mikilvægi samskipta heilbrigðisgeirans við háskóla og iðnfyrirtæki til þess að örva...

Mikilvægi samskipta heilbrigðisgeirans við háskóla og iðnfyrirtæki til þess að örva vísindi og þróun

Birgir Jakobsson

Karolinska University Hospital

26. janúar 2011

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The Doctor. Sir Luke Fildes, 1891. The Tate Gallery, London.

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Hjärtkirurgi. (Foto 2003 © Johan Garsten, Karolinska universitetssjukhuset).

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There has been a great medical and technicaldevelopment in health care

We still work more or less in the same old fashion

but

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Sir Cyril Chantler:

“Medicine used to be simple, ineffective, and relatively safe. Now it is complex, effective, and potentially dangerous.”

Lancet. 1999; 353(9159):1178-81, p. 1181.

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High risk organizations according to

Amalberti, R. Safety Science, 2001.

6

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Lack of quality

Lack of integrationbetween academia, industry

and health care

Restricting rulesand regulations

Insufficient clinical pathways

Accidents and mistakes

Inefficiency

Demography

Differences in cultureand conflicts of interests

Källa: Value guided healthcare, The Boston Consulting Group, AB 2009Källa: Value guided healthcare, The Boston Consulting Group, AB 2009

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Health care to day

Evidence based

Patient safety

Focused on the needs of the patient

Efficiency

Equality

Accessibility

Improvement is needed in almost every aspect

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Ad hoc

To late

To early

How do we introduce new drugs and technique, new innovations into daily health care ?

This is not only inefficient but also dangerous to the safety of our patients

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Health care

Industry

Academia

Karolinska

The triple helix

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Karolinska University Hospital-one institution at two sites

Solna Huddinge

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2008 2009 2010

Strategy for change and development

Balanced budget/finances

Safety culture

2011

R & D + Triple helix

Presentation 100826 12

Karolinska´s Strategy and planing 2008 - 2011

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The road map towards a high security organisation?

Lean transformation

R&D, Innovation,Triple helix

Leadership

Signals change !

© Copyright 2010, IC Quality AB

Development of leadership in focus 2006-2010

15

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Waiting for doctor, 5 days a week, 08-16whole hospital

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Waiting for doctor, 5 days a week, 08-16in Huddinge

241217193169145121977349251

2:00

1:00

0:00

Konsekutiva veckor 2006-2010

Vän

tan

på lä

kare

_X=0:49

UCL=1:03

LCL=0:35

Före Fas1 Fas2 Fas3

Mål

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Throug-time <4hrs, 5 days a week, 08-16whole hospital

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Patient satisfaction, E&A

0 20 40 60 80 100

"Alltid/nästan alltid" hjälp vid behov

"Helt och hållet" rekommendera K

"Helt och hållet" organiserat på ett bra sätt

"Acceptabel" väntetid för att träffa läkare

Fick träffa läkare inom 30 minuter

"Acceptabel" väntetid för att träffa specialist

"Helt och hållet" tillräcklig info om tillstånd

Fick info om beräknad väntetid till läkare

Personalens samarbete "Utmärkt", "Mkt bra"

Patienten lämnade akuten inom 3 timmar

2007

2009

%

20 20

Karolinska University Hospital – Economic results 2005 - 2010

Mkr

-400

-300

-200

-100

0

100

200

300

resultat -54 -191 -358 -250 115 181

år 2005 år 2006 år 2007 år 2008 år 2009 år 2010

Presentation 100826 21

0

5

10

15

20

25

30

35

40

45

50

K199

7K1

998

K199

9K2

000

K200

1K2

002

K200

3K2

004

k200

5k2

006

k200

7k2

008

k200

9

AN

DE

L(%

)

STOCKHOLM

LUND

GÖTEBORG

UPPSALA

UMEÅ

LINKÖPING

External funding: Karolinska is competitive on a national level

© Copyright 2010, IC Quality AB

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Karolinska Trial Alliance (KTA) - handlingsplan

Totalt antal startade kliniska läkemedelsprövningar i Sverige 2001-2009:

Källa: LIF rapport 2010:1, april 2010

Kliniska läkemedelsprövningar i Sverige 2001-2009

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Totalt antal startade kliniska läkemedelsprövningar i Sverige 2001-2009:

Källa: LIF rapport 2010:1, april 2010

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Why Central Unit for clinical trials?

Central unit in Stockholm County Council

A. Övergripande ansvar för:

Prövningsstatistik

Avtal och compliance

Kostnadstäckning

Patientsäkerhet

B. Support för:

Juridik

Ekonomi inkl kostnadsanalys

Etik

Kompetens avseende olika nationella och internat regelverk

Myndighetskontakter

Utbildning

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Näringsliv

KTA

Prövare

Support

Centrala krav

Förfrågningar mm

Avtal mm

Karolinska trial alliance (KTA)

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Health careKarolinska

Research, Development Education

Academia and industry

Innovation & DevelopmentSupport

Traditional Facility Management

Space On Demand

Health care

Academia Industry

We have to co-operate if we are to succeed

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Innovationsplats Karolinska

A physical building and a concept

– a meeting place where

researchers and industry can

encounter the challenges facing

the healthcare sector and its

future development

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Karolinska University Hospital

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Areas of future excelence

KTHKI

Industry

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Fellowships in Stanford - statistics

Av 49 st hittills examinerade Fellows har 80 % (!) fått ett patent beviljat.

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The strategi for change

Improve leadership

Eliminate waste from the view of the patient

Introduce system thinking, standardisation and team work

Creating a meeting place where health care, academy and industry can work together to promote innovation and to facilitate introduction of medical technology

Creating a central node where the pharmaceutical and med tech companies can have one entrance into the hospital (Clinical trial alliance)

To form an academic health care system in Stockholm

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Conclusion

Patient safety and medical quality

Innovation

Efficiency

Getting the wheels to turn

Economic growth

National wellfare

Win - win solution for everyone involved

If we want different results - we have to do things differently