Introduction to the theory of research hospitals (series 5): scientific research in the research hospital
Review Article

Introduction to the theory of research hospitals (series 5): scientific research in the research hospital

Jun Yao1, Tian Gao2

1Chinese Research Hospital Association, Beijing 100039, China; 2Department of Performance Management, Jinan Central Hospital Affiliated with Shandong University, Jinan 250013, China

Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

Correspondence to: Jun Yao. Chinese Research Hospital Association, Beijing 100039, China. Email: m18611717182@163.com.

Abstract: Scientific research in the research hospital is different from general hospitals, with three important characteristics. First, in addition to the task of the routine treatment, based on medical science research, the research hospital will use advanced theory, research methods and technical methods to do systematic research on the major difficult diseases to create new knowledge. Second, it will transfer the latest research results into clinical practical results and treatment technologies through collaborative research and clinical verification. Third, it will apply and promote the latest medical results in clinical works.

Keywords: Scientific research; research hospital; hospital


Received: 04 August 2016; Accepted: 06 September 2016; Published: 25 October 2016.

doi: 10.21037/jrh.2016.10.02


Scientific and technological development plan of the research hospital

The scientific and technological development plan of the research hospital is the research objectives and tasks in a certain period, which carries on the overall plan to the personnel training, the experimental platform, the fund investment, the information resources and the organization management and so on, and provides a strong support for achieving tasks and objectives efficiently.

Basic principles of scientific and technological planning in research hospitals

The research hospital should grasp the frontier trend. Human beings have entered “the post genomic era”, stem cell research is in the ascendant, and brain research has become the new “moon landing program”. At the same time, new models and new technologies promote medical progress. Individual treatments, new biomedical models and translational medicine have become important or promoted medical progress. The wide spread cross integration of life sciences and other disciplines breeds a number of new disciplines so that engineers, physicists, biologists and clinicians can participate in solving the difficult problems of biomedical field.

The research hospital should aim at the major demand, curb the spread of major chronic diseases, improve the prevention and control of major infectious diseases, reduce the occurrence rate of birth defects, improve the disaster rescue capability, and accelerate the modernization process of traditional Chinese medicine.

The research hospital should also highlight translational medicine research, emphasize independent innovation, pay attention to basic research, accelerate the development of equipment and drugs and pay attention to the characteristics of research. “Do some things, and leave some things undone”.

Objectives and tasks

The overall objective is to accurately grasp the development trend of world medical science and technology so as to closely integrate scientific research and clinical works based on the major health needs of the country and the region. The research hospital should optimize the organization mode, and establish a scientific and technological innovation system with distinctive characteristics of the research hospital by focusing on the strength of the advantages. It should also carry out research around the common diseases, multiple diseases, and difficult diseases to provide a strong scientific and technological support for improving health level of the whole people.

The technical objectives are as follows: the research hospital should master and develop a number of new technologies and methods to solve the key issues in basic research to discover the key mechanisms and important molecules that can reveal the occurrence and development of a disease. In translational medicine research, the research hospital should speed up the transformation of the latest theoretical research results to the clinical applications. In clinical research, it should make full use of the resources to carry out evidence-based medicine research, multi-center clinical research trials and epidemiological studies, to develop standards and guidelines for the diagnosis and treatment of Chinese people.

The ability objectives are as follows: the research hospital should establish a technology research platform based on key research technologies; it should build a superior discipline group focusing on key research directions and form a mechanism with open sharing of resources and interdisciplinary collaborative research. It should also shorten the transformation time from basic research to clinical application, thus significantly improving its scientific and technological innovation ability.

According to the characteristics and requirements of scientific research in research hospitals, scientific research in research hospitals has seven key tasks: to develop frontier technology research; to pay attention to the study on prevention and treatment of chronic diseases; to strengthen the prevention and control of major infectious diseases; to enhance developmental and reproductive studies; to carry out the research on disaster medical rescue; to promote the study on traditional Chinese medicine; and to highlight translational medicine research.

