Integrating Mental Health Care, Education and Research Glenda MacQueen Vice Dean, Cumming School of Medicine University of Calgary

Disclosures Relationships with commercial interests: -Advisory Board or similar committee: Lundbeck; Pfizer -Speaker’s Bureau/Honoraria: Lilly, Lundbeck, Pfizer Managing Potential Bias: -The industry companies listed above were not involved nor did they influence the content of this presentation. -The following content complies with the UBC CPD standards.

Objectives To review the objectives of the health systems in which academic health science centres function To consider how research fits into the mission of academic health science centres To consider how individual clinicians / scientists find a role in academic health science centres

4 Healthcare value = Healthcare Outcomes/Total Cost Outcome = Quality of Life X Length of Life Quality of Life = Functional Capability X Patient Perception Dale Sanders. Sr. VP, Strategy. Health Catalyst. March *We need to collect better data around total cost and functional capability The Health Cost Equation

Quality and a Sustainable System

Efficiency in health care systems

Physician A Agency F Physician W Primary Care Group Service 467 Service 311 For Profit Rehab. Agency Y Public Rehab. Service 222 Service 1 Service 179 Problem: Complexity of care

Problem: complexity leads to conflicting goals and changing directions

Problem: We do not have the data we need to make choices COST – if known COST – if known (lowest cost possible) ACCESS – if known ACCESS – if known (satisfactory or not) QUALITY – if known QUALITY – if known (all dimensions) PATIENTS

Problem: non-malicious consumerism by patients AND providers

Characteristics of high performing health systems Success is defined and terminology is clear for all stakeholders. Physicians are engaged at all levels. ‘Innovation’ is defined and embraced: people, processes, and systems. Not just devices/drugs. People in teams and networks lead a culture of innovation across processes, systems, services. People test innovation; it’s OK to fail. Champions of change are identified, developed and supported. Evidence-based treatments and approaches are used and pursued through research. The system improves value for money for all as a major goal. Good information for decisions is essential: real time evidence is key. The system invests to buy positive changes. There is a good human resource system. Careful incentives for all stakeholders. Measurement for goals- aware of what is not measured. Strong and engaged primary care and strong community care. Planning models with embedded research. Meet or exceed patient expectations.

What is innovation? Something new that enhances quality In a health care context, an innovation can be a device, a drug, a technique, a method, a system or a service. Innovations can be procured or developed within

Connect all research pillars with health needs

Options for Priority Setting

The biggest opportunity?

Quality and a Sustainable System

Your role in all of this What do I want to do? What do I need to do it? What value will it bring to others? Is this the right place to do it?

What value do I bring? Who needs what I have to offer? Collaborators – understand who is in your environment, know what they do and how you would make the group better This involves knowing who is there and what they do

What do I want to do? Be realistic – Have a 3-5 year plan Activity profile – Protected research time – Time in clinic? – Teaching time? – Administrative roles What are the expectations

The Research Problems The Givens

Is it a good fit? Do you know what you will be doing that will differentiate you from others? (distinct population, or skill set). Do you have colleagues? Is there likely to be a mentor there? Places really do have cultures – some will fit and some will not Are your colleagues people with whom you can work

Developing a Research Centre Training Strategy: A Handbook for Professional Development, Leela Damodaran and Andrew Wilson, Loughborough University, 1995

Bridging the Gaps: Creating a Research Ecosystem

Bridging the Gaps: Creating a Research Ecosystem

Logic Model of Knowledge Translation

Knowledge Translation The search for engaged end users

Health Research Ecosystem: Alberta 32

Summary We know that we need to improve all aspects of quality for mental health services To move the system forward, innovation is necessary To innovate, we must generate and translate This is most likely to occur in an academic health science centre