Steering towards and organizing the 'research' strategic business unit in the UMCA alliance corporation : are research institutes part of the solution?

Hele tekst

(1)Steering towards and organizing the ‘research’ strategic business unit in the UMCA alliance corporation: are research institutes part of the solution?. August 17th, 2015. Student: Prof.dr Judith K Sluiter, student no. 10733655, j.sluiter@amc.nl, 06-50516977 Thesis MBA Healthcare Management, University of Amsterdam, Amsterdam. MBA-HC Supervisor: Prof.dr J. Strikwerda, j.strikwerda@uva.nl Alliance supervisors AMC&VUmc: Prof.dr M.J.A.P. Daemen (m.j.daemen@amc.nl) & Prof.dr S. Zweegman (s.zweegman@vumc.nl).

(2) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Executive summary This thesis concerns the strategic business unit of ‘research’ that is currently being developed within the new alliance organization of AMC and VUmc (UMCA). It addresses research questions regarding the ways in which alliance research institutes (ARIs) can be used by the UMCA administration to direct and organize ‘research’ as one of the alliance’s strategic business units, and how this strategic business unit should be governed and organized within the UMCA, given the strategic goals set. A triangulation of methods was used, including a comprehensive context analysis, a comparison of quality indicators of research for AMC and VUmc with a qualitative and quantitative analysis of retrospective sampled and available data. Using information from the alliance research coordinating team on the current state of planning research institutes, an analysis was done given the strategic aims set and the different governance (in-control) functions. Theoretical frameworks were identified that might help in setting directions for the changes in research in the coming years. Meetings with the coordinating teams were organized. It was concluded that: 1. Given the governance functions that the administration is required to arrange to be able to direct and organize its research unit, the current stage of the ARI plans cannot be used to fulfill several of those needs. The ARIs should modify their plans to better align themselves with the strategy set thus far, or other tools or instruments should be used. Currently, there is a wide variety in the budgeted content of the plans that will lead to unforeseen costs and which can easily increase to several million euros. More specific instructions will be needed that allow for sufficient planning of research in each institute without overkill; 2. Taking the current strategic goals as a basis, a new and major corporate research culture change program should be planned once it has been determined which specific aspects will increase the chance of becoming the best UMC and a Top 5 European faculty. The mechanisms and drivers of innovation synergy should be selected. A strategic learning program should be started at all levels of seniority amongst researchers and at the corporate level in combination with a collective researcher-development program in a socalled ‘UMCA research academy’. 2.

(3) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Table of contents Page: Executive summary. 2. Table of contents. 3. I Introduction A. The research topic. 4. B. The case and the research questions. 5. II Framing: methods used A. Context analysis. 7. B. Retrospective data analysis. 7. C. Theoretical frameworks. 9. D. Group meetings. 9. E. Conclusions and recommendations. 10. III Results A. Context analysis. 10. B. Retrospective data analysis. 27. C. Theoretical frameworks. 34. D. Group meetings. 44. E. Summary, conclusions & recommendations. 44. Reference list. 49. 3.

(4) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. I. Introduction A. The research topic The two university medical centers in Amsterdam are working towards a merger to become one organization. As long as a total merger is not possible from a legal point of view, the combination of two organizations may be framed as a friendly acquisition or alliance. This type of merger might be called a symbiotic merger in the original typology of Haspeslagh & Jemison (Risberg (2003)), with a high need for both interdependence and for organizational autonomy. From a social identity perspective (Rouzies (2011)), a merger is viewed as a recategorization of employees from one group to another. Employees are required to recategorize themselves as employees/members of the newly merged organization. In its current form, the alliance organization (abbreviated as UMCA) demands a shared mission and vision with respect to its three ‘strategic business units’: care, research, and education, in a new institutional context. These three units are strategically distinctive since specific tasks are performed and each unit serves a defined external market. In addition, management can conduct strategic planning in relation to the different products offered and the different markets served. For each of the strategic units, a longer-term strategy is to be developed, leading to clear strategic goals for these main businesses of the ‘new’ corporation UMCA (de Wit & Meyer (2014)). In the coming years, the UMCA will need a system to execute its set strategy efficiently. In optimizing the processes, structuring, coordinating, and planning the ‘research’ business unit may reveal new ideas for the administration compared to what either of the original university medical centers was accustomed to doing. With clear strategic goals as a starting point combined with a fitting research organization, a way should be found to coordinate, reach, inform, and motivate all research stakeholders throughout the UMCA (divisions, departments, professors and associate professors, PIs, researchers, PhD students, medical students) regarding the strategy that will facilitate the move towards the directions that have been set. A theoretical framework (program development) might be needed to guide the (cultural) changes for both workers and administration in the coming years. In addition, best fitting forms should be 4.