Measures of safeguard

The research hospital should continually invest in key research directions. In addition to actively seeking national and local research funds, it must also set up research funds through self-financing or enterprises. By the development of planning, it should emphasize supporting and nurturing the characteristics of research directions, improve the input-output ratio, and promote the improvement of innovation ability.

The research hospital should pay attention to integrate training, introduction and use of the research talents with scientific research around research team building in their strategic planning. First, it should cultivate outstanding research talents based on themselves to provide a good growth environment for young scientific and technical talents, by studying abroad, financial support, project support and other ways, to promote the overall improvement of the level of hospital scientific research team. Second, it should introduce the international first-class research personnel through a variety of channels. Third, it should provide a strong support to the talents on system and policy, welfare and research conditions, etc., grant it a certain autonomy, rapidly form the multidisciplinary or interdisciplinary research team with high-level research personnel as the core, with strong independent innovation ability, and finally, enhance the overall research strength of the hospital.

The science and technology planning of the research hospital should lead to creating a good academic atmosphere. There are three characteristics of the academic atmosphere in the research hospital. First, it often organizes academic lectures. Second, it advocates democracy in academic rights that different academic views can be fully published. Third, it requires achieving good faith in academic ethics.

The research hospital should promote international scientific and technological exchanges and cooperation in their science and technology planning. First, it should encourage the staff to study abroad. Second, it should encourage cooperation to improve their research ability by the form of developing project cooperation research, appointing of visiting professors, and inviting the distinguished level researcher to do lectures in China. Third, it should encourage the staff to organize and participate in the large international academic conferences, or join the international academic organizations and associations with certain academic influence. It should establish international research and cooperation platforms to attract more overseas talents.

The research hospital should improve the utilization efficiency of scientific and technological resources. In the science and technology planning, on the one hand, the research hospital should increase investment in the software of scientific research, on the other hand, it should strengthen resource sharing to promote the cooperation and sharing among the disciplines in the hospital through building the mechanism and measures of the resource sharing in the hospital. At the same time, it should make full use of the public resource service platforms provided by national and regional government, research institutions and enterprises to enhance the competitiveness of hospitals.


The management of scientific and technological innovation strategy in research hospitals

Plan the innovation achievement type

The first type is new knowledge and new ideas. Research hospitals should adhere to develop themselves with obvious characteristics by innovating, and constantly improve the level of diagnosis and treatment to create a medical service brand and shape the hospital culture and hospital core competitiveness.

The second type is new business and new technology. Research hospitals should make breakthrough progress through independent innovation, joint research, and widely use the research results in clinical works to form characteristics and advantages.

The third type is new drugs and new standards. Standardization construction of research hospitals is an important content of building research hospitals, and the purpose of it is to make the hospital construction into a scientific and standardized track.

The research hospital should strengthen the supervision of drug use, formulate the optimal treatment plan and clinical pathways to strengthen the rational use of drugs, and strengthen the training of using antibiotics and other drugs to avoid excessive medical treatment. It should ensure that the main medical resources are used for the diagnosis and treatment of patients with difficult or serious illness and to carry out innovative technology through the development of standardized disease diagnosis and treatment processes, through evidence-based medicine to explore the optimal treatment plan and clinical path, and finally to form the inherent advantages and core competitiveness for the sustainable development.

The fourth type is the new model and new system. The research hospital must innovate the management mechanism to research, solve the structure, mechanism and system problems of the hospital by using medical quality, resource consumption rate and customer satisfaction as a measure for process design.

The hospital must concentrate on its dominant power to build a number of key specialties, create special disease centers based on their own advantages, and strive to achieve a breakthrough in the clinical diagnosis and treatment technology to form a competitive advantage. It should pay attention to the construction of talent teams, and firmly grasp the three links including training, attracting and reasonable use of talents. It should adhere to mainly relying on internal training, with external introduction as a supplement, using training masters, distinguished teachers, famous doctor teams and talent teams to provide a solid support for building research hospitals.

Research hospitals should establish a quality standard system which is in line with the international standards, promote the continuous improvement of medical quality, and provide patients with quality, safe and reliable medical services.

