mikilvægi samskipta heilbrigðisgeirans við háskóla og iðnfyrirtæki til þess að örva...
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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
11
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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
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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