(5) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. chosen to facilitate continuous learning from the perspectives of the people working in the UCMA, the strategy implementation, the business unit development and the corporate development. The topic of this thesis project is relevant for the current developmental phase with respect to the ‘research’ unit within the alliance organization of AMC and VUmc. By merging the organizations of research of the two university medical centers and steering this from one new business administration, significant benefits should become clear in the long term in terms of a more efficient infrastructure to perform high-quality research, getting more funding by embedding expertise, achieving higher quality and more scientific output, highquality clinical research on specific patient groups, and higher-impact research to better tackle the societal health challenges in the coming decades (Alliantie AMC-VUmc (2014)). The most important resource of the alliance organization – the researchers – should be facilitated to perform at their best. This project will gather information in a way that will result in a theoretically sound analysis of the current issues at hand at this stage (summer of 2015) of the alliance development with respect to the ‘research’ strategic unit and will guide future decision making with a format for implementing new activities.. B. The case and research questions The two university medical centers in Amsterdam are in the midst of an alliance process that should lead to a merger. Both university medical centers can be seen as specialized highquality hospitals but also as the faculties of medicine within the two universities in Amsterdam. Each university medical center can be approached as a multi-business corporation with three large product groups embedded within them. The three core product groups are: 1. Delivering cure or care that adds value to patients; 2. education such that medical students/nurses and student nurses/medical doctors develop toward their chosen specialization; and 3. Performing clinical and health research resulting in high-quality scientific and translational output for the research community and professionals, like scientific international articles, national reports, and theses but also other products such as 5.

(6) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. new treatment methods, guidelines, patents, etc. (Alliantie AMC-VUmc (2014)). Most employees are engaged in producing at least two of these three core products.. The topic of this thesis concerns only the business strategic unit of ‘research’ that is currently developing in the UMCA (for in-depth analysis, see p.20-27). Both UMCs have clinical (intra- and extramural-oriented) and basic science researchers grounded in research groups. Most research groups are part of one department, sometimes they come from more departments. The combination of the two types of researchers creates powerful translational medicine. Although both UMCs have a certain amount of funding for research through their medical faculties, both get a much larger amount of funding (AMC-VUmc summing up to about 160 million Euros in 2014) from the research councils at the national or international level, from charities and from projects undertaken in collaboration with industry. Other faculties in the two universities and several biotech companies collaborate with researchers in the UMCs in solving biomedical mechanisms in disease, developing new methods for diagnostics or therapeutic interventions, and evaluating the results in clinical trials.. The focus in this thesis is on helping the executive board of the alliance to determine the direction in which the research activities can be organized, in such a way that future strategy execution is facilitated and in compliance with the strategic goals set. The coordinating UMCA-program group is interested in how the new institutional administration can optimize the steering towards and organization of the planned alliance research institutes.. The following research question will therefore be studied: 1. In what ways can research institutes be used by the UMCA administration to steer and organize ‘research’ as one of the corporation’s strategic business units? 2. How should the ‘research’ strategic business unit be governed (structured and organized) in the new UMCA alliance corporation, given the strategic goals set? 6.

