Blacktown and Mount Druitt Research Strategic Plan 2019 - 2024 Welcome

Mr Ned Katrib General Manager, BMDH

Clinicians at Blacktown and Mt Druitt Hospitals (BMDH) have been involved in clinical research for many decades. However, in the new era of BMDH as a major teaching , we will see this aspect of our institution become increasingly important. BMDH recognises that research and education are integral parts of the delivery of high-quality health care. We will support the development of research capability and activity in all aspects of the organisation. Our partnerships with other hospitals in Western Sydney, Western Sydney University (WSU), the Westmead Research Precinct and other partnerships are critical in this. This research strategic plan outlines clear steps for the next stage of development of BMDH as a research-active hospital. It envisages the incorporation of research practice into all parts of our organisation, making it part of the fabric of our professional lives. In this way we will enrich the professional experience of our staff, bring best practice to the care of our patients, educate the next generation of health professionals, and benefit the community that we serve. I commend this plan to all members of the BMDH team, and the partners who work with us.

Cover image: Blacktown and Mount Druitt Hospitals Expansion Project/Richard Glover

This work is copyright. It may be reproduced in whole or in part for study or training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from NSW Health. © NSW Health April 2019 ISBN 1740801717 www.wslhd.health.nsw.gov.au/Blacktown-Mount-Druitt-Hospital BMDH Research Strategic Plan

Preface Preface Professor Stephen Leeder AO Professor Annemarie Hennessy AM Director, Research & Education Network, Dean, School of Medicine, WSU Western Sydney Local Health District As Dean of a medical school, I often am asked, ‘What As BMDH develops into a major teaching facility does the future of medical practice look like?’ I would in association with WSU, research is growing and answer today that it looks like what is being created at being translated into improved care. The growth BMDH and embodied in this research strategic plan. of research is such that it is appropriate now to This plan puts people at the centre of the strategy and decide on priorities and seek the resources to this especially includes the patients, their families and support what BMDH decides to do. the wider community. Just as the hospital plans were designed by the community and partners according It is encouraging that research in allied health to their vision and needs, so is this research strategy and nursing are also flourishing, reflecting the informed by the community-at-large, the health care commitment at BMDH to multi-disciplinary community and its educator partners. care. Cooperation of this calibre signals a bright future and will lead to success in the hospitals’ The future of health care, with its focus on disease endeavours. prevention through better mapping in the community, is already exemplified by the research efforts of the Blacktown Mt Druitt Diabetes and Obesity teams. This team shows a whole-of-institution approach. It provides opportunities and support for its people; it is attracting important funding support; it allows the dissemination of research results in a way that constantly improves care; and it shows leadership to the Local Health District (LHD), the region and on a national scale. This strategic plan takes those ideas and expands them across the Blacktown–Mt Druitt collective and shows us that all health professionals have a role to play in enhancing care to the highest possible standard. As a major partner in the education endeavours of BMDH at the Blacktown Clinical School and Research Centre, and on behalf of the WSU team, I commend this strategic plan and look forward to the fun and hard work involved in realising its full potential.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 1 Introduction to research at BMDH Our strategic plan 2019–2024 is an outline of how we will develop our capacity and performance in each Dr. Mark McLean, Director, of these domains over the next five years. The plan Research and Education, BMDH has been developed by a multi-disciplinary group of This is an exciting time to research-active staff at BMDH and it outlines specific be working at BMDH. We strategies and actions to be undertaken, as well as are experiencing a phase of measurable outcomes against which to assess our extraordinary growth in services, progress. Our overall vision is that we all work together facilities and staffing. BMDH is to make health research an indispensable part of our emerging as a major academic ‘day job’, and that it will be integrated with clinical care and teaching hospital, and as part and enhance the experience of staff, patients and our of this new identity we are developing research as a entire community. key activity. Why would we want to undertake research at 5 FOCUS AREAS BMDH? Isn’t it enough to simply deliver good quality health care? Actually, the two are inseparable: health research STRATEGIES has a very high value to society. It generates new Assessment, knowledge and, importantly, seeks to translate that Milestones, knowledge into better delivery of care. It is important SPECIFIC ACTIONS, Feedback ACTIVITIES, that we participate in this because the research PROJECTS questions and the translation challenges are different in every population and location. Development of research at BMDH, alongside our clinical care, will make Research Landscape of BMDH us better health care providers, better teachers and People better members of the health professions. Our people are our most important resource; patients, their families and the community are the most How does an emerging academic hospital like ours important ingredient for clinical research. The diverse, develop the expertise and capacity to undertake vibrant and growing population of Western Sydney research? To address this challenge we have identified has shown itself to be very willing to become involved five key focal areas for us to work on together as laid in medical research. Our clinicians are well placed to out this strategic plan. These key focal areas are: identify the important research questions that arise 1. Culture: Establish an institutional research culture from their clinical work – especially questions relevant and academic leadership to our local community. 2. People: Develop our research workforce and When our clinicians form partnerships with our support research-active staff patients, and with experts in research design and 3. Funding: Increase funding and resources for research methodology, we have the right ingredients for world- 4. Information: Disseminate information about our class research. The integration of research into health research care offers opportunities for staff development and 5. Collaboration: Foster research collaboration within delivers evidence based, high-quality health care to Western Sydney Local Health District (WSLHD), our our community, ensuring the quadruple aim of health university partners and beyond care: high-quality care, high-value care, good patient experience and good staff experience.

