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Connecting Further

UMC Utrecht Julius Center

Foreword You have before you the new “Connecting Further” strategy of the Julius Center for Health Sciences and Primary Care of the University Medical Center (UMC) Utrecht for the period 2015-2020.

This strategy came about with the input of numerous employees of various organizational units within the Julius Center. We first held so-called cappuccino brainstorming sessions regarding the future of our division. The staff members of the Julius Center subsequently discussed the key topics relating to research, education, healthcare and operational management during the staff day held in October 2014. Naturally, the UMC Utrecht’s new Connecting U strategy was an important factor in several of the decisions made. Since its establishment in December 1996, the Julius Center has developed into an internationally authoritative institute in the areas of applied medical scientific research, (bio)medical education and primary care. An important feature of the Julius Center is that all its research – both disease-related and methodological research – ensues from a multidisciplinary approach taken by the various scientific disciplines, such as (clinical) epidemiology, general practice,

public health, biostatistics and medical humanities. In addition, our division organizes a wide range of educational activities and collaborates closely with the academic primary care environment, Leidsche Rijn Julius Care Centers, in the areas of education, research and innovation in primary care. We will continue doing what we do best in the upcoming strategy period and we will build on the existing success formula of our division, with multidisciplinary cooperation within and outside the division being pivotal. In anticipation of the healthcare of the future, we will focus on a number of topics within research, education, healthcare and operational management. The Julius Center has traditionally played a uniting role between the various departments of the UMC Utrecht, for instance through joint appointments of Julius employees in clinical divisions and departments. The Julius Center has strong connections with regional, national and,

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increasingly, international healthcare providers, hospitals and research institutes. We aim to reinforce this unifying role in the coming years. By means of our “Connecting Further” strategy, the Julius Center aims to increase the impact of scientific research and education on patients and society in line with the UMC Utrecht’s “Connecting U” strategy.

On behalf of the Board of Directors of the Julius Center, Prof. A.W. (Arno) Hoes, MD, PhD Chair

This booklet contains the abridged version of the Julius Center Strategy 2015 -2020. The full strategy is available on our website

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The Julius Center: mission and ambition

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Motivated by the relevance and practical application for patients and society, the Julius Center seeks to play a leading national and international role in the acquisition and dissemination of knowledge and innovation in Health Sciences and Primary Care.

This mission translates into the following goals: • We provide a working environment in which the quality of scientific research and education, development and innovation are pivotal, making us the preferred choice of national and international talent. • Our research contributes substantially to the quality of national and international health and healthcare. • We provide high-quality educational programs, which is why national and international (bio)medical students, researchers and (clinical) professionals opt for us and acquire the knowledge that is important for their future. • We play an important role in the regional healthcare network, through evidence-based transmural collaboration and by designing and introducing innovations in healthcare. We aim to achieve these goals by: • Conducting high-quality research in populations of patients and/or healthy people in which we study descriptive and causal relationships between determinants on the one hand and health outcomes on the other.

• Translating the knowledge about these relationships directly into better prevention, diagnosis, prognosis and treatment of these diseases so as to improve the health of patients and the population at large. • Conducting our research in research programs in which multidisciplinary collaboration between epidemiology, general practice, public health, biostatistics, health technology assessment and medical humanities is pivotal. • Adding social value to our research by means of innovation and entrepreneurship, in addition to its scientific impact. • Bringing our knowledge to the general public through high-quality educational programs. • Sitting on leading medical science and healthcare bodies and committees, both nationally and internationally. • Developing , improving and providing academic primary care in the regional care network. • Setting up our organization in such a way that ensures the best possible collaboration between employees and provides them with opportunities to maximize their potential and realize their aspirations.

The relevance and practical application for patients and society are of paramount importance to us. - Prof. A.W. (Arno) Hoes, MD, PhD Chair of Board of Directors, Julius Center

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Strategic themes 2015-2020

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Research For many years now, the Julius Center is one of the best performing divisions of the UMC Utrecht in terms of quality and quantity. Both our applied research and our methodological research score highly on the international stage as well.

We aim to maintain this leading position. In light of the sharp increase in the number of innovations in day-to-day care, the increasing attention given to the societal impact of scientific research and the UMC Utrecht’s new strategy, we have decided on a number of focus areas, some of which are new, in our plans for 2015-2020. On the one hand we will continue to optimize our current scientific research by (1) intensifying multidisciplinary research and (2) expanding translational research. We will also invest explicitly in the following new initiatives in the coming years: (3) Center for Healthcare Innovation Research and (4) Clinical Trial Center of Excellence.

