, MBBS, PhD, faculty dean, University of Leeds
Noble and Hillhouse have been analyzing the political, economic, educational, and managerial issues that impact the development of academic health centers to help build the enterprise in the United Kingdom. Of key concern was how institutions improve performance, because U.K. institutions are not integrated and education and research don’t figure in the National Health Service’s performance framework. Visits to the U.S., Australia, India, China, and Europe revealed varying perceptions on how performance can be improved.
Noble and Hillhouse identified enablers and barriers to improved academic performance, gathered best practices, and learned how performance management can be embedded within a health system.
Five key characteristics of high-performing academic health centers emerged from two cohorts of academic health centers in the U.S.: (1) “traditionally great” institutions, which have maintained their high standards over many decades, and (2) “transformationally great” institutions, which have rapidly transformed themselves into high-performance entities:
- Clarity of expectations
- Leadership development
- Mentoring and coaching
- A strong sense of vision and values
- Sustainability
Creating Academic Health Centers in Singapore
John Eu-Li Wong, MBBS, FAMS, FRCP, vice president, Research/Life Sciences, dean, Yong Loo Lin School of Medicine, National University of Singapore
Singapore’s development of an academic health center enterprise highlights (1) the country’s movement toward a knowledge-based economy, (2) institutional integration, and (3) a priority to encourage and increase the pool of academic and health leaders.
- The world’s economic center is tilting toward Asia.
- Singapore is uniquely situated to interact with other Asian countries and to help the region develop its health care capacity in order to deal with increased demand of health care services.
- Geography and demographics also put Singapore in an ideal position to be at the forefront of phenotypic and personalized medicine.
- Medicine remains the most competitive school for university admission in Singapore; applicants exhibit extremely high levels of achievement.
- A key initiative has been to merge Singapore’s existing medical school and teaching hospital into a single institution operating under unified governance.
- An advisory panel and leaders of academic health centers in other countries counseled Singapore’s government that the best way to achieve system efficiency and management of scarce resources was through integration.
- Advisers recommended the development of institutions that did not focus solely on clinical services, but integrated clinical care with education and research.
- For the future, the focus is to develop outcome measures that can show progress in all three mission areas.
Academic Health Centers in the United Kingdom
Stephen Smith, DSc, FMedSci,principal, Faculty of Medicine, CEO, Imperial College Healthcare NHS Trust
Smith addressed the establishment of the first academic health center in the United Kingdom.
- Historically, there has been an institutional separation of health care provision from research and education in the U.K.
- Imperial College Healthcare NHS Trust was launched through the merger of two hospital trusts and integration with Imperial College London.
- The establishment of this institution created a new organizational structure with integrated leadership and management, formally bringing together education, patient care, and research.
Goals include:
- To enhance and professionalize the U.K.’s clinical trials process.
- To contribute to the development of a biomedical hub in London.
- To become a top-five global academic health science center by 2012, and attract the most highly qualified and motivated staff and students.
Academic Health Centers in Israel
Rafael Beyar, MD, DSc, FACC, FESC, director general and CEO, Rambam Healthcare Campus, Israel
Rambam Healthcare Campus provides an example of strategic collaboration for education and research.
- Israel has four academic medical centers in four major cities, producing a total of 400 students per year.
- Technion medical school is located in the North of Israel, near the Lebanon border, and is adjoined to the Rambam Healthcare Campus.
- Increased visibility for Technion’s research capacity was a catalyst for collaboration on research and clinical activities.
- Given Rambam Healthcare Campus’ location and attacks during 2006, new emergency plans were developed, including:
- Ensuring access to electronic medical records system
- 500 beds located underground
- Diversity and competition exists between Israeli medical schools; an association of deans coordinates activities between the schools.
- In the last ten years, half of Israel’s physicians came from outside the country.
- The country is trying to double the number of medical students produced per year given decreased immigration.
- Key strategic issues include decisions on whether to build new medical schools or expand existing ones.
- Rambam has collaborations with Johns Hopkins University, The University of Toronto, and the Mayo Clinic.
- The institution is looking to expand on Middle East collaboration, seeing health as a step towards peace.
