Hasnat M Alamgir |
April 23, 2022 8:52:35 PM
With the establishment of several very large high-end and profitable private sector tertiary care hospitals in Bangladesh, it is time for them to start thinking about undertaking internal research initiatives to improve their performance in care delivery, increase clinician efficiency, improve service delivery standards, build a global reputation inside and outside the country, and help achieve international accreditation standards. These well-resourced hospitals can build and improve research capacity in their facilities. These private hospitals can take the initiative to initiate the building of a research infrastructure where clinical and other health professionals will be engaged, and apply health research that will benefit these hospitals, their patients and the community. society in general.
The development of research capacity in a tertiary level hospital can be planned at three different levels:
⦿ foundational skills in research use (e.g. how to seek, evaluate and deliberately apply research evidence to update practice),
⦿ participation in research (e.g. assisting in recruitment of research subjects and data collection led by external experts), and
⦿ conduct research (for example, develop research protocols, conduct research studies, publish research articles and seek external funding).
A hospital in Bangladesh may decide to undertake the following three sequential steps.
Step 1: It can help clinicians and other healthcare professionals develop their research knowledge, skills and confidence. A range of approaches they can take include: arranging relevant education and training to command aspects of the research process such as writing research proposals and submitting ethical requests; create opportunities to learn and apply skills such as collecting data for projects, identifying research questions, analyzing collected data, conducting small research projects, and attending seminars , workshops and book clubs; establish a research-friendly workplace that welcomes and values the research interests, motivations, abilities, time commitments, and career paths of clinicians; encourage mentoring and coaching of experienced researchers; provide access to resources, including library, software, desktop, and computer use; arranging sheltered time and offering support in applying for external research funding; developing a reward and recognition system by providing greater career opportunities, research career paths and financial incentives; provide support to undertake formal higher education.
2nd step: Research capacity building is strengthened and enriched when hospital professionals work with others to exchange ideas, knowledge, skills and resources and to train a “critical mass” of personnel active in research. This can be accomplished by building:
tactical alliances, partnerships, connections and networks within and between teams, departments and organizations, including universities, NGOs, government and the pharmaceutical industry; mix of clinicians and non-clinicians with different levels of research skills within each team; coordinated and team projects; opportunities to share research expertise with other team members and with wider networks.
Step 3: To build research capacity, hospital professionals need to feel that their engagement in research is valued and contributes to excellent service delivery. This can be fostered by: demonstrating visible support and endorsement of research at the hospital leadership level, including developing structured processes and systems for research and restructuring clinical roles to include time for research; prioritize research as part of the hospital’s core business by including research in the hospital’s vision, mission, strategic plans, key performance indicators, and role descriptions; prioritize research projects that are more relevant to practice and in line with the hospital’s strategic priorities; reporting, disseminating and applying research results.
A previous research study proposed the following indicators that signify the creation of a research culture in a hospital and demonstrate its commitment to building research excellence:
1) a reformed performance appraisal system to recognize the importance of collaborative health research; 2) increased institutional support for health research through supervisory support, release time, incentives and rewards for research participation, and institutional funds to support a center, program or a central health research office; 3) established internal partnerships to conduct health research; 4) increased skills and involvement of staff and faculty in health research; 5) regular meetings for the project and other interested staff to discuss research topics; 6) new curricula related to health research; 7) a central research oversight committee.
In a previously proposed research capacity building model, the following stages of development were listed. First, the hospital will increase the research interest, awareness and skills of its staff who will then seize opportunities, collaborate with internal and external partners and participate in formal training provided by the hospital or on external platforms. . These will lead to raising the experience and qualifications of doctors and they will start publishing research articles in local or regional journals and some of them will gradually take on research supervisory roles. In the final stage, there will be a cadre of research professionals who will be involved in postgraduate supervision, mentoring junior clinicians in research, collaborating with internationally and nationally renowned researchers, securing funding competitive external research and publication in high-impact peer-reviewed international journals. .
Many young clinicians and health professionals in Bangladesh want more access to academic mentorship to develop and promote their research skills. They often cite factors such as personal attention, guidance, motivation and feedback from mentors as strengths that can influence their research training.
In the new reality of the rise of private sector enterprises and the general decline of public sector enterprises in Bangladesh, private sector tertiary care hospitals must take innovative and applied research seriously.
Hasnat M Alamgir is a professor of public health.