Mikilvægi samskipta heilbrigðisgeirans og iðnfyrirtækja til þess að örva vísindastarfsemi og nýsköpun Birgir Jakobsson Karolinska University Hospital 26. janúar 2011
The Doctor. Sir Luke Fildes, 1891. The Tate Gallery, London. 2 Island 2011-01-26 Birgir Jakobsson
3 Hjärtkirurgi. Island 2011-01-26 (Foto 2003 Johan Garsten, Karolinska universitetssjukhuset). Birgir Jakobsson
There has been a great medical and technical development in health care but We still work more or less in the same old fashion 4 Island 2011-01-26 Birgir Jakobsson
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. 5 Island 2011-01-26 Birgir Jakobsson
High risk organizations according to Amalberti, R. Safety Science, 2001. 6 25
Differences in culture and conflicts of interests Restricting rules and regulations Demography Lack of integration etween academia, industry and health care Inefficiency 25 Lack of quality Källa: Value guided healthcare, The Boston Consulting Group, AB 2009 Accidents and mistakes Insufficient clinical pathways
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 8 Island 2011-01-26 Birgir Jakobsson
How do we introduce new drugs and technique, new innovations into daily health care? Ad hoc To late To early This is not only inefficient but also dangerous to the safety of our patients 9 Island 2011-01-26 Birgir Jakobsson
Health care will not manage to improve patient safety on its own Ultimately, patient safety can only be improved through a close collaboration between health care, academy and industry This collaboration will generate positive side effects and win-win solutions 10 Island 2011-01-26 Birgir Jakobsson
Karolinska University Hospitalone institution at two sites Solna Huddinge 11 25
The road map towards a high security organisation? Leadership Lean transformation R&D, Innovation, Triple helix 25
Karolinska s Strategy and planing 2008-2011 R & D + Triple helix Safety culture Balanced budget/finances Strategy for change and development 2008 2009 2010 2011 25 Presentation 100826 13
Karolinska s main strategies Change culture and daily routine work Create safety culture Improve leadership Lean transformation Process orientation and continuous improvements Develop process oriented management Change in culture as a result Create Academic Health Care System in Stockholm Strengthen clinical research Increase cooperation between health care, academy and industry 15 25
Development of leadership in focus 2006-2010 16 Copyright 2010, IC Quality AB
17 Waiting for doctor, 5 days a week, 08-16 whole hospital
Waiting for doctor, 5 days a week, 08-16 in Huddinge Väntan på läkare Före Fas1 Fas2 Fas3 2:00 1:00 Mål UCL=1:03 _ X=0:49 LCL=0:35 0:00 1 25 49 73 97 121 145 169 193 Konsekutiva veckor 2006-2010 217 241 18
19 Throug-time <4hrs, 5 days a week, 08-16 whole hospital
Patient satisfaction, E&A Patienten lämnade akuten inom 3 timmar Personalens samarbete "Utmärkt", "Mkt bra" Fick info om beräknad väntetid till läkare "Helt och hållet" tillräcklig info om tillstånd 2007 2009 "Acceptabel" väntetid för att träffa specialist Fick träffa läkare inom 30 minuter "Acceptabel" väntetid för att träffa läkare "Helt och hållet" organiserat på ett bra sätt "Helt och hållet" rekommendera K "Alltid/nästan alltid" hjälp vid behov 0 20 40 60 80 100 % 20
Karolinska University Hospital Economic results 2005-2010 Mkr 300 200 100 0-100 -200-300 -400 år 2005 år 2006 år 2007 år 2008 år 2009 år 2010 resultat -54-191 -358-250 115 181 21 21
ANDEL(%) PROJEKTANSLAG (%) External funding: Karolinska competitive on a national 50 level 45 40 35 30 25 20 STOCKHOLM LUND GÖTEBORG UPPSALA UMEÅ LINKÖPING 15 10 5 Presentation 100826 22 0 K1997 K1998 K1999 K2000 K2001 K2002 K2003 K2004 k2005 k2006 k2007 k2008 k2009
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Kliniska läkemedelsprövningar i Karolinska Trial Alliance (KTA) - handlingsplan Sverige 2001-2009 Totalt antal startade kliniska läkemedelsprövningar i Sverige 2001-2009: Källa: LIF rapport 2010:1, april 2010 25
Totalt antal startade kliniska läkemedelsprövningar i Sverige 2001-2009: Källa: LIF rapport 2010:1, april 2010 25
The triple helix Health care Karolinska Industry Academia 25
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 25
Karolinska trial alliance (KTA) Avtal mm Näringsliv Förfrågningar mm KTA Support Prövare Centrala krav 25
The Innovation Centre s triple helix Healthcare Innovation & Development Support Partnership, Education and Industry Space On Demand Education Industry Internal Karolinska Hospital activities The aim of The Innovation Centre is to promote successful collaboration between industry, education and healthcare in the field of medical technology Traditional Facilities Management Building shell 29 Island 2011-01-26 Birgir Jakobsson
Industry Areas of future excelence KI KTH Karolinska University Hospital 30 Island 2011-01-26 30 Birgir Jakobsson
Fellowships in Stanford - statistics Av 49 st hittills examinerade Fellows har 80 % (!) fått ett patent beviljat. 31 Island 2011-01-26 Birgir Jakobsson
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 32 Island 2011-01-26 Birgir Jakobsson
Conclusion If we want different results - we have to do things differently Patient safety and medical quality Innovation Efficiency Getting the wheels to turn Economic growth National wellfare Win - win solution for everyone involved 33 Island 2011-01-26 Birgir Jakobsson