Constructing research mechanism

The research hospital should innovate its talent training mechanism to establish a fair competition mechanism. Based on self-training talents and to attract the best talents, the research hospital will train a high level of medical talents with medical, teaching, and scientific research abilities to achieve internationalization, high level, and diversity of the talent team.

The research hospital should strengthen exchanges and cooperation, give full play to the advantages in technology, talent and brand, and realize the communication and cooperation between disciplines, hospitals at home and abroad.

The research hospital should aim at a world class goal to construct superior discipline groups through reasonable allocation of medical resources, research resources, information resources and human resources, thereby finally increasing the overall competitive advantage of the hospital.

Construction and management of scientific research platform

According to the requirements of the development of medical science and technology, the research hospital should build a research sharing platform. Combining its own reality and characteristics, it should establish a scientific and technological innovation platform based on discipline and laboratory, a scientific technology resource sharing platform on the basis of informatization, and a transformation platform for scientific and technological achievements with the organic integration of production, education and research.

The research hospital should establish a modern hospital management system to achieve innovation of the management ideas. Managers should take a look at home and the world, and pay close attention to new trends in the field of hospital management; at the same time, they should be rational to look at the positive and negative effects in the management process, and be reasonable in using of a variety of effective management tools to achieve the best effect of management.

The research hospital should be the digitalized hospital, which can carry out the collection, analysis and storage of large sample information. It is an important guarantee for the development of research hospitals.

The research hospital should pay attention to interdisciplinary research. It must integrate the research strength, resources and equipment of multi-sectoral and multi-discipline around solving the clinical problems, to break the barriers between basic and clinical research, basic and pharmaceutical research, to build a centralized management model of translational medicine.


The distinctive features of scientific and technological innovation in research hospitals

The research topic should be from the clinical works

The research hospital should pay attention to clinical medicine research. Comparing the research process from the experiment table to the bedside, clarifying the clinical problems in the laboratory and then using the findings in the clinical work will have relatively minor restrictions in management and ethics, so they are low risk with a high potency ratio. More attention should be paid to this.

The research hospital should create an academic atmosphere. It should strengthen exchanges and cooperation between clinical and scientific research personnel, organize interdisciplinary discussion and cooperation, and stimulate innovative thinking.

The research hospital should strengthen the construction of distinctive disciplines. It should take discipline construction as the core, focus on creating a number of key disciplines and superior discipline groups with a strong innovative ability, quickly improve the core competitiveness of the hospital, and promote the comprehensive and rapid development of the hospital.

Laboratory should serve clinic

Laboratories in the research hospital should first meet the requirements of clinical routine diagnosis and treatment. On this basis, it can achieve rapid response to the scientific research demands.

The research hospital should enhance the mutual penetration between the laboratory and the clinic. It should strengthen communication and cooperation between laboratory and clinic staff, strengthen the rotation of research students in standard laboratory, stimulate and cultivate scientific thinking, and cultivate compound talents.

The achievements apply to clinical

The achievement transformation from clinic-laboratory-clinic is the aim of scientific and technological innovation. Scientific and technological innovation ideas of research hospitals comes from clinical work, and then they are carried out efficiently in the hospital research institutions at a high level, and ultimately the result of the research is transformed and applied in clinical works. The high level innovative achievements of the research are the core symbol of the research hospital.

The application of the achievements will provide a driving force for the development of research hospitals. In the era of translational medicine, innovation is a process of moving in circles. It applies research achievements to clinical practice, joints innovation achievements and medical markets, and creates huge social and economic benefits. It can further promote the clinical diagnosis and treatment level, and provide a sustainable development momentum for the development of research hospitals.

The research hospital should promote the transformation from traditional medicine and, experience medicine to evidence-based medicine, and translational medicine. The trend of the development of medical science is evidence-based medicine and, the hot spot is translational medicine. Scientific and technological innovation will continuously enhance the level of medical scientific research in the research hospital.