2 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

Facilities WSU has formal relationships with BMDH as a teaching The Blacktown Clinical School of WSU, adjacent to hospital and as a research partner. WSU has established Blacktown Hospital, features a purpose-built clinical a Clinical School and Research Centre on the Blacktown trials centre including consulting rooms, treatment areas Hospital campus, and a Clinical School at Mt Druitt and sample processing facilities; as well as diagnostic Hospital. equipment such as a FibroScan, dual energy X-ray WSU’s clinical academics have extensive experience in absorptiometry (DEXA) scanner and retinal camera. research methodology and practice, and they are keen These facilities are available to all clinician–researchers to collaborate with practicing clinicians to identify and who conduct clinical research projects in collaboration address ‘real-world’ research questions and to recruit with WSU. The WSU Clinical School also accommodates patients as participants for research studies. a physical containment level 2 research laboratory WSU facilitates translation of research into clinical equipped for molecular biology, genomic and cell practice through their Translational Health Research culture research techniques, as well as a physiology Institute (THRI), and is also a partner in the Ingham laboratory. These facilities allow an array of options for Research Institute (at Liverpool Hospital). As part of translational or basic research in collaboration with full- WSLHD, BMDH employees also have access to research time scientists who are keen to form partnerships with institutes in the Westmead Research Hub such as the BMDH clinicians. Westmead Institute for Medical Research, Children’s Research support Medical Research Institute and Kids Research. WSLHD Research and Education Network (REN) These institutes offer access to shared facilities and maintains an office at Blacktown Hospital to provide high-cost equipment such as genomics laboratories, on-site support to BMDH researchers. REN manages animal holding facilities, electron microscopy, research ethics approvals through the Western Sydney bio-banking and other state-of-the art research Human Research Ethics Committee (HREC), and methodologies. research governance approval through the Research Governance Office (RGO).

At Blacktown, REN staff (including HREC and RGO) will assist with applications for research ethics approval, management of research funds and applications for research grant funding. REN also provides expert statistical advice for any WSLHD staff undertaking research, assists in establishment and management of clinical trials, and runs a program of skills development for researchers. Partnerships to enable research BMDH clinicians will find willing research partners in multiple institutions very close to home.

The new Acute Services Building at Blacktown Hospital, due for completion in mid-2019.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 3 Many other partnerships are available through Research students collaborations with two National Health and Medical Research students are a valuable resource and future Research Council (NHMRC) Advanced Health Research research workforce. University students in medicine, and Translation Centres: Sydney Health Partners nursing, allied health, social sciences, public health and () and Sydney Partnership for other disciplines are often keen to become involved in Health, Education, Research and Enterprise (SPHERE); hospital-based research projects. Students undertaking incorporating WSU, University of an honours, masters or PhD degree program are able (UNSW), University of Technology Sydney (UTS) and to devote extended periods of time to a major project. others. Funding for such work may be arranged through the Academic appointments university (e.g. WSU or University of Sydney) in the form of a tax-free scholarship or stipend, if the student Several research and teaching academic positions have is enrolled in a higher degree program. This can be a been established, based at Blacktown and Mount Druitt highly cost-effective way of bringing enthusiastic young Hospitals. These include professorial appointments in people to work on a research project in the hospitals. allied health, medicine and surgery. Clinicians employed The pursuit of a research higher degree can be an by BMDH are eligible for consideration for adjunct important step in career development for many health or conjoint academic appointments with WSU and professionals. the University of Sydney. These appointments enable hospital staff to supervise research students, access BMDH appreciates the advantages that accrue to the university facilities and libraries, and participate in the hospital when members of our clinician workforce academic life of the universities. Development of strong undertake career development through research academic units is one of the key strategies for growth training. The hospital is committed to supporting its of research at BMDH (see ‘Our vision for the future’, staff to undertake such training, e.g. through part- page 22). time work or support of research projects which are embedded in clinical service roles. This enables the

4 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

Left: part of the Molecular Research Laboratory in WSU Clinical School, at Blacktown Hospital. development of a future workforce equipped with Centre: the WSU Clinical School and Lecture Theatre. research skills and experience. The WSLHD Board Right: Kathleen McMillen, Parnita Sharma and Anne Gray, staff in the also supports staff development through its bursary Peter Zelas Medical Library. scheme, and has recognised the valuable contribution of research by supporting staff pursuing these opportunities. Library and information services Funding for research at BMDH As part of WSLHD Library Services, Blacktown and Mount Druitt Hospitals both have professionally Funding for research is always keenly sought and staffed libraries. The libraries provide access to high- is often scarce. In general, the funding of BMDH for quality information resources, client-focused services clinical activity does not extend to research activity. and state-of-the-art physical and online spaces that However, much research can arise from routine clinical support teaching and research at our hospitals. activity without needing specific additional funding (e.g. audit activity, descriptive research). Local sources of Our library staff can transform the way researchers funding for broader research projects include the Better engage with information, and can provide key Foundation, REN and other local philanthropic donors. resources and services to support researchers throughout their project. Pharmaceutical companies seek hospital partners for the conduct of clinical trials of new therapies (drugs, devices and protocols). These studies provide funds to employ research-focused staff within a clinical department, and often allow the conduct of investigator-initiated projects in parallel with the sponsored studies, while also giving access to cutting-edge therapies.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 5 Improving the health of our community through investigation and innovation

1. Culture • Research translation • Evidence-based best practice • Innovation • Knowledge transfer 1 Page 7 > 2. People Support • Develop research skill • Develop research champions • Develop a BMDH research agenda Page 9 > 1 2 3. Funding • Centre of Health Research Excellence • Increased grant success • Research fellows 3 Page 13 > 4. Information • Share success • Public and peer awareness • Research impact 4 Page 16 > 5. Collaboration • Multi-disciplinary research • Multi-organisation research • Academic partnership 5 Page 19 >