Further optimization of scientific research 1. Intensifying multidisciplinary research The Julius Center is organized as a matrix structure in which our disciplines work together on clinical and socially relevant care issues. An important feature of our scientific research is the integration of the clinical problem in healthcare, the ensuing research question and the applied research methods. In the coming years we will continue to work towards optimizing and, if necessary, developing this multidisciplinary collaboration both with our partners in the UMC Utrecht and with our national and international partners.

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2. Expanding translational research: even closer to the patient In the coming period we will continue to focus on translational, patient-oriented research. We aim to optimize this by focusing our attention even more on the following: • Collaboration with research programs in the UMC Utrecht. We will continue to expand the existing collaboration with the research programs and the clinical divisions within the UMC Utrecht and emphasize the added value of this collaboration. • Clinical epidemiology of cancer, infectious diseases and cardiovascular diseases. We will invest in extensive and innovative intervention research as well as research into new diagnostic and prognostic interventions in oncology, infectious diseases and cardiovascular diseases. • Organizing contact with the (future) patient. We will seek ways to make scientific output easier to find and to understand for patients and other interested parties, and we will increasingly involve patients in deciding which clinically relevant research questions to tackle first.

Investing in new initiatives 3. Center for Healthcare Innovation Research The changing healthcare landscape and a significant increase in the number of innovations in daily practice (ranging from new surgical techniques and devices to transmural

experiments) call for an increase in applied medical research that generates knowledge regarding the effects of these interventions and innovations. We will combine expertise in the field of healthcare innovation research, not only within the Julius Center but also within the UMC Utrecht and our strategic partners in the vicinity. The Julius Center will be in charge of setting up a UMC-wide, or even Utrecht-wide, expertise center for healthcare innovation research. Various internal stakeholders (e.g. research programs and clinical departments of the UMC Utrecht) and external stakeholders such as the National Institute for Public Health and the Environment (RIVM), other hospitals and health insurers have a role to play in this. The Leidsche Rijn Julius Healthcare Centers and the Leidsche Rijn Health Project are ideal pilot sites for primary care innovation projects and therefore play an important part. 4. Clinical Trial Center of Excellence Since its establishment, the Julius Center has built up a strong track record when it comes to acquiring, setting up, conducting, analyzing and reporting large-scale, often international, randomized trials. In the coming years the Julius Center will continue to expand and combine its knowledge with partners within the UMC Utrecht in a Clinical Trial Center of Excellence. This will occur in close collaboration with Julius Clinical, the academic clinical research organization of the UMC Utrecht and a spin-off of the Julius Center. Within this Center of Excellence we will further expand the collaborations in the UMC Utrecht with research programs and other divisions.

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Education The Julius Center participates in Medicine programs (both CRU and SUMMA), Biomedical Sciences, Clinical Health Sciences and in advanced medical training.

The Julius Center provides more training than any other division of the UMC Utrecht. We also provide several programs of our own, including a postgraduate General Practice raining Utrecht, Master of Science in Epidemiology, MBI Life Sciences & Health, and we have established a platform for online education (Elevate). In recent years we have worked hard on a coherent quality assurance policy for education. Our goal for the coming strategy period remains to keep our education at a high level by continuing to operate based upon the quality of our teachers, our learning practices, our organization and our testing. The Julius Center will continue to evolve so as to continue to dovetail as best as possible with the current developments in (bio)medical education and research. We will continue to provide the best education for current and future health professionals. We will therefore focus in 2015-2020 on the following strategic educational themes: (1) Evidence-based lifelong learning; (2) From research to education and vice versa (3) Securing improvement and (4) Internationalization of education.

1. Evidence-based lifelong learning • Better use of existing knowledge. We will ensure that teachers can make better use of existing knowledge in their teaching. This includes both educational knowledge and qualitative and quantitative information about our in-house training. • Collecting evidence. We will develop methods for evaluating and examining our teaching: we regard education as a complex intervention and will use our own expertise to measure and map quality parameters. • Integrated education continuum for the (international) health professional (in training). In the coming period we will work on a distinctive “Julius” programming from student education and PhD training to advanced medical training and refresher and postgraduate courses. It is important that the Julius Academy products become more distinctly coupled to our profile. • Own teachers to “the next level”. We will ensure that our own teachers can continue to learn in terms of both the subjects they teach and their teaching skills.