Research project management of research hospitals

The selection of research projects of the research hospital should be scientific, innovative, practical and feasible. The research hospital should carry out innovative research around solving clinical problems to promote the improvement of clinical diagnosis and treatment. In the management of research project selection, the research hospital should pay attention to the translational medicine research, the evidence based medicine research, the big data mining and multi discipline cross.


The process management of a research project includes three parts.

First is pre-management, which includes the organization of the project planning, acceptance of the application and approval. The scientific research management department of the research hospital should give full play to the link between the higher authorities and the scientific and technological staffs, guide the technical personnel to formulate a scientific research plan and help the project to be successful in winning with the project application.

Second, in the middle term management, the research hospital should carry out 1–2 inspections or evaluations about the research at all levels, and notify the whole hospital of the results. It should enhance the rewards and punishment system, and implement dynamic management.

Third, in the final-period management, the research hospital needs to establish a scientific project performance evaluation system based on the nature of the project and the form of the achievements.

The research hospital should achieve administration of the project by different levels. Large project funding of the research hospital can be a million, or even tens of millions. And usually, a lot of units, organizations and personnel are involved in the study. Hence, the establishment of the “Hospital Research Management Department-the person in charge of the project-the research project manager” three levels of management system, and scientific management of resources allocation, will be helpful for smoothly doing the research.

Research hospitals should conduct integrity management. They must stop all kinds of academic misconduct, conduct scientific research integrity education, establish research integrity investigation committees, standardize research integrity investigation procedure, establish the right protection mechanism for the informant and the accused and strengthen the punishment of scientific misconduct.

Research hospitals should strengthen ethical management. The direct research object of clinical research is patients, involving social, psychological, ethical, feasibility, and other complex issues. The establishment of a scientific, reasonable and standardized organizational management system is an important guarantee to ensure the safety, objective and efficient conduct of clinical research in research hospitals.

The basic unit of hospital clinical research organization management includes: a steering committee, coordination center, ethics committee, research team, research departments, and supervision and management department. These units and sponsors, contract research organizations and the superior or the third party supervision and management departments, together constitute a clinical research organization management system architecture. Its functional module is divided into the overall design, organization and implementation, and quality control (Figure 1).

Figure 1 The structure of the organization and management of clinical research.

The management of research funds in research hospitals

Research hospitals should establish a multi-level, multi-channel technology innovation fund security system, which is based on the guidance of hospital and government investment as the main body, and social investment as the supplement, to promote the sustainable development of scientific research in hospitals.

The research hospital should co-ordinate the management of research funds within the hospital. It should establish the hospital fund project, which is helpful for cultivating independent innovation projects, cultivate young discipline backbone, accumulate a research foundation and establish key research directions of the hospital. At the same time while increasing scientific research investment, the research hospital should pay more attention to efficiency, orientation and systematicness, and gradually establish the investment system of research funds in the initial stage and mature stage.

The initial stage is the basic construction stage, in which the funds input needs to cast a wide net. The research hospital should focus on supporting the subject with a strong innovative nature and potential research value, gradually form a competitive mechanism, and establish a scientific and technological investment orientation. The major financing models include: providing extra financial support to state funded projects, establishing the hospital research project financing plan, and conducting layered and hierarchical support in accordance with the different types of projects.

The mature stage is the planning guidance phase, that is, to design a special support program focusing on the hospital’s key research directions, technologies and products.

The research hospital should strive for national research foundation

It includes project funds, such as the 973 Program; talent fund, such as the Yangtze River scholars and innovation team development plan of the Ministry of Education; and platform type funds, such as the State Key Laboratory.

The research hospital should make full use of social capital

For raising social funds for research, research hospitals should focus on the following three aspects: actively undertaking clinical trials of drugs and instruments; accelerating the research and development of new drugs and new instruments; trying to explore more channels to attract charitable funds, establishing charitable fund management mechanism, and promoting the development of domestic charitable funds.

The research hospital should ensure efficient use of funds. It should improve the use, management and supervision mechanism of research funds, and ensure the legitimacy, rationality and effectiveness of the use of funds.

The transformation management of research achievements of research hospitals

The main methods of paper management include database management and quality indicator management. Paper management is based on the number of papers, but should pay more attention to the quality of the paper. High impact factors should be emphasized, but it should not be the only factor.