6 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 Former General Manager Sue-Anne Redmond (centre) and staff celebrate the 50th anniversary of Blacktown Hospital. 1. Culture 1Establish an institutional research culture Building clinical teams that value research Research translation | Evidence based best (a BMDH example) practice | Innovation | Knowledge transfer Obesity is a major health problem in Western Sydney. To treat morbid obesity and its complications requires Everyday health care at BMDH should be based on the sustainable weight loss. Bariatric surgery is a highly best available knowledge and research findings. For effective treatment strategy to achieve this, but many this to be realised, all our health professionals need other treatment approaches (diet, lifestyle modification to become critical consumers of research, and our and drug therapy) can also be employed. Blacktown organisation needs to become one where research is Hospital has recently been granted substantial funding valued at all levels and integrated into all clinical activity. by NSW Health to establish a new obesity service Individual clinicians at every level need educational including funding for 100 bariatric surgical procedures support in research processes. Young investigators each year, and a large multi-disciplinary clinical and require mentors to help them grow in their research program. understanding of research. Our clinical teams, both While this new service is being established, the team departmental and multi-disciplinary, need support will ensure that they incorporate a sophisticated clinical and encouragement to conduct research projects and and translational research program and a multi-faceted have appropriate resources, training and team-level research agenda. This will involve all team members, mentoring. our patients and even their families and carers At an organisational level, we aspire to build structures, developing a strongly collaborative research culture processes and systems that value and promote within the team. The team has already established research. BMDH will seek stronger links with research collaborative relationships with Nepean and Westmead partners within WSLHD, and with other LHDs, Hospitals and several research institutes. The research universities and institutes. Of particular importance efforts span many disciplines, from surgery and are our existing partnerships with WSU, Sydney Health hepatology to dietetics, metabolism and psychology. Partners and the Westmead Research Hub.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 7 Because the research and clinical work are integrated, This new clinical and research program is set to be the results will feed back immediately and directly into an exemplar for other multi-disciplinary clinical teams the clinical management of our patients. Aligning this at BMDH, demonstrating that research can be new clinical program with a strong research program embedded within the clinical environment. will develop multi-faceted research capacity and provide a platform for future funding applications.

1. CULTURE – key areas of strategy and activity

KEY AREA OBJECTIVE ACTIVITY/STRATEGY TARGET MEASURES SPONSOR/CHAMPION

1. CULTURE 1.1 Research is 1.1.1 Research is an • Modify document templates for BMDH Executive Establishing incorporated into the agenda item for all committee terms of reference an operational goals of all standing committees and agenda/minutes institutional aspects of the organisation • Evaluate activity in Research BMDH Research Committee research Committee culture 1.1.2 Research • Establish a database of grants BMDH Research Committee performance indicators funded, presentations and BMDH Librarian are established and publications monitored

1.1.3 Each clinical • Each BMDH department to BMDH Research Committee department has a develop a research plan research plan • Annual departmental reports Clinical heads of department, of research activity highlighting researchers, divisional heads research-based changes to 2 practice

1.2 Multi-disciplinary teams 1.2.1 Every MDT has • Each MDT to develop a research BMDH Research Committee (MDTs) function as both a research plan plan clinical and research teams • Annual MDT reports of research MDTs/researchers activity highlighting research- based changes to practice

1.3 Future Research 1.3.1 Plan for a WSLHD/ • Preliminary development of a WSLHD Executive Institute WSU co-funded BMDH ‘virtual’ institute to establish and BMDH Executive Research Institute develop relationships before WSU (Schools of Medicine, planning institute building Nursing & Midwifery, • A signed memorandum of Science & Health) understanding between WSLHD and WSU to establish BMDH Research Institute

Better Foundation A joint initiative of Blacktown City Council, WSLHD and WSU, Better Foundation is dedicated to raising funds and support for BMDH – to provide equipment, enable research programs, and to support professional development and clinical education. Better Foundation is an independent organisation committed to enriching the health and lives of people in our communities by facilitating exceptional patient care and innovative clinical practice in our local hospitals.

8 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 Dr Scott Read, WSU Senior Lecturer, in the Blacktown Molecular Research Laboratory. 2. People and support 2Development of a research workforce Each clinical team at BMDH will be encouraged to and support of research-active staff identify and support their ‘research champions’, and Develop research skills | Develop research to direct resources to support their work. champions | Develop a BMDH research agenda BMDH will encourage inclusion of students from BMDH will provide support for all health professionals affiliated institutions in research projects, for example to undertake research, and build their capacity for as honours projects or research higher degree projects. research involvement. Support will include research This will foster research efforts in clinical teams by education and training, with a focus on skills providing additional research personnel, building development, networking, supervision and mentorship collaborations with academic partners and developing of researchers (including research students). a future research-ready workforce. Supervision of students will occur as a partnership of our health A survey conducted across all WSLHD health professionals with tertiary institutions, and will focus professionals in December 2016 confirmed that on research areas of priority to BMDH. people who were actively engaged with research, or had completed or were undertaking a research BMDH will develop funding streams for creation of degree, were more confident in conducting research research-focused positions within clinical teams, and in translating research findings into practice. We including positions for research nurses and allied health will encourage staff to undertake research training, staff. We will partner with academic institutions to including research higher degrees, to enhance these bring additional resources to the clinical environment, skill within our workforce. facilitating staff to perform research as part of their clinical service role.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 9 Research-active staff at BMDH

