A Research Strategy for South Western Sydney Local Health District

A Research Strategy for
South Western Sydney
Local Health District
Paper No 2: Potential Research
Directions
19 April 2012

A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Final April 2012
Table of Contents
Executive Summary ................................................................................................................................. 1
Introduction .............................................................................................................................................. 2
Consultation Process ............................................................................................................................... 2
Vision .......................................................................................................................................................... 3
Potential Strategies .................................................................................................................................. 4
1. Strengthening Health Research Leadership Across South Western Sydney ...................... 4
2. Developing Priorities and Innovation for Research ................................................................ 5
3. Building Research Capability .................................................................................................... 6
4. Building Workforce Capacity to Undertake Health Research ............................................. 8
5. Increasing Community Interest and Participation in Health Research ............................... 9
6. Strengthening Research Infrastructure Enablers .................................................................. 10
7. Improving Monitoring of Performance and Implementation ............................................ 11

A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
Executive Summary
In October 2011, the Research and Teaching Committee of the Board of South Western
Sydney Local Health District (SWSLHD) requested the development of research strategic plan
to embed a research ethos across LHD activities, with longer term (10 year) and shorter term
(5 year) strategies.
The planning process initiated within the District occurs within the context of considerable
change in the way in which health services are managed, structured and funded and at a
local level, demographic changes in the size and age structure of the population. It builds on
considerable work nationally and within NSW to achieve a strategic and more focused
approach to health research and improve the way it is coordinated and leveraged. It also
builds on the growing depth of expertise in health research within South Western Sydney, the
establishment of new health researcher units within the District including the Ingham Institute
of Applied Medical Research and the opportunities created through new and emerging
partnerships with universities and other groups.
Over a four month period, consultation occurred with a range of groups including senior
researchers, senior university leaders, clinical leaders and senior managers, consumers, staff
and other interested groups about the issues facing health researchers within this District and
potential strategies which could be implemented to improve research activity.
Two papers have been developed which summarise the results of this consultation. These
papers have been developed to encourage further discussion and to assist in clarifying the
potential directions that SWSLHD could take in enhancing health research. The first paper
addresses the issues faced by local health researchers. This includes concerns with leadership
and direction, priority setting and innovation, the need to build research capability including
workforce capacity, and the need to focus on infrastructure enablers that support a
flourishing research environment.
The second paper (this paper) considers each of these strategic issues and outlines the
potential strategic areas for development. The directions outlined focus on: strengthening
health research leadership; developing priorities and innovation for research; building
research capability and workforce capacity to undertake health research; increasing
community interest and participation in health research; strengthening research
infrastructure enablers; and improving monitoring of performance and implementation.
Following further consultation, the Research Strategy will be finalised.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
Introduction
In October 2011, the Research and Teaching Committee of the South Western Sydney Local
Health District Board requested that a research strategic plan was developed to embed a
research ethos across LHD activities, with longer term (10 year) and shorter term (5 year)
strategies. The major aims of the SWSLHD Research Strategy would be to:
Support and further develop the capacity for research across the SWSLHD.
Enhance the profile of current research in the SWSLHD.
Strengthen the quality and quantity of research in the SWSLHD.
Encourage new researchers, including junior staff, and, sustain the commitment to
research of SWSLHD personnel in management, support and research roles.
Identify the resourcing required to implement the strategies in the Plan and identify
potential sources of funding.
Develop governance arrangements which ensure accountability and responsibility for
research conducted according to ethical principles, scientific, regulatory and
professional standards and the principles of risk management
Ensure structures support creativity and lead to research which improves health and
health service provision.
The development of the Research Strategy builds on the considerable achievements in
health research that have occurred over the last decade in South Western Sydney. These are
reflected in the endeavours and successes of individual researchers, clinicians and research
units. They are also reflected in the development of the Ingham Institute of Applied Medical
Research, the considerable benefits it offers to health research in South Western Sydney and
the collaborative and cooperative partnership that it has with the District.
Consultation Process
As part of the process to develop the Research Strategy, consultation occurred with a broad
cross-section of stakeholders. This consultation included:
Interviews with SWSLHD senior health researchers and District Executive and key
research partners such as universities
written submissions (via questionnaire) from SWSLHD Clinical Stream Directors and
General Managers
targeted meetings on specific issues or with specific groups e.g. Aboriginal people,
people from culturally and linguistically diverse (CALD) backgrounds, Consumer and
Community Council and networks, and clinical trial nurses/coordinators
discussions with managers of SWSLHD support services
an on-line survey for staff (completed by two hundred and forty two staff).
