We have managed to accomplish a great deal in a short time, but at the same time we have barely scratched the surface of the possible. One of the things we have not done well has been communicating with the many communities who have interests of one sort or another in what the Institute is up to. For that, I apologize. My only excuse (though it is a good one) is that I have been without staff (save for a one-half-time liaison agent at CIHR-central), and I have spent much of the winter and spring on a different sort of communications mission that kept me on the road (on that, more below).
The five major sets of activities that have occupied the Institute's attention over the past six months have been a) strategic priority setting; b) interaction with the research and policy communities; c) getting an Advisory Board up and running; d) developing a preliminary strategic plan; and e) developing some Requests for Applications to support priority research beginning this fiscal year.
Strategic Priority Setting
The IHSPR was one of five partners in a winter priority-setting workshop series organized on our behalf by the Canadian Health Services Research Foundation (CHSRF). In addition to the CHSRF and the IHSPR, the other partners were the Canadian Institute for Health Information, the Canadian Coordinating Office on Health Technology Assessment, and the Federal/Provincial/Territorial Advisory Committee on Health Services. The aim of these workshops was to canvass key representatives of the research, policy, management, voluntary and other sectors across the country, on what they saw as emerging issues and priorities that should be the focus of research attention. The result of that partnership can be found in Listening For Direction: A national consultation on health services and policy issues elsewhere on this web site. These workshops and other canvassing activities described in that report resulted in 15 priority research themes. At present the partners are engaged in discussions regarding which themes each agency will take the lead on, which will result in funding partnerships, and so on.
Interaction with the Research and Policy Communities
To complement the core canvassing activities of the workshops, I visited a significant number of universities across the country, participating in information forums, meeting with groups and individuals, and exchanging information and ideas. The locations visited are included in my activities list. I will continue this series of outreach meetings and presentations in the fall, hopefully by then with the assistance of an Assistant Director for the Institute. In addition, the Institute posted an "Open Call for Suggestions" on this web site for a number of months, affording researchers and others an opportunity to provide suggestions for areas in need of strategic research funding. While the response to this Call was disappointing, we did receive over 20 constructive suggestions. Happily, all of the suggestions fit within one of the fifteen themes that emerged from the workshops. We are interested now in your thoughts on how we can better elicit suggestions from members of the Institute on research and other priorities.
On this front we are still struggling with the absence of a comprehensive database of interested researchers and research users from across the country. But we are hard at work developing plans to rectify this situation so that we can more effectively communicate with you.
Advisory Board Activities
Members of the Advisory Board were announced in February, and we have already held two meetings (March and May). It has been a privilege and pleasure to begin the task of developing strategic directions and early initiatives for the Institute with this remarkably talented, eclectic, energetic and committed group of individuals. Synopses of the meetings, in the form of abbreviated IAB meeting minutes, can be found elsewhere on this site. The major tasks for the Advisory Board have been related to developing Requests for Applications (on this, more below) that either have been, or will be, issued to support projects or training programs beginning this fiscal year.
Preliminary Strategic Plan
We have identified four envelopes of activity on which to focus the Institute's energies over the near term - people, data infrastructure, strategic research, and knowledge transfer and uptake. Details on these can be found in the Institute's "Strategic Directions Outlook". In brief, however, the focus within the "people" envelope will be to support training and other forms of capacity-building to address the shortages of expertise in health services and policy research generally, but also in specific sub-areas. The challenges within the "data infrastructure" remit include supporting the development of critical databases and data linkage efforts in support of health services and policy research, and working on a variety of issues related to data privacy, security and access for our research community. The "strategic research" agenda has involved identifying priority areas in which to develop tailored requests for applications (see below) over the next two to five years. And finally, none of this other activity is of much value unless we can also develop and implement effective approaches to ensuring that the results of the work the Institute supports come to the attention of those to whose decisions it is most relevant. On that front, we have struck a working group of the Advisory Board, which will be working closely with staff at cihr-central who are developing an overall CIHR knowledge translation strategy. We have also commissioned some work looking at the feasibility of, developing a new Canadian journal focusing on communicating health services, health policy, and population health research results to policy-makers and managers [see the executive summary of the report, Interest in and Feasibility of a New Canadian Journal of Health Services and Population Health Research] Comments and further suggestions can be sent to Terry Albert at <talbert@cihr-irsc.gc.ca>.
Requests for Applications (RFA)
The Institute has already been involved in the development of four RFAs. The first, issued in May 2001, was a joint undertaking involving the Canadian Institute for Health Information, IHSPR and the Institute of Population and Public Health (IPPH). The topic is "Improving the Quality of Health Care in Canadian Hospitals". The second, issued in late May 2001, was an Institute-wide Request for Applications for support of Research Training Grants. The IHSPR flagged two specific priorities within this general call, one being collaboration to develop joint training capacity in population health and health services research, the other being training capacity in mental health health services research. IHSPR committed, in that RFA, to supporting at least three training programs whose core thrust was the development of new health services/policy research expertise for Canada. The final two RFAs are on priority research themes that emerged from the priority-setting activities described above and the deliberations of the Advisory Board. They are on "Financing Health Care in the Face of Changing Public Expectations", and "Improving Access to Appropriate Health Care Services for Marginalized Groups". The latter is in partnership with the Institute of Gender and Health and the Institute of Aboriginal Peoples' Health. In addition the Canadian Health Services Research Foundation (CHSRF) will be committing significant program support to specific sub-areas within each of these strategic themes, later this fall.
Other Activities, Plans and Commitments
The Institute has also processed a number of requests for workshop or meeting support. To date we have provided small amounts of support on an ad hoc basis to activities of this nature that align with the efforts of the Institute to identify research or capacity gaps and develop strategic initiatives directed at closing or eliminating those gaps. We are in the process of developing guidelines and an application template for groups planning activities of this nature. These will be posted on the web in the near future.
The Institute has also worked closely with CIHR-central in cementing CIHR's commitment to health services research through the CADRE program (partnered with CHSRF).
And finally, each of the Scientific Directors is in active discussion with our colleagues around opportunities for partnering on future strategic initiatives. Some of these (e.g. health services research and genetics; development of a national longitudinal cohort on "healthy aging") are in very formative stages, and we will venture into these new areas first through support of developmental activities, and only later through the issuance of joint RFAs. Others (e.g. palliative cancer care) are likely to result in partnered RFAs within the near future.
And finally..
Over the last seven months, the 'noise' around Canada's health care system has, if anything, intensified. It seems appropriate, therefore, to close by retaining a part of my initial message, which was true then, and has been reinforced since: These health care issues fuel heated debates that, more often than not, suffer from glaring gaps in basic information and research evidence. The challenge for the researchers of this Institute will be to collaborate with a wide variety of community, government, and other partners, to develop the capacity to fill those gaps in a scientifically rigorous, comprehensive, and timely fashion. The creation of the Institute of Health Services and Policy Research presents a historic opportunity to improve the information and evidence base on which health care policy decisions are made across this country.
I welcome your comments and suggestions. While we are still a virtual Institute (no space, no staff), both of these situations should be resolved in the near term. In the meantime, please send your thoughts to me at IHSPR@cihr-irsc.gc.ca.