Dr Gary Gan (MBBS, Professor Vicki Flood FRACP) completed his (MPH, PhD) holds a conjoint medical degree in appointment as Professor 2009, graduating from of Allied Health with the University of New WSLHD and the University South Wales. He then of Sydney. Her role at undertook prevocational WSLHD is to build research and physician training capacity among allied at with numerous health professionals across the LHD. She works commendations. In 2013 he commenced closely with a range of disciplines including staff cardiology training at Blacktown Hospital, at BMDH. which he completed in 2015, and was accepted Prof Flood’s own research background is in as a Fellow of the Royal Australasian College of public health, nutritional epidemiology, nutrition Physicians. science and dietetics. She also conducts research Dr Gan is both a dedicated physician and a in longitudinal cohort studies and clinical trials. passionate academic, and has a great interest in WSLHD Allied Health implemented a strategic clinical research. His enthusiasm for research was plan for research in 2017 and elements of this sparked in his medical internship working on the plan have informed this BMDH Strategic Plan. early diagnosis and staging of pancreatic cancer. The principles include a focus on translation of This work led to a publication. research into practice; working in collaboration Now, as a cardiologist, Dr Gan’s focus is on the to conduct multi-disciplinary research; and mechanisms underlying cardiovascular disease to communicate the research findings to and heart failure. In his research, he uses non- peers, consumers and the wider population. invasive imaging techniques and clinical trials. Initiatives include Kickstarter grants for research, He has presented his work at the European publication and grant-writing workshops, and Society of Cardiology and European Heart Failure supporting people to enroll in higher degree Congress. He is a conjoint lecturer with the WSU research training. and has supervised over 25 student research projects.

Dr Gan’s commitment to research has led him to pursue a PhD degree which he is undertaking concurrently with his work as a clinician. His thesis is on the identification of novel echocardiographic parameters to help identify early cardiovascular disease in patients with chronic kidney disease.

10 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

Dr Caleb Ferguson Professor Vlasios (RN, BScN, MHlth, PhD) is a Brakoulias (MBBS [Hons], Senior Research Fellow MPsychiatry, PhD, FRANZCP, at the Western Sydney Cert. Psychotherapies) is a Nursing and Midwifery senior staff specialist Research Centre in Psychiatry at BMDH. (WSNMRC) and holds a Dr Brakoulias heads the conjoint appointment new Western Sydney with WSU and WSLHD. Dr Ferguson has over obsessive–compulsive and related disorders a decade of clinical experience caring for service, which aims to assess and treat people individuals with stroke, cardiovascular and with these disorders as promptly and efficiently neurological conditions. His research primarily as possible. This service is an international focuses on stroke prevention, management leader in research on this topic, with researchers of atrial fibrillation, and digital health. He has conducting studies locally, and implementing methodological expertise in both quantitative their results in local clinical practice. Dr and qualitative research, particularly focus Brakoulias is passionate about improving mental groups, survey methods, cohort studies and health in the Blacktown area and he has a strong social media research. focus on his local community, having been born and raised in the area. Dr Brakoulias is currently Dr Ferguson is committed to delivering the the Editor in Chief of the Australasian Psychiatry WSLHD Nursing and Midwifery Research Strategy journal. and building nursing and midwifery research capacity in Western Sydney. Current initiatives of the WSNMRC include research methods masterclasses, lectures from visiting professors, journal clubs, writing for publication and qualitative master class series, and Kickstarter grants. Dr Ferguson is also available to supervise higher degree research (HDR) students.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 11 2. PEOPLE AND SUPPORT – key areas of strategy and activity

KEY AREA OBJECTIVE ACTIVITY/STRATEGY TARGET MEASURES SPONSOR/CHAMPION

2. PEOPLE 2.1 Build capacity for 2.1.2 Train staff in research • Establish links with university Academics AND SUPPORT clinician involvement skills and methodology partners to support training Prof Medicine Development in research to enable them to be • Establish an annual introductory Prof Surgery of a research ‘research ready’ e.g. literature research skills workshop at BMDH workforce, reviews, research methods Prof Nursing and support of (quantitative, qualitative), Prof Allied Health research-active statistics, data management, • Establish research degree candidate BMDH Research staff grant writing, ethics support meetings Committee proposals and writing for publication • Instigate a program for research skills development • Develop a calendar of research REN training and education events

2.2 Increase the number of 2.2.1 Encourage and support • Audit of the number of HDR higher degrees in research staff to undertake HDR students at BMDH (HDR) undertaken by health • Develop a reporting method for staff/clinicians (e.g. Masters HDR research being undertaken of Research, PhD) • Conduct poll of HDR student needs Academics • Establish research education Prof Medicine program for HDR students and staff Prof Surgery • Provide office hub for HDR student Prof Nursing use Prof Allied Health • Increase of 50% of health staff WSU enrolled in HDR 2019-24

2.3 Increase dedicated 2.3.1 Plan for establishment • Establish research positions based BMDH Executive 3 research positions within of research time/support within BMDH BMDH staff for research (e.g. Centre • Increase academic appointments REN of Nursing/ Midwifery ) with WSU and University of Sydney Clinical School Dean (WSU) Director of Medical Services (BMDH) Divisional Medical and Nursing Directors (BMDH)

2.3.2 Increase clinical • Build capacity with protected BMDH Executive research positions within time, with back-fill employment, BMDH Research divisions and departments connected to grant success Committee of BMDH (Strategy 3) REN • 4.0FTE additional research-focused personnel across each clinical division of BMDH

2.4 Support people 2.4.1 Increase student • 50% increase in the supervisor Academics with multi-institutional involvement in research pool (primary and associate) of Prof Medicine academic support (e.g. (e.g. honours projects and HDR students. Prof Surgery supervision of hospital MD program) • Establish HDR contact lists staff by university Prof Nursing • HDR Research Student Association/ academics) Prof Allied Health peer support group formed. • Track student involvement in research activities based at BMDH