The comments from the consultation were themed to identify the strategic issues and
concerns that required consideration in the Strategy. These were summarised in Paper No. 1
Issues.
The consultation process identified ideas and suggestions for research strategic leadership
and direction within the District. This paper identifies potential directions and strategies
identified through the consultation process. These directions require further consideration and
discussion.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
Vision
The Board of South Western Sydney recognises the importance of research in improving the
health of the community and improving patient care, and in attracting and retaining highly
skilled health practitioners.
The vision for health research in South Western Sydney is that:
Researchers in South Western Sydney have a reputation for high quality health
research that improves the health and health outcomes of local communities
and has broad applicability nationally and internationally.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
Potential Strategies
1. Strengthening Health Research Leadership Across South Western Sydney
1.1 Develop a District-wide Approach to Research Leadership
1.1.1 Develop a SWSLHD Research Policy Statement that emphasises the
importance of health research, the benefits to the health service and
community, the role of managers and staff in encouraging research and
expectations including recognition of SWSLHD in multicentre studies.
1.1.2 Implement a Communication Strategy targeted to existing and future staff
which includes:
a. Development of a Research webpage which provides information
about research undertaken in the District, grants and financial and other
supports available, and achievements using print and audio.
b. Coverage of research achievements (such as new research
qualifications, forums and research papers) in internal and public forums
and media.
c. An annual research report which summarises achievements in research
and research related activities and progress in implementing the
Research Strategy.
d. Reporting of research in all facilities.
1.1.3 Include a research strategy/ies in all District strategic, clinical and service
plans and extra-ordinary funding proposals.
1.1.4 Build research activity into annual performance agreements of all clinical
directors and facility managers with key performance indicators (KPIs) to
assess performance.
1.1.5 Target recruitment in clinical leadership positions to people who are active
researchers or who are actively upgrading their research knowledge and
skills;
1.1.6 Hold annual research forums to showcase new and emerging research in
the District. This may include targeted forums which address priority
research areas or professions e.g. Allied Health. There is also potential for
forums in all facilities.
1.2 Clarify the Roles and Relationship between SWSLHD and the Ingham Institute
SWSLHD and the Ingham Institute have a mutually beneficial, collaborative and
cooperative arrangement for research that benefits the broader community in
South Western Sydney. This includes the provision by the Institute of research and
research facilities of an international quality and standing which can support the
research activities of SWSLHD prevention and clinical staff.
1.2.1 Review and refine the roles and responsibilities of SWSLHD in research vis a
vis the Ingham Institute. In particular:
a. Appoint a Director of Research for SWSLHD with clearly articulated
responsibilities in relation to SWSLHD governance and oversight.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
b. Determine the scope of work and activity for the SWSLHD Research
Office under the direction of the SWSLHD Director of Research.
c. Clearly identify those areas of Research coordination which are the
within the remit of SWSLHD to support research and those which are
within the remit of the Ingham Institute and define the contributions of
each to these activities.
d. Where research units are jointly funded by SWSLHD and the Ingham
Institute, define the role, reporting relationships and accountabilities for
research coordination and support.
e. Establish a budget for the SWSLHD Research Director and Research
Office.
1.2.2 Maintain a close and cooperative working relationship with the Ingham
Institute through:
a. The ongoing involvement of SWSLHD senior staff in the Board of the
Ingham Institute;
b. Consultation with the Ingham Institute in strategic planning and
development of new service initiatives.
2. Developing Priorities and Innovation for Research
2.1 Develop District-wide Stream Priorities for Research
2.1.1 Require Research Streams to develop five year plans which identify key
issues, priority research agendas and directions. These should:
‣ be aligned where appropriate to NSW health and medical priorities;
‣ include attention to national imperatives in Aboriginal health;
‣ identify expertise within the research stream;
‣ clearly identify the impacts on the health of CALD communities and
include research which targets communities with poorer health
outcomes;
‣ specify the priorities for clinical research, clinical trials, biomedical,
translational, population health, and health policy and/or health
services;
‣ incorporate projects which are innovative and/or support translation
into practice and strategies which build capacity within the research
stream e.g. regular journal clubs, interdisciplinary research meetings,
and research rounds building supported by teleconferencing capability.