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2. From research to education and vice versa

3. Securing improvement

In the Julius Center we opt for constant cross-fertilization between research and education. All our researchers are permanently involved in the education we provide and the research focuses within the educational programs are highly integrated. This enables us to provide better quality education at a high scientific level.

We believe that a solid organization, educational support and providing room for the utilization of specific qualities of individual teachers are paramount to the quality of education. All researchers have a role to play in the education our division provides. Employees are given the opportunity to contribute their own expertise to a strong education division.

• From education to research. The students of today are our colleagues of the future. We get people enthusiastic about our disciplines and get to meet talent with whom we can work to improve health and healthcare. • From research to education. Via our teaching (future) healthcare professionals will receive the latest (evidence-based) insights.

4. Internationalization of education We will continue to focus on international activities through ongoing cooperation with the international learning portal (and our spin-off ) Elevate. We will also work towards internationalizing our training programs, for example, by developing a joint international Master of Epidemiology (e.g. in collaboration with University College London) and organizing an international (curricular) MBI Life Sciences & Health program.

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Care The ultimate goal of everything the Julius Center undertakes is to improve the quality of health and healthcare.

We focus our attention on the entire health and disease chain: from the “base level� in which prevention, self-management and patient information are important factors; via the primary and secondary level, where most care interventions occur, to the tertiary level, with which we link up directly with the population of our home base, the UMC Utrecht.

1. Optimizing academic workplace function of LRJG

In the coming strategy period we will continue to contribute directly and indirectly to better care, with our themes linking up with a number of future developments in healthcare on which we will place emphasis. In particular, the effective organization of regional care chains, a central role for the patient, substitution and expansion of diagnostics and prognosis at the primary level.

2. Contributing to effective care in the region

In the coming period we will focus specifically on:

Following on recent developments in healthcare, we will work towards expanding the function of the Leidsche Rijn Julius Healthcare Centers as academic workplaces for care innovation, education and research.

The Julius Center will actively contribute to the process initiated by the UMC Utrecht in collaboration with hospitals, GP cooperatives and health insurers, to coordinate the care in the region more efficiently by setting up regional care chains and diagnostic facilities.

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Operational management In recent years the Julius Center has established a solid foundation for the organization’s operational management. The division is financially sound, we work in accordance with a planning and control cycle, and a new organizational structure has been implemented. As an added result, we have ensured firm embedment in UMC-wide processes and systems. At the same time, the Julius Center aims to continue to invest in the further professionalization of its operational management via the following themes: 1. Focus on talent Employees are the principal capital of the Julius Center. We want top talent to consciously make the Julius Center their preferred choice. We consider it our task to guide employees and to assist them in their further development. By means of talent management we will select and train future leaders. 2. Optimization of organizational structure Our matrix structure has proven to be very useful but can still be improved. Tasks, responsibilities and competencies will be defined more explicitly. Budget decentralization will continue.

3. Leadership Leadership is essential for achieving the Julius Center’s ambitions. Leadership in the sense of taking responsibility, identifying and seizing opportunities, bridging differences and establishing cooperation, and thinking in terms of solutions instead of impossibilities. During the next few years we will work on leadership (inside and outside our organization). 4. Management Information Accurate and timely management information is essential for managing the research, education and operational management processes. We will work with UMC applications such as SAP and PURE to acquire this information. Because some of this management information cannot be accessed from central systems, we will determine whether databases

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should be developed separately or in cooperation with other divisions. 5. Branding and Marketing: “Julius Center on display� The Julius Center aims to show its stakeholders how it contributes directly or indirectly to health and healthcare. Much of our knowledge is traditionally translated into guidelines and protocols for professionals. Julius Support for Research & Trials is a new way for sharing our knowledge within the UMC Utrecht. We introduce healthcare professionals (of the future) to the latest insights via the education we provide. In the coming period we will also consider other channels inside and outside the UMC Utrecht for distributing our knowledge to the patient and the general public. We also aim to show students, prospective employees and professionals what we stand for.

Julius Center


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> Intensifying multidisciplinary research > Expanding translational research: even closer to the patient > Center for Healthcare Innovation Research > Clinical Trial Center of Excellence

Education > Evidence-based lifelong learning > From research to education and vice versa > Securing improvement > Internationalization of education

Care > Optimizing academic workplace function of LRJG > Contributing to effective care in the region

Operational management > Focus on talent > Optimization of organizational structure > Leadership > Management Information > Branding and Marketing: “Julius Center on display�

UMC Utrecht Julius Center

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Julius Center  

Connecting Further

Julius Center  

Connecting Further