12 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 Mt Druitt Hospital Expansion Project (Picture: Kane Construction). 3. Funding 3Attraction of funding and resources research activity and success, in practical terms, other Centre of Health Research Excellence | sources of research funding must be found as well, Increased grant success | Research Fellows such as philanthropic donations, and collaborations with industry (especially pharmaceutical trials), non- Health and medical research doesn’t ‘just happen’. government agencies, such as the Heart Foundation It takes careful thought and great energy, time and and Cancer Council and community groups such as resources. Since many of our researchers are busy Lions and Rotary. clinicians, additional resources (workforce and supplies) are needed to undertake research projects. Funding story

The ability to attract funding for our research is essential In Blacktown Hospital’s busy obstetric service, more to the success of our research teams, to enable them to than 500 women each year develop the pregnancy answer important health and health service questions. complication of gestational diabetes (GD). Fortunately, BMDH aspires to being competitive for research with appropriate treatment, a healthy baby and funding at local, state, national and international mother result in nearly every case. A specialised clinic levels. Highly competitive research grant schemes are provides approximately 80 consultations every week a principal source of research funding, and provide and these patients have been willing participants in necessary research staff, equipment and materials several landmark clinical trials, including the Australian required for research. They are, however, very hard won. Carbohydrate Intolerance Study and Metformin in Gestational Diabetes Trial, which were published in the While these high-level grants (e.g. NHMRC and prestigious New England Journal of Medicine and have Australian Research Council) are a principal metric of had a major impact on modern pregnancy care.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 13 Planning image – Blacktown Expansion Stage 2, Acute Services Block. Currently the GD clinic is participating in three international multi-centre trials of diabetes management in pregnancy. This is supported Additional projects in the GD clinic have recently through grants from NHMRC (), the Canadian been funded by Diabetes Australia, REN and local Institutes for Health Research and from Novo Nordisk philanthropic donors. This busy clinical service Pharmaceuticals. This allows the employment of two integrates research with clinical care, with our patients research midwives who work directly in the Blacktown being the direct beneficiaries. It also creates a story to Hospital Antenatal Clinic to keep the projects moving, open doors to funding opportunities. and also contribute to patient care and staff education.

14 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

3. FUNDING – key areas of strategy and activity

KEY AREA OBJECTIVE ACTIVITY/STRATEGY TARGET MEASURES SPONSOR/CHAMPION

3. FUNDING 3.1 Identify research 3.1.1 Integration with the Better • Participate with Better Better Foundation Attraction of funding sources, and Foundation in fundraising Foundation in Quarterly REN funding and generate new ones activities community and interest Researchers, Academic units resources group research meetings and presentations

3.1.2 Promote and foster • Outreach meetings and BMDH Research Committee consumer and community presentations by researchers BMDH corporate engagement with BMDH in community setting communications research outside BMDH (at clubs and Researchers community centres) Better Foundation • BMDH research website with fresh research stories • Involve consumer groups in research planning

3.1.3 Identify and develop • Identify sources of potential BMDH corporate relationships with Philanthropic philanthropic funding communications funders and trusts • Facilitate at least 5 applications Better Foundation per year to various funding Researchers sources for specific projects

3.1.4 Develop industry • Develop new strategic REN partnership to support partnerships with commercial Researchers collaborative research groups research organizations and key industry groups

3.2 Each division to have 3.2.1 Support active research • Identify top 5 research BMDH Research Committee one Category 1 or 2 grant groups to obtain research groups, teams, departments Better Foundation in the next 5 years funding • Actively match research projects to funding opportunities and donors • Teach grant-writing skills REN

3.2.2 Build partnerships with • Identify WSU research groups BMDH Research Committee strong WSU health research with interests similar to BMDH groups by providing access to research groups patients. • See also Information (4.3.1) Academics and Collaboration (5.1.2)

3.3 Increase grant and 3.3.1 Identify and promote • Advertise grant availability REN clinical trials funding grant funding opportunities through email newsletters BMDH Research Committee Better Foundation

3.3.2 Develop relationships • 50% increase in clinical trials by REN Clinical Trials Manager with research-active BMDH departments by 2024 Researchers pharmaceutical companies and clinical research organisations

3.3.3 Excess funds from • 5 investigator-initiated Researchers pharma-sponsored trials to be projects funded from directed to investigator-driven pharma-generated income research

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 15 4. Information BMDH will develop strategies for communication of research activity and outcomes which will include 4Dissemination of information and staff meetings, seminars, electronic and print research outcomes communication and public dissemination of our work. Share success | Public and peers awareness Results of our work will be communicated to peers and | Research impact consumers through scientific publications, conference communications and changes in local policy and Research aims to generate knowledge, but knowledge practice. is only valuable if it can be shared and implemented. Our research plan addresses the dissemination of the It is vital that our patients and local community become learning gained from research, and communication more aware of the impact our research has on the of our work to our most important audience, the treatment we deliver, and how it ultimately improves population of our region and local community. the lives of our patients. We will communicate our research to our local community through public Dissemination of research information can occur seminars; print, electronic and social media; and a locally, or to the wider clinical and scientific community BMDH research website. Consumer engagement through national and international conferences throughout the process will be encouraged for all and peer-reviewed scientific journal publication. clinical research. Importantly, locally derived research outcomes are often directly translated into improvements in clinical care for our patients at BMDH.