2.1 Develop Research in new and Emerging Priority Areas
2.1.1 Develop research expertise which prevent major health problems for South
Western Sydney communities e.g. overweight and obesity.
2.1.2 Seek expressions of interest from Clinical Streams and Networks to establish
Clinical Academic Units in priority areas.
2.1.3 In collaboration with local Aboriginal people and organisations, undertake
and develop population health and health services research which
addresses health problems in the Aboriginal community.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
2.1.4 In collaboration with the South Western Sydney Medicare Local and the
General Practice Unit Fairfield, strengthen research in primary health care in
areas of shared clinical priorities i.e. mental health, complex care and
continuity of care building on new technology and new alignment of
services.
2.1.5 In collaboration with the South Western Sydney Medicare Local, undertake
research in new models of care and management in the new Integrated
Primary and Community Care Centres and related primary health services
planned for the South West Growth Centre. Include attention to
technology, access to research expertise and leadership, and capacity
building for staff and general practitioners.
2.1.6 Incorporate a research focus in the development of all new services and
other initiatives in all facilities.
2.1.7 Building on new infrastructure, further develop research in:
a. cancer treatment utilising the new Research Radiation Oncology Bunker
at Liverpool;
b. student and workforce education and models for translating research
and evidence into practice in the new Clinical Skills and Simulation
Centre at Liverpool.
2.1.8 Lever off state-wide initiatives and new partnerships and the
redevelopment of Campbelltown Hospital as a teaching hospital with the
University of Western Sydney to develop a stronger focus on Paediatrics
and Maternity services.
2.1.9 In partnership with local Aboriginal organisations and communities develop
and fund projects which seek to implement existing knowledge in effective
models of care for Aboriginal people.
3. Building Research Capability
3.1 Management of Research
3.1.1 In consultation with clinical streams and facilities develop a District-wide
approach to the allocation of dedicated time for research.
3.1.2 Incorporate the requirement to participate in research into the job
descriptions of all clinical staff and evaluate participation through annual
performance reviews.
3.1.3 Require all services to report their research performance.
3.2 Develop Specialist Research Support
3.2.1 Establish a comprehensive SWSLHD Statistical Support Unit in conjunction
with Ingham, UNSW and UWS to provide a broad range of statistical
services and advice for all phases of research. This includes randomisation
services, bioinformatics, health economics and survey methodology with
advice provided at a project level and involvement in broader workforce
capacity building strategies.
3.2.2 Implement a research small grant fund to support research projects which
are tied to successful grants and District priorities.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
3.3 Develop Information Retrieval Capability
3.3.1 Improve information retrieval and systematic search capability by
consulting with Medical Librarians in initial phases of research project
design.
3.3.2 Trial and purchase new electronic resources e.g. Dynamed to broaden the
range of information which researchers can access through Medical
Libraries.
3.3.3 Develop affiliations between medical libraries and universities to improve
access to additional data bases held by University libraries.
3.3.4 Increase flexibility in meeting information needs e.g. short term purchase of
journals, trial/purchase of new databases through development of new
funding models such as donations and sponsorship.
3.4 Develop Elite Research Expertise
3.4.1 Identify potential elite researchers who require additional support to remain
within SWSLHD and/or who could be recruited to the District in priority
areas.
3.4.2 Identify funding sources/sponsors for space, expertise and recurrent
funding to support research in District priorities. This funding could be used
for the appointment of clinical chairs (in collaboration with universities),
senior researchers and/or research managers.
3.4.3 Examine on-costs charges for management of research grants to ensure
they are competitive with those of other institutions.
3.4.4 Create a number of multidisciplinary academic units based on the
research streams.
3.5 Increase Clinical Trial Capability
3.5.1 Develop standard operating procedures for clinical trials and evaluate their
effectiveness.
3.5.2 Building clinical trial pharmacy capability by;
a. Appointing clinical trial pharmacists to the three main hospitals with
outreach capacity to Fairfield, Braeside and Bowral.
b. Building in flexibility for out-of-hours clinical trial pharmacy.
c. Development of processes and capacity to ensure funding is captured.
d. Development of a sustainable funding model through use of
pharmaceutical industry, SWSLHD, SP&T and Ingham Institute funds.
e. Establishing a small seeding fund for two years to develop clinical trial
pharmacy capability.