The research hospital should establish the strategy of patent-based knowledge assets. The construction of the patent management system in the research hospital should be based on the strategy of the development of its own intellectual assets. It should adhere to “suit one’s measures to local conditions, do the right thing at the right time”, scientifically organize the construction, implement it step by step, focus on strengthening the protection of intellectual property rights, strengthen the connection with the international industry, and strengthen the management system construction and professional management.

Research hospitals should innovate the transformation mechanism of scientific and technological achievements, and set up the translational medicine institution. For example, the Western medical technology transfer center of Huaxi Hospital integrates the government, enterprise, clinic, subject, and platform resources. It has scientific and technological information, intellectual property rights, exploratory research before patents, exploratory research before clinical application, animal model of rhesus monkeys, pilot platform, clinical research, product registration, product post market evaluation, technical evaluation and academic promotion and other technical platforms, and covers an integrated pharmaceutical innovation chain (Figure 2).

Figure 2 The organization structure of the Western medical technology transfer center in Huaxi Hospital.

Translational medicine emphasizes highlighting the multi-discipline cross, combination of industry and research. The key of the mechanism construction lies in the innovation of the management mechanism and organization mode. The basic construction frame of the translational medicine institution in research hospitals should be split into hardware and software construction. Hardware includes the investment, research base and sharing platform construction, etc. The software includes a multi-discipline cross team, a full-time management institution, and a talent training mechanism, hospital operation mechanism and assessment mechanism, etc.

The research hospital should pay attention to the study of the award system, achievement declaration planning and achievement content concise and other aspects, to improve the efficiency of reward declaration.

Science and technology resources sharing in research hospitals

First, talent resources sharing is to take the improvement of the ability of innovation research or the completion of the study task as the goal, to effectively integrate talents from different disciplines or fields, to form the complementary collaboration of knowledge, intelligence and technology, and maximumly stimulate innovation potential. The sharing of talents consists of the following activities.

Introduction of high level talents. The introduction of high level research talents can promote the innovation ability of the hospital in a relatively short period, so it is the strategic focus of the talent resources sharing in the research hospital.

With the help of external intelligence. With the help of external intelligence refers to the hospital uses external talents without changing the ownership of the talents, which is another important means for quickly improving the innovation ability of research hospitals.

Training research talents. In practice, the introduction or use of external intelligence can only partially solve the demand for talent of research hospitals. Cultivation of its own research talent is the fundamental way to solve the problem of the talent needs of the research hospital. The research hospital should carry out interdisciplinary continuing education programs, set up interdisciplinary research projects, establish interdisciplinary research platforms, and send personnel to go out to learn and exchange, to promote scientific and technological backbone to continuously enhance the awareness of interdisciplinary collaboration, adjust and optimize their knowledge structure, to become an new research personnel with modern medical research.

Team building. The core objective of talent sharing in the research hospital is to establish the research team with innovative ability, and to create a good environment for stimulating and maintaining the innovation vigor. The team building of the research hospital should focus on choosing first-class strategic scientists as team leaders, creating an atmosphere of knowledge sharing of open disciplinary boundaries, and establishing a perfect security system.

The research hospital should realize the sharing of platform equipment. It should strengthen the overall planning, establish shared experimental platforms, and strengthen the shared consciousness and other work, to avoid repeating the purchase of large scientific instruments and to improve their utilization.

The research hospital should also realize information resource sharing. The research hospital should strengthen the sharing construction of medical information resources, enrich the literature database, unify the electronic medical record database, and construct the biological specimen database. At the same time, it should perfect the sharing of medical information resources management, pay attention to the protection of personal data privacy, and realize the organic unity of information sharing and intellectual property protection.


Acknowledgements

The authors would like to thank Dr. Robert Peterson for proofreading the paper.


Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

doi: 10.21037/jrh.2016.10.02
Cite this article as: Yao J, Gao T. Introduction to the theory of research hospitals (series 5): scientific research in the research hospital. J Res Hosp 2016;1:17.

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