16 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

Information story Our group continues to study the role of interferons Liver Research Group – Prof. Golo Ahlenstiel in chronic liver inflammation and what role the gut and Dr Scott Read microbes might play in liver disease. Dr Scott Read is Chronic liver inflammation (hepatitis) is caused through leading the development of a ‘gut organoid model’ at viral infection and fatty liver disease, and can results Blacktown Hospital to study the interplay between the in liver cirrhosis, liver failure and liver cancer. We have gut and the liver and understand why some patients identified and published, in the prestigious scientific have faster disease progression or poorer treatment journal Nature Genetics, research showing that certain responses. genetic variations in the gene of interferon lambda 3 Information story – BMDH research publications can affect the clearance of hepatitis C virus from the An effective way to ensure that the outcomes of body. We also found that once chronic hepatitis has research are dispersed widely among the research and been established, these same genetic variants can drive clinical community is to publish the results in peer- chronic inflammation and progression to cirrhosis. This reviewed medical and scientific journals. Since the research was published in Nature Communications. development of the new clinical school at Blacktown Our findings led us to file a patent for the diagnostic Hospital in 2011 and the increased academic activity of identification of these genetic variants of the interferon WSU on site, there has been a seven-fold increase in the lambda 3 gene and to develop a diagnostic scoring publication output of BMDH (see graph below). system (FibroGENE) that predicts a patient’s risk of BMDH publications progressive liver damage in chronic hepatitis, research 40 also published in one of the top international liver 35 journals. 30 Recently we published significant work identifying zinc 25 as a natural inhibitor of interferon lambda 3 described 20 above and showing that zinc also has direct antiviral 15 10 action. These findings were recently summarised in an 5 international review article. 0 2011 2017 2012 2013 2014 2015 2016 2010 1997 1995 1998 1996 1999 2001 2007 2002 2003 2005 2009 2008 2006 2004 2000

Many of these publications have been in international, peer-reviewed journals of a high standard, and our publication output has been across a wide variety of medical disciplines: anaesthesia and intensive care, cardiology, cancer and oncology, diabetes and endocrinology, forensic medicine and pathology, gastroenterology, geriatrics, infectious diseases, neurology and neurosciences, orthopaedics, pharmacology, paediatrics, psychiatry, radiology and medical physics, and surgery. The output reflects the wide range of our research activities. We intend BMDH research to continue on this upward trajectory as Allison Sigmund (clinical trials co-ordinator), Susan Hendon and Anna Bubb (research midwives), and Dr Anna Duke (Endocrinologist) – research is embedded into the culture of this rapidly Diabetes in Pregnancy research team. expanding hospital precinct.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 17 4. INFORMATION – key areas of strategy and activity

KEY AREA OBJECTIVE ACTIVITY/STRATEGY TARGET MEASURES SPONSOR/CHAMPION

4. INFORMATION 4.1 Develop research 4.1.1 Create a register of active • Establish and maintain BMDH Research Dissemination of metrics for BMDH projects database of research activities, Committee information and including projects, publications, REN research results presentations, conference Library abstracts, HDR enrolment and completion • Establish a database of BMDH Librarian research publications

4.2 Increase awareness 4.2.1 External • Develop a BMDH research of BMDH research website • Create a BMDH research • Develop a BMDH ‘research BMDH Research brand internally centre’ space within BMDH Committee and externally facilities • Develop BMDH research social BMDH Research media strategy (LinkedIn, Committee/REN ResearchGate, Facebook, Twitter) • Quarterly community and Corporate interest group research and Communications

diseases-specific presentations REN by researchers at BMDH

• Workshops, seminars, Academics information evenings Researchers with community, GPs, Better Foundation pharmaceutical industry, WSU, Westmead Research Hub partners on new BMDH/WSU grounds 5 4.2.2 Internal • Organisational awareness: • Install TV displays featuring BMDH Executive BMDH research stories to have research and other good news Better Foundation a higher profile through the stories use of diverse media • Submit regular BMDH research REN • Better integration with WSU stories in The Pulse School of Medicine, THRI • See also Collaboration (5.3.1) Academics and facilities such as Health • Establish a research grand BMDH Research Sciences, IT etc rounds or research seminar Committee • Workshops/seminars/ series information evenings with hospital staff

4.2.3 Establish a local Disseminate local research BMDH Research ‘translation academy’ findings to relevant clinical Committee where research findings are departments to inform policy targeted for local and LHD and procedures implementation

18 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 Blacktown Obesity and Metabolism Research Team (left to right): Navneeta Reddy (clinical research nurse), Dr Vita Birzniece (Senior Lecturer WSU), Allison Sigmund (clinical trials co-ordinator), Prof 5. Collaboration Golo Ahlenstiel (WSU Professor of Medicine, Hepatologist), Sarah Fostering research collaborations in WSLHD, Driscoll (Dietitian), Dr Dhanya Sanjeev (Endocrinology trainee), 5 Danielle Moxin (patient), Dr Ramy Bishay (Endocrinologist), Kate WSU and beyond Buckingham (WSU), Amy Moffitt (University Clinic receptionist). Multi-disciplinary research | Multi-organisational research collaboration | Academic partnership us to upskill our research staff, and provide access to Research is increasingly multi-disciplinary, cross- additional research funding and research students. This will enable us to train the next generation of organisational and international. BMDH will develop health and medical researchers. strategies to enhance the research activity of our multi-disciplinary clinical teams locally and expand our We will develop a fertile environment for research research partnerships and multi-centre collaborative collaboration through regular local research meetings, projects across WSLHD. our research grand rounds, seminars and cross- disciplinary conferences. These will include speakers We will continue to promote collaborative research from our local research community and research and with our existing academic partners, universities academic partners. and their affiliated research institutes, Sydney Health Partners, SPHERE and the Westmead Research Hub, Collaboration story while expanding our collaborations, including those with industry and pharmaceutical companies. Dr Vita Birzniece is a Senior Lecturer in Endocrinology and Metabolism at WSU, a fellow of the WSU THRI and Our research collaborations will provide access to a clinical researcher at the Garvan Institute of Medical the latest research technologies and expertise, assist Research with a conjoint Senior Lecturership at UNSW.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 19 Blacktown Hospital Molecular Research Laboratory has been established in the WSU Clinical School with a variety of laboratory techniques available for support of clinical research. Dr Haleh Shahidipour has capabilities in genomic analysis, cell culture, immunoassay and chromatography methods. The staff aim to undertake research in collaboration with BMDH clinical departments.

