First published in Collegian (2011) 18, 1—2
Interdisciplinary, cross- institutional collaborations
The Academic Health Sciences Centre as a key to addressing complex health problems and advancing research-based health care
Changes in disease patterns and the economic climate have created challenges for contemporary health care systems (Bennett, 2009). Meeting increased demands for care in a fiscally responsible manner requires new collaborative approaches involving not only health care professionals but also, managers, researchers, educators and basic scientists. In addition it is increasingly recognised that unless we engage consumers, policy makers and clinicians actively in the research process, the relevance, application and uptake of research findings are limited (Lavis et al., 2005). Unfortunately, efforts to ensure the collaboration and synergy required between all of these stakeholders are often challenged by organisational boundaries, and differences in research cultures and paradigms (Smith, Mitton, Peacock, Cornelissen, & MacLeod, 2009). It is not uncommon for researchers and clinicians working in the same organisation to have limited conversations and dialogue. Yet when they come together solutions to challenging problems are often enabled by merging unique perspectives and the sharing of knowledge (Boivin et al., 2009).
The need for collaborative approaches to health sciences research and education has been recognised by peak bodies, such as the National Institutes of Health in the United States, the National Health Service in the United Kingdom (Brooks, 2009) and the National Health & Medical Research Council in Australia. The Academic Health Science Centre (AHSC) model embraced by many countries including Canada, the USA and the UK is a contemporary vehicle which can enhance research, and translational research in particular in health care (Brooks, 2009; Watts, 2009). Lozon & Fox advise that ‘the term Academic Health Sciences Centre is a relatively recent label given to the relationship that exists between university-level health/clinical education programs and affiliated hospitals/health regions that provide the physical facilities necessary for research and education’ (2002, p.12).
The AHSC has a 'threefold mission of patient care, teaching and research' (Lozon & Fox, 2002, p. 11). AHSC benefits can include closer working relationships and synergies between academic institutions and the clinical practice setting, better interdisciplinary health care team work, better integration of research, teaching and practice, and facilitation of quality ‘research intended to improve human health by translating knowledge into practical applications’ (Nicogossian et al., 2010, p. 2). Values such as the quest for excellence in patient care and health outcomes are reflected in the mission of the AHSC. Notwithstanding acknowledgement of the importance of facilitating interdisciplinary, cross- institutional collaborations, operationalising this concept can be challenging (Grainger, 2010).
As Titler (2010) notes ‘Evidence-based health care practices are available for a number of conditions such as asthma, smoking cessation, heart failure and management of diabetes. However these practices are not routinely implemented in care delivery and variations in practices abound. Implementing evidence-based practices (EBPs) is challenging and difficulties implementing evidence may be largely explained by contextual factors. Thus strategies are needed that address the complexity and systems of care, individual practitioners, senior leadership, and ultimately changing health care cultures to promote an evidence-based practice environment’ (Titler, 2010, p. 35). Grainger (2010) notes the importance of ‘ensuring nursing/midwifery research achieves equal partner status in academic health science centres, which are predominantly biomedically research led organisations’ (2010, p. 229).
Australia has been slow to embrace the AHSC model (Brooks, 2009). However in December, 2010 the University of New South Wales (UNSW) Faculty of Medicine announced the creation of the nation’s first AHSC. Collaborators in this initiative include Prince of Wales Hospital, Royal Hospital for Women, Sydney Children’s Hospitals, Randwick Children’s Cancer Institute Australia, Neuroscience Research Australia, Black Dog Institute, Eastern Heart Clinic, UNSW Medicine and University of Technology, Sydney Faculty of Nursing, Midwifery and Health This initiative is likely to be the first of many throughout Australia. It is anticipated that for the nursing and midwifery professions enhanced multidisciplinary research opportunities will arise heightening potential for new approaches to patient care based on evidence, 'best science' and 'best practice'.
John Daly RN PhD FRCNA, Professor of Nursing & Dean, Faculty of Nursing, Midwifery & Health, Head, WHO Collaborating Centre for Nursing, Midwifery & Health Development, University of Technology, Sydney
Patricia M. Davidson RN PhD, Professor of Cardiovascular & Chronic Care, Faculty of Nursing, Midwifery & Health, University of Technology, Sydney and Faculty of Health, Curtin University, & St Vincent’s Hospital, Sydney.
Christine Duffield RN PhD, Professor of Nursing & Health Services Management, Faculty of Nursing, Midwifery & Health, University of Technology, Sydney.
Terry Campbell MBBS, MD, DPhil, FRACP, Professor of Medicine & Senior Associate Dean, Faculty of Medicine, University of New South Wales
Robyn Ward MBBS, PhD, FRACP, Professor of Medicine &Clinical Associate Dean, Prince of Wales Clinical School Head Adult Cancer Program, Lowy Cancer Centre, University of NSW. Director of Area Cancer Services South East Sydney Illawarra Area Health Service Sydney.
Bennett, C. (2009). A Healthier Future for All Australians:Final Reprt of the National Health & Hospitals reform Commission. Canberra: AGPS.
Boivin, A., Currie, K., Fervers, B., Gracia, J., James, M, Marshall, C., Burgers, J. (2009). Patient and public involvement in clinical guidelines: International experiences and future perspectives. Quality & Safety in Healthcare. doi:10.1136/QSHC.2009.034835.
Brooks, P. M. (2009). The challenge for academic health partnerships. eMJA: The Medical Journal of Australia, 191(1), 26—27.
Grainger, A. (2010). Will working in an academic health science centre enhance nursing/midwifery research capacity and capability? Journal of Research in Nursing, 15(3), 229—241.
Lavis, J., Davies, H., Oxman, A., Denis, J. L., Golden-Biddle, K.,
Ferlie, E., & Burgers, J. (2005). Towards systematic reviews that inform health care management and policy making. Journal of Health Services Research & Policy, 10(Suppl 1.), 35—38.
Lozon, J. C., & Fox, R. M. (2002). Academic health sciences centres laid bare. HealthcarePapers, 2(3), 10—36.
Nicogossian, A., Kloiber, O., Zimmerman, T., Grigoriev, A. I., Koizumi, N., Mayer, J. D., & Beritashvili, T. (2010). Translational research, evidence-based medicine and medical policy. World Medical & Health Policy, 2(4), 1—5.
Smith, N. C., Mitton, S., Peacock, S., Cornelissen, E., & MacLeod, S. (2009). Identifying research priorities for health care priority setting: A collaborative effort between managers and researchers. BMC Health Services Research, 9(165), 1—9.
Titler, M. (2010). Translation science and context. Research and Theory for Nursing Practice, 24(1), 35—55.
Watts, G. (2009). From bench to bedside to population. BMJ, 338:b990.