(7) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. II. Framing: methods used The research problem treated in this thesis is the ‘design’ type in the business research typology of Van Thiel (2009). Therefore, triangulation of research methods was used in order to make an appropriate analysis. The following research activities were initiated to make a proper analysis: A. In order to perform an external and internal ‘context of institution’ analysis, desk research was the preferred method: for the external ‘context of institution’, information was gathered about the tasks and ways to achieve the in-control function for the business administration, about existing policies and regulations on the organization of research from the perspective of the Ministry of Education, the KNAW (research school policy), the association of the Dutch Universities (VSNU) (SEP protocol), and publications of the Federation of University Medical Centers (NFU) in which all eight university medical centers cooperate. For the internal ‘context of institution’ analysis, the running ideas and plans concerning ‘research’ thus far made in the alliance organization and the strategic goals set on the topic of research for the alliance AMC/VUmc (alliance papers 2014-2015) were searched for. In addition, the existing rules and regulations in the two universities and faculties of medicine were used. Finally, the plans for the research institutes (version June 2015) were read and analyzed, using the sampled information in the external and internal environment. B. To be able to compare different organizational choices to structure research in academic centers, a case study format was used: retrospective data was sampled in three ways to gain further insight into, and describe the results in terms of quality of, the two different research policies of both academic medical centers (i.e. PI system in the AMC versus Research Institutes in VUmc) in the last 3-6 years. First, a retrospective comparative analysis was performed at the highest aggregate level (i.e. the whole academic medical center) using two indicators: 1.The central scientific output information from both academic medical centers that was brought together by the NFU CTWS analyses which were reported in 2014. With this analysis, AMC and VUmc can be compared and the two can be compared to the other university medical centers in the Netherlands; and 2. The European figures of the QS world 7.

(8) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. ranking 2015. This QS-ranking was chosen because it combines the educational and research qualities of the medical faculties. The QS world university ranking has been published annually since 2004 and results can be retrieved at both the medical faculty level and the European level. Academic reputation is the first and most important QS indicator measured using a global survey, in which academics are asked to identify the institutions where they believe the best work is currently taking place within their field of expertise. The advantage of this indicator is that it gives a more equal weighting to different discipline areas than research citation counts. The second most important QS indicator is the citations per faculty and is an indicator that aims to assess universities’ research output. A ‘citation’ means a piece of research being cited (referred to) within another piece of research. Generally, the more often a piece of research is cited by others, the more influential it is. So the more frequently cited research papers a university publishes, the stronger its research output is considered to be. The student-to-faculty ratio is the third QS indicator and is a simple measure of the number of academic staff employed relative to the number of students enrolled. The employer reputation indicator is the fourth and also based on a global survey, which asks employers to identify the universities they perceive as producing the best graduates. The final two QS indicators aim to assess how successful a university has been in attracting students and faculty members from other nations. This is based on the proportion of international students and faculty members in relation to overall numbers. Second, success rate and the absolute numbers of successful individual NWO/ZonMw Veni, Vidi, Vici funding and European individual funding (starting grants, two consolidator grants and two advanced grants) were searched for on the websites of the NWO/ZonMw and the European Union, and described for the last three years. These figures were taken into account because it is the people in the organization that are responsible for a large part of the success in research organizations. Third, research output level and growth in a subset of 30 group leader researchers was planned for, from and throughout both centers. This sample of researchers was matched at the level of research field or department as well as at the professional level (associate professor/professor). The criterion that was used in this analysis was the A part of the AMC 8.