Examples of their projects include work with the mental health team to identify genetic determinants of side effects in anti-psychotic drug treatments, Staff in the newly expanded operating theatres at Mt Druitt Hospital. collaboration with the toxicology and emergency Dr Birzniece heads a metabolic research group at departments on adverse drug reactions, a study of the Blacktown Clinical School and is establishing a genetic predisposition to diabetes and obesity, and network of collaborative research projects within collaboration with intensive care to establish innovative WSLHD in endocrine, metabolic and cancer research. real-time monitoring of antibiotic drug levels. She has a particular interest in the hormonal control The scientists’ positions are funded by WSLHD, and the of metabolism and cancer development. She brings laboratory is housed in the WSU building providing endocrinology, oncology and other specialties together laboratory and clinical research infrastructure. The and is a partner in a range of multi-centre clinical trials projects are proposed by clinician collaborators – a implementing exercise and diabetes drugs to suppress picture of true collaboration to establish research cancer progression. She is also a principal coordinating excellence at BMDH. Collaboration also occurs with investigator in the multi-disciplinary research program the genomic analysis facilities at the Westmead that surrounds the bariatric surgery and lifestyle Research Hub, the National Measurement Institute management service at Blacktown Hospital. and other external bodies. The laboratory welcomes Dr Birzniece’s collaborations range from those with approaches from clinical teams at BMDH to develop local clinicians and researchers at Blacktown and new collaborative projects. Westmead Hospitals, through the University of Sydney, Western Sydney University, UNSW and University of Western Australia to the University of Surrey (UK) and Aarhus University in Denmark. Through these and many other research collaborations by Blacktown- based researchers, we are able to answer important questions and have international influence and impact.

Dr Haleh Shahidipour.

20 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

5. COLLABORATION – key areas of strategy and activity

KEY AREA OBJECTIVE ACTIVITY/STRATEGY TARGET MEASURES SPONSOR/CHAMPION

5. COLLABORATION 5.1 Build strong 5.1.1 Build contributions to co- • 50% increase in collaborative Academics Fostering research research funding of projects, positions, externally funded projects BMDH Research collaborations in partnerships scholarships, etc Committee WSLHD, WSU and REN beyond

5.1.2 Target WSU research groups • Identify WSU research groups WSU to partner with with common research interests Academics to BMDH • 50% increase in WSU partnered projects (including joint PhD projects)

5.1.3 Conduct regular (e.g. bi-annual) • Establish twice-yearly research BMDH Research research meetings between WSLHD meetings with university partners Committee and academic institutions (WSU, • Establish medical, nursing, allied Researchers USyd), with invited speakers from health and multi-discipline journal two organisations e.g. journal clubs, clubs. workshops • Establish a BMDH ‘Hospital Week’

5.1.4 Facilitate BMDH researchers See also People Support (2.2) Academics to register for postgraduate degree programs at Universities (WSU) – for professional development

5.1.5 Facilitate the networking • Run quarterly researcher BMDH Research opportunities between BMDH networking functions e.g. organise Committee researchers and clinicians wine & cheese nights, student BBQ

5.2 Develop 5.2.1 Network research activities with • 50% increase in multi discipline Academics WSLHD-wide Medical, Nursing and Midwifery and research projects BMDH Research research Allied Health staff of Westmead and Committee projects Auburn Hospitals.

5.3 Build 5.3.1 Nominate Medical, Nursing • Establish a BMDH ‘Research Leads’ BMDH Research research and Midwifery and Allied Health list Committee relationship representatives to relevant inter- • Run annual ‘Research Leads’ with Primary disciplinary research committees meeting (in conjunction with Health Network of PHNs research forums) (PHNs) 5.3.2 Invite PHN to present research • Establish twice-yearly research meetings with PHN research partners

5.4 Build 5.4.1 Facilitate collaborations with • Establish twice-yearly research BMDH Research relationships industry and pharmaceutical meetings with Industry and Committee with Industry partners to develop multi- pharmaceutical partners BMDH Departments and Pharma disciplinary collaborative research • BMDH departments develop at Academics project with BMDH researchers least one HDR project that can REN be advertised and seek funding through external sources

5.4.2 Facilitate BMDH staff to • Conduct investigator training by REN organise in-house research activities/ clinical research organisations and WSU training in industries and pharma pharma training companies. • Training in good clinical practice and intellectual property

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 21 Our vision for the future of all research teams at BMDH. We envisage a BMDH Research Institute being a hub for BMDH and an Research infrastructure – a new research important part of a network of research facilities institute across Western Sydney. BMDH is currently in its infancy as an academic BMDH Research Institute will serve a critical function medical institution. Other emerging teaching of connecting a range of scientists and clinicians to hospitals have found that a critical enabler of growth collaborate on innovative research work. BMDH will in research activity is the establishment of a research provide our Institute with direct access to clinicians, institute. Initially this might exist as a virtual institute patients and the community. Furthermore, a Research – a functional collaboration of research teams who Institute building will be a visible physical embodiment share knowledge and resources. of the importance of research in modern health care.