3.5.3 In collaboration with CEWD and universities develop a regular mandatory
training program in Good Clinical Trials Practice.
3.5.4 In collaboration with the research streams, build the capacity of the clinical
workforce to use clinical trials for health services research.
3.5.5 In collaboration with the South Western Area Pathology Service (SWAPS):
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
a. Develop a policy, protocols and processes for the management of
human tissue samples including standard operating procedures for the
collection, banking, distribution, cataloguing and disposal of samples;
b. Review research pathology arrangements including cost recovery;
c. Provide seeding funding to SWAPS to develop clinical trial capacity;
d. Identify pathology equipment used to support clinical trials and ensure;
effective asset management including sharing of resources.
3.5.6 Develop standardised documentation and minimum data set
requirements.
3.5.7 Review and streamline the SWSLHD Ethics Approval processes.
3.5.8 Investigate and address issues relating to Indemnity.
3.5.9 Investigate cost-effective translation of trials information and consent.
4. Building Workforce Capacity to Undertake Health Research
4.1 Build the Research Capacity of Early Career Researchers
4.1.1 Develop a Research Education Program coordinated by the Centre for
Education and Workforce Development which builds on existing SWSLHD
and university courses, researcher expertise and university collaborations. E-
learning and face-to-face courses would include:
‣ Good Clinical Practice;
‣ Introductory and advanced courses in research skills e.g. research
development and planning, developing collaborations, funding options,
writing successful applications;
‣ Governance and ethics processes;
‣ Legal issues and risk management;
‣ Intellectual property;
‣ Statistics.
4.1.2 Promote research training opportunities provided by external bodies such
as universities e.g. including PhD and health researcher courses.
4.1.3 Establish a Research Scholarship Program to provide part financial support
to staff enrolled in a post-graduate research degree course. Include
capacity to target specific health issues and professions.
4.1.4 Develop a Mentoring Program to support early career researchers which
includes identification and education of mentors, individual mentoring and
regular meetings.
4.1.5 Explore and trial the effectiveness of chat-rooms to support emerging
researchers and PhD students.
4.1.6 In consultation with Nursing executives, CANR, CHETRE and clinical nurse
consultants, develop a targeted and coordinated approach for increasing
the research skills and outputs of Clinical Nurse Consultants and Clinical
Nurse Specialists.
4.1.7 In partnership with universities, strengthen research in Allied Health practice
via the progressive establishment of Clinical Academic Units with Chairs in
Allied Health.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
4.1.8 Develop a Small Grants Program (which is tied to larger research projects)
to enable early and middle career researchers to further develop their
expertise.
4.2 Build the Research Capacity of Middle Career Researchers
4.2.1 Develop a model for conjoint appointments with universities for all
professions and supports the development of a community of researchers:
a. which recognises expertise and innovation;
b. outlines the benefits of a conjoint appointment e.g. access to statistical
packages;
c. provides them with an induction package to welcome them;
d. includes a focus on expected performance.
4.2.2 Provide clinical academic and research fellowships for mid and senior
career researchers in priority research areas.
4.2.3 Establish an annual SWSLHD Research Prize to recognise and reward
expertise and excellence in research.
5. Increasing Community Interest and Participation in Health Research
5.1 Develop a District policy regarding the approach to be used and supports
available for engaging patients and the community in research and review local
processes to ensure its effective implementation.
5.2 Consistent with Plain English guidelines, develop information for consumers (written
and audio/video) about the types and value of research and the ways to
participate in research. Translate this into major community languages.
5.3 Develop and implement a broader Community Research Engagement Strategy to
increase the community’s knowledge and interest in research e.g. a community
focused webpage, regular local press, general and targeted promotional
information for waiting areas, and interviews with researchers.
5.4 In collaboration with multicultural health services, develop a Community Research
Engagement Strategy targeted at culturally and linguistically diverse communities
(CALD). This would include:
‣ modification of broader community engagement strategies for non-English
speaking communities;
‣ protocols for researchers on how to increase participation and target CALD
communities;
‣ guidelines for researchers on how to arrange translation and interpretation.
5.5 Develop protocols and provide training to clinicians and researchers in patient
and community engagement, including the process to be used for engaging with
Aboriginal people and people from CALD communities.