(9) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. PI score that consists of three parts in total (A, B, C). Because the VUmc does not yet apply these scores, and the B part can only be calculated by an external institution, and data collection for the C part would have taken several months, it has not been possible to use the PI score in both institutions. The A part of the PI score was chosen for this thesis. Before this parameter was used, pre-analyses were performed (regression analyses, not shown) to gain more confidence in how the A part was predictive of the final PI score: it was shown that the A-score in a certain time period explained 57% of the future PI score while the B part explained only 25%. The A part constitutes of direct production research data over a sixyear period and leads to a score between 1 (low) and 5 (high). The score is made up of three parts, which are averaged. The first part is the number of publications in peer-reviewed journals in the number of years in the time period (n) divided by 2*n (maximum score is 5); the second part is the impact factors of the journals belonging to the publications in this period where the total of the impact factors is divided by 10*n (maximum score is 5), and the third part is the number of times that the person was either promotor or co-promotor of a completed PhD thesis times 2, divided by n (maximum score is 5). C. Desk research was used to select theoretical frameworks that can be used from a business or corporate perspective to tackle and analyze the organizational problem at hand. Applying the ideas from the theoretical frameworks chosen, and by using the information from research parts A and B should lead to the construction of a possible ‘UMCA organizational learning research culture in the year 2020’, and this would result in ideas for developing a program through which workers and administration can adapt to the new situation. The theoretical background and options for such a program is described by Kaplan & Norton (2008), Strikwerda (2014, chapters 6,7) and by Rademakers (2014) and De Wit & Meyer (2014). The selected theoretical frameworks were used to analyze the problem at hand using the sampled information from A through C. D. The research plan and the ideas that emerged from A through C was challenged in group meetings. Meetings with the two ‘alliance research coordinators’ were held twice to discuss 9.

(10) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. the plans and the intermediate findings of the analysis. Meetings with the larger current group of frontrunners who constitute the new research institutes in the alliance organization were visited three times in the period May-August 2015 and were used to present plans and ask for cooperation, observe the developmental phase of forming the research institutes, and to get input when parts of the analysis were presented. E. From the analysis, conclusions and recommendations were derived. The analysis was presented and discussed with the two ‘alliance research coordinators’ and two board members (the deans) of the two university medical centers. In the results section, parts A through D are presented in sequence, followed by the E part with a summary, conclusions, and recommendations.. III. Results A-1. The external context of institution The business administration: tasks and ways to achieve ‘in-control’ governance The tasks of a business administration (here, the executive board in the Dutch University Medical Centers (UMCs): ‘Raad van Bestuur’) emerged from the classic view of Chandler in the 1960s. He described the tasks of a business administration in large corporations as containing identifiable activities that concern mainly the administration (i.e. coordination, appraisal, and planning) instead of performing functional work that should be done by others. The question is, how can these identifiable activities be performed in such a way that an executive board is said to be ‘in-control’? Strikwerda (2011, 2012) provides an economic/managerial view of when the executive board is in-control: they have to acquire, to control (internal and external), and to exploit the (future) resources as needed for the continuity of the firm. In other words, the administration is ‘in-control’ if it has access to the right resources and is able to exploit these resources as needed for its long-term continuity. He explained his view on control from cybernetics because that is the formal study of control. Having and keeping control consists 10.

(11) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. then of three problems: the problem of maintaining organization, the problem of adapting goal-directed processes to variation and change in external conditions, and the problem of reprogramming less successful goals and procedures while at the same time preserving more successful ones. A crucial element is communicating the information (planning of information flow) needed to keep control. From a human behavioral perspective, Merchant and Van der Stede (2007) describe that management control involves managers taking steps to help ensure that the employees do what is best for the organization because it is the people in the organization who make things happen. However, to be able to take these steps, the company strategy needs to be translated into task control by means of setting specific goals and the allocation of resources. Following Strikwerda (2014), the idea is that by organizing a corporation in the most decentralized way, as many workers as possible can decide themselves which alternatives or decisions they can take, assuming they will choose and act on those that are the most valueadded to the desired results of the corporation (assuming that desired results are known). In this way, the information-processing capacity of the organization is increased by which, conditionally, the chances of surviving in a dynamic-complex environment are safeguarded. The board’s performance is good when the mission of the corporation under changed circumstances is realized in an efficient way. There is an implicit necessity to change the incontrol strategies of the corporation when circumstances are changing. By change management then is meant the adaptation of the corporation as a whole or in parts to changing circumstances. This includes changing also the ambitions and strategies. By Dutch law (Wet op het Hoger Onderwijs en Wetenschappelijk Onderzoek (2015)), the UMC board decides upon the departmental structure and content, and appoints department heads (professors, appointed to arrange education and research in their specialty). The executive board makes use of the staff convent, which performs functional work delegated by the board. Heads of the departments are members of the staff convent (the Law is unclear about having only heads of clinical departments as member). As was taught at the MBA in year 1 during