Our longer-term goal will be the construction of a Realisation of the goal to build a Research Institute dedicated research building on the BMDH hospital will likely be a decade-long project, and will require campuses. This would be the hub for all health-related substantial resources. However, the first step in such research activity within BMDH and our surrounding a journey is to envisage the objective. This is now community. This building would house important underway. infrastructure such as laboratories, computer facilities and staff accommodation. Additionally, it would be a Development of academic units home for experts in disciplines such as epidemiology, At this stage in our history we are transitioning from public health, biostatistics and health informatics. being a clinical service institution to becoming an These disciplines will greatly enhance the capabilities academic health care facility. This process will be

22 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

accelerated by development of lead academic units Our research visible to all, influencing that have a critical mass of clinical activity, research clinical practice productivity and education and training capability. BMDH will develop a communication plan which will Academic units typically embed staff who are research make our research work visible to all staff, our partners and/or teaching-focused within a strong clinical team, and our community. A fundamental part of this will be and develop special interests that are relevant to the an electronic communication platform – including a health needs of their community. Once established, website and social media presence. We will develop academic units are key enablers of research activity. a profile in traditional media (print and electronic), Their expertise will ideally spread to other teams and we will continue to grow the volume and impact through collaboration and partnership. Academic units of publication by our researchers in the scientific are also the focus for development of training positions literature. An important aspect of this visibility will be branding of work as having originated at our hospitals. and attract education and training accreditation by It is important that all researchers identify themselves specialist colleges and universities. as having an affiliation with BMDH, in addition to any An academic unit requires resources and funding other institutional alignments (e.g. a university). beyond that of a standard clinical service. Sources The ultimate value of health research lies in its ability of funding include WSLHD, universities, government to improve the care of patients, and the health of our bodies such as the NHMRC, non-governmental community. BMDH will showcase the outcomes of its organisations and foundations, industry and private research activity, and will close the knowledge loop by philanthropy. BMDH will develop resources and bringing research advances back to patient care. Clinical partnerships that enable development of key leaders will constantly strive to incorporate research academic units over the lifetime of this strategic plan. evidence into care plans and service protocols.

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 23 Appendices

Key research leaders at BMDH

Dr Penny Abbott, General Practice, WSU ([email protected]) Professor Golo Ahlenstiel, Gastroenterology and Hepatology, Professor of Medicine, WSU ([email protected]) Dr Vita Birzniece, Endocrinology and Metabolism clinical scientist, WSU ([email protected]) Professor Vlasios Brakoulias, Blacktown Mental Health Services ([email protected]) Dr Alan Bullingham, Anesthetics ([email protected]) A/Professor Matt Carlino, Medical Oncology ([email protected]) Dr Helen Crowther, Haematology ([email protected]) Professor Michael Edye, Professor of Surgery, WSU ([email protected]) Dr Caleb Ferguson, Conjoint Senior Research Fellow – Nursing, WSLHD and WSU ([email protected]) Professor Vicki Flood, Conjoint Professor of Allied Health, WSLHD and University of Sydney ([email protected]) Dr Bo Gao, Medical Oncology ([email protected]) Dr Naren Gunja, Toxicology ([email protected]) Dr Amy Hayden, Radiation Oncology ([email protected]) Dr Sue Lynn Lau, Endocrinology and Osteoporosis, ([email protected]) Professor Richard Lindley, Geriatrics, Stroke, Clinical Trials ([email protected]) Ms Marie March, A/ Musculoskeletal Physiotherapist Clinical Educator BMDH and PhD Candidate, University of Sydney, ([email protected]) Professor Glen Maberly, Diabetes and Public Health, Western Sydney Diabetes Prevention and Management Initiative ([email protected]) Professor Mark McLean, Endocrinology, WSLHD ([email protected]) Dr Adnan Nagrial, Medical Oncology ([email protected]) A/Prof Graham Reece, Director of Intensive Care, BMDH ([email protected]) Dr Scott Read, Scientist, Gastroenterology and Hepatology, WSU and University of Sydney [email protected] Mrs Allison Sigmund, Diabetes Clinical Trials, ([email protected]) Mr Raymond Tangunan, Oncology Clinical Trials ([email protected]) A/Prof Tim Tan, Cardiology ([email protected]) A/Prof Sanjay Swaminathan, Immunology, WSU Clinical School Dean ([email protected]) Mr Milan Vaghasiya, Clinical Documentation Specialist, Health Informatics ([email protected])

24 BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 BMDH Research Strategic Plan

Key contacts

Chair BMDH Research Committee – Dr. Mark McLean. E: [email protected] Secretariat BMDH Research Committee – Mr Mark Smith. E: [email protected] BMDH/WSU Professor of Medicine – Professor Golo Ahlenstiel. E: [email protected] BMDH/WSU Professor of Surgery –Professor Michael Edye. E: [email protected] WSLHD/WSU Professor of Nursing – [email protected] WSLHD/Sydney Professor of Allied Health – Professor Vicki Flood. E: [email protected] WSLHD Human Ethics – [email protected]

Table of Abbreviations

BMDH Blacktown Mount Druitt Hospitals DEXA Dual Energy X-ray Absorptiometry GD Gestational diabetes HDR Higher Degree Research HREC Human Research Ethics Committee MDT Multi Discipline Teams PHN Primary Health Networks REN Research and Education Network RGO Research Governance Office THRI Translational Health Research Institute WSLHD Western Sydney Local Health District WSNMRC Western Sydney Nursing & Midwifery Research Centre WSU Western Sydney University

BMDH RESEARCH STRATEGIC PLAN 2019 - 2024 25 www.wslhd.health.nsw.gov.au/Blacktown-Mount-Druitt-Hospital