5.6 Provide a fund for translations and use of interpreters to increase participation by
people from CALD communities in research.
5.7 Work with Ingham Marketing and LHD Public Relations to promote the research
achievements of SWSLHD researchers.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
6. Strengthening Research Infrastructure Enablers
6.1 Improve SWSLHD Ethics and Research Governance Office Activity
6.1.1 Increase staffing in the SWSLHD Ethics and Research Governance Office to:
‣ facilitate the timely processing of ethics applications;
‣ meet accreditation requirements for Lead NSW Health Human Research
Ethics Committee status;
‣ streamline processes and protocols including those relating to adverse
impacts and annual reporting.
6.1.2 Build the expertise of the SWSLHD Ethics Committee and SWSLHD
researchers by developing information about health literacy.
6.1.3 Increase the capacity of the SWSLHD Ethics and Research Governance
Office to support the implementation of the SWSLHD Research Strategy
and future research activity. In particular:
a. Develop information for researchers and clinicians in SWSLHD about
research funding and other supports and guidelines to support
appropriate practice.
b. Maintain a data base about research outputs, research related activity
and key points of contact across the District including within streams.
c. Establish a SWSLHD Research website linked to local research units and
which uses a range of media to promote local research expertise and
achievements and capacity building opportunities.
d. Facilitate and liaise with specialist research services, research streams
and SWSLHD support services to strength broader research supports such
as workforce capacity building enablers, information technology,
human resources and finance.
e. Produce an annual report about research achievements.
f. Organise and coordinate an annual research showcase.
6.2 Develop Finance Systems and Accountability to support Research
6.2.1 Develop a framework for financial reporting and accountability of research
which is underpinned by comprehensive stakeholder engagement. This will
include:
‣ processes to ensure the identification of funded research;
‣ policies and processes for managing research funds i.e. grant
management, operation, acquittal and closure;
‣ development of guidelines about factors to be considered in ensuring
adequate funding;
‣ timely and efficient financial processes and reporting of research
accounts.
6.2.1 Strengthen the capacity of finance and business managers in facilities and
clinical streams to provide financial support and governance to research
projects and to assess their financial viability.
6.2.2 Investigate opportunities to develop block funding grants from universities.
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A Research Strategy for South Western Sydney Local Health District – Paper No. 2 Potential Directions Revised March 2012
6.3 Develop Research Human Resource Management
6.3.1 Develop and implement a Research Human Resource Strategy which:
‣ identifies models for flexible employment of researchers;
‣ includes clearer guidelines and processes for research related grading
and award determination appropriate to researchers;
‣ has a single streamlined approval process for recruitment of research
staff;
‣ facilitate a streamlined approval process for research related
conferences, meeting and mandatory training leave and funding
applications. This will need to be specifically tailored for non-medical
staff.
6.4 Develop Information Technology and Capital Asset Capabilities
6.4.1 In collaboration with the SWSLHD Information Management and
Technology Division, further develop information technology solutions for
research. This would include:
‣ building a research capability into the electronic medical record (eMR)
with capacity to download deidentified data. This will include
identification of data information and reporting requirements,
programming, and guideline development and training.
‣ take full advantage of the IT benefits available through conjoint
appointments with universities.
‣ providing researchers with access to new initiatives e.g. web based online
survey tools.
‣ working with key partner universities to address communication barriers
created by information technology firewalls.
6.4.2 In existing and new capital redevelopments, develop a model for how and
where clinical and other research will be undertaken on the campus i.e.
within a dedicated Research/Education Centre or shared with other
clinical and non-clinical services. In particular consider:
‣ Liverpool (including capacity to expand the Ingham Institute),
Campbelltown and Bankstown-Lidcombe hospitals.
‣ Facilities required reflecting the type of research e.g. access to
bookable clinical rooms and storage, and arrangements for clinical and
non-clinical support e.g. backup for arrests, arrangements for funding
recurrent costs and governance.
7. Improving Monitoring of Performance and Implementation
7.1 Develop qualitative and quantitative key performance indicators and a reporting
template which can be used to gauge overall research and research related
activity.
7.2 In this Strategy, identify and clearly articulate how success in implementation will
be evaluated.
7.3 Provide annual reports to the Research and Teaching Subcommittee of the
SWSLHD Board on research activity and progress in implementing the SWSLHD
Research Strategy.
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