The Philippine General Hospital (PGH) is the designated National University Hospital, state-owned, administered and operated by the University of the Philippines Manila. It was created under Act No. 1688 of the Philippine Commission on the 17th of August 1907.1What used to be a 330-bed hospital back in 1910 when it first opened is now a 1,500-bed hospital. Over the years, it has undergone major renovations and has expanded its services. The Out-Patient Service alone sees close to 600,000 patients in a year. It caters to 18 fully accredited residency and 65 post-residency fellowship training programs.
The PGH vision remains clear, that is, to be “globally competitive and committed to the health of the Filipino people, through a system of networking and teamwork of competent, compassionate and ethical professionals, and shall be the center of excellence and leadership in health care training and research that impacts on health policies”.2Its mission for research is to undertake biomedical and health system researches that will serve as basis for relevant health policies.
Why should a national university hospital take the tab on research? Research in the health sciences can really be expensive. There is manpower, equipment, diagnostics, and workspace needed. Though it is also true that science should be able to adopt to the environment where research can be done. Researchers would always say the environment can be made more conducive for the conduct of research.
At the turn of the century, Dr. William Pinsky of the Alton Oschner Medical Foundation of New Orleans identified the roles of the academic medical center in research.3Research can take many forms from bench to health services to clinics. Clinical research, in particular, aims to promote health. Clinical trials find home in these centers. But the clear edge is in the large and diverse population of patients coupled with interested and experienced investigators. Having organizational support and infrastructure to carry the research make the process even better.
Philippine General Hospital has taken gradual steps to make the institution more conducive for research. A research agenda was developed which was consistent with the National Unified Health Research Agenda (NUHRA). A dedicated research fund was established which its research office coordinates. Humble research grants have been given to trainees, faculty, nurses, and paramedicals now on its third year. Subscription to 2 lead journals has been made where constituents can publish their works.
The question now is what is the role of PGH as a funder? Is it taking the traditional role? Or is a stepping up on its way? Kessler and Glasgow defined the traditional funder’s role as following these steps: receive grant applications, evaluate the applicants, fund the most suitable ones, and evaluate research outputs.4
There is a necessity, however, for an emergent role for research funders. This is what Brantnell et al define as facilitative.5 The facilitative role has something to do with implementation: facilitating the steps leading to implementation and the implementation itself. They further gave examples of facilitate roles as follows: Involvement in implementation of innovations in health care; advocating for the use of research results; managing implementation programs; creating interaction between researchers and research users; making sure that researchers submit an implementation plan together with their grant application; and disseminating research findings.
Implementation needs initiators, facilitators, and persons responsible for it. There has to be a monitoring process for the implementation outcomes. The effectiveness of interventions found in research finds its true value when applied to the end-users.
Imperative to this implementation process is also adopting to expansions in clinical research including “big data” repositories across clinical networks, involvement of communities, and focusing on quality improvement, patient satisfaction, efficiency, and integration of these in healthcare delivery.6
This facilitative role and the implementation process may be the answer to the problems of wide knowledge-practice gap, inadequate implementation of clinical research, and ultimately optimal patient care in the setting of a national university hospital. This is the direction the national university hospital as a researcher and funder has to take for a better health service delivery to the constituents it dutifully serves.
Jean Anne B. Toral, MD, MScCoordinator for ResearchPhilippine General Hospital
REFERENCES1. Acts of the Philippine Commission [Internet]. [cited 2020 June 4]. Available from: www.officialgazette.gov.ph.2. Habana MAE, editor. University of the Philippines Manila Philippine General Hospital Training Manual 2017, published by the Office of theDeputy Director for Health Operations.3. Pinsky WW. The roles of research in an academic medical center. Ochsner J. 2000; 2(4):201-2.4. Kessler R, Glasgow RE. A proposal to speed translation of healthcare research into practice: dramatic change is needed. Am J Prev Med. 2011;40(6):637-44.5. Brantnell A, Baraldi E, van Achterberg T, Winblad U. Research funders’ roles and perceived responsibilities in relation to the implementation ofclinical research results: a multiple case study of Swedish research funders. Implement Sci. 2015; 10:100.6. Konstam MA, Hill JA, Kovacs RJ, Harrington RA, Arrighi JA, Khera A. The Academic Medical System: reinvention to survive the revolution inhealth care. J Am Coll Cardiol. 2017; 69(10):1305-12.
Impact of implementing a competency-based job framework for clinical research professionals on employee turnover