So You Want toHave to do Research at your Institution

1
So You Want to/Have to do Research at your
Institution?

• Brian W. Little, MD, PhD
• Vice President for Academic Affairs and Research
• Christiana Care Health System

2
CHRISTIANA CARE HEALTH SYSTEM
Roxana Cannon ArshtSurgicenter
Christiana Hospital
Wilmington Hospital
Eugene du Pont Preventive Medicine
Rehabilitation Institute
Helen F. Graham Cancer Center
Riverside Transitional Care
3
Christiana Care Health System
2 Hospital System 1,100 Beds 54,000 Admissions
152,000 ED Visits
7,300 Deliveries
16 ACGME- and AOA- Accredited Residencies
Dental, OMFS, Podiatry 246 Residents TJU-JMC and
PCOM Affiliate
4
Christiana Care Health System

• Community Clinical Oncology Program CCOP
• 300 Clinical Oncology trials

• 70 pharmaceutical or device trials
• active in-house research projects
• management functions, IRB

5
Where are we?
6
(No Transcript)
7
Christiana Care Health System Mission

• Christiana Care Health System is dedicated to
  improving the health of all individuals in the
  communities we serve through health care
  services, education and research

8
Objectives

• Initiate planning and development of one or more
  research activities in his/her hospital
  
• Discuss at least three major areas in which
  hospitals participate in research, and the
  advantages and disadvantages of being involved in
  each.

9
Disclosures

• I have no significant relationship with any
  commercial supporter
  
• I have never received to the best of my
  knowledge funds from any commercial supporter
  

10
Why are you doing Research?

• You know scholarly activity is required for your
  GME programs
  
• Your faculty is interested in publishing
• Your medical school affiliate requires evidence
  of research/scholarly activity for faculty
  appointment
  
• You want to improve the health of your community
  and patients
  

11
Where do you get research faculty?

• Experienced
• Recruit, and expect to pay
• Train, with the help of mentors
• New
• Recruit from medical schools or fellowships
• Train, with the help of mentors

12
Do you have support from

• The Board?
• The CEO?
• The CFO?
• The Chairs?
• The GMEC?
• The faculty?
• The clinical care givers?
• The community?

13
What is the level of support from your
administration?

• Shallow, short term
• Shallow, long term
• Deep, short term
• Deep, long term

14
Who is going to do the Research?

• You
• Employed, key faculty
• Residents
• Volunteer, community faculty
• Nursing and other allied health staff

15
What types of research are you planning on?

• Basic, bench research
• Translational research in cooperation with a
  university or medical school
  
• Clinical trials supported by industry
• Independent clinical trials
• Case reports and retrospective reviews
• Outcomes research
• Population research

16
On Bench Research

• Dont do it
• If you have to, get a 5 million commitment for
  at least 5 years
  
• Regulatory nightmares, only eased by volume

17
Translational Research

• You need excellent links to a major university
• Learn about CTSA - Clinical and Translational
  Science Award, and seek to partner with a CTSA
  awardee
  

18
On Clinical Trials

• Oncology is easiest if you have a CCOP, or can
  join one
  
• Cardiology loves devices, but is expanding
• Become very experienced in being a partner before
  setting up your own trial
  
• Do what you are good at, and have a lot of
• Resources for rapid turn around

19
On outcomes research

• Easiest for administrators to understand - link
  to PI/QI
  
• Hardest to get external funding for
• Need a significant number of non-physician
  specialists - statistics, epidemiology, data
  management

20
On population research

• Access to data
• Mathematician and epidemiologist intensive
• Links to state and federal research needs
• Long term commitment

21
What are you good at?

• Acute disease
• Chronic disease
• Aging populations
• Health disparities
• Biodefense and bioterrorism

22
What support services do you have, or need?

• Mentors and counselors
• Grant writers
• Statisticians
• Epidemiologists
• Research nurses/coordinators

23
What support services do you have, or need?

• Mathematicians
• Psychologists
• Nurses
• Economists
• Engineers
• Dentists
• Sociologists

24
What support services do you have, or need?

• Finance experts
• IRB or IRB access
• Medical editors
• Research Librarians

25
Do you plan for your program to be

• Centralized?
• Federated?
• Distributed?

26
What is the final goal of your research program?

• No RRC Scholarly Activity citations
• x faculty with y peer reviewed publications
  per year
  
• Sufficient publications to meet medical school
  faculty requirements
  
• Regional reputation as an academic medical
  center
  
• National reputation as an academic medical center

27
Who will you partner with?

• No one
• Community college
• College or university without a medical school
• Medical school
• State or city government

28
NIH/External Funding

• NIH Annual Funding at DVICTS Partner
  Institutions
  
• Thomas Jefferson University     64,653,069
• University of Delaware     23,779,793
• Nemours 2,638,423
• Christiana Care   
  3,906,537          
  
• Total 94,977,822
• Overall External Funding in Excess of 300 million

29
Some specific questions
30
Things that have worked for me

• Excellent, committed faculty
• Knowledgeable key leadership
• Getting scientists onto the campus

31
Things that have not worked for me

• Begging seemingly good faculty to start a
  research program
  
• Convincing administration to hire non-physician
  researchers into clinical departments
  

32
Do not expect to

• Make money
• Make and keep everyone your friend

33
Conclusions

• Know why you are starting, expanding or
  continuing a research program
  
• Get full leadership support for the long term 5
  year plans help
  
• Establish your support staff FIRST
• Be honest in your financial forcasts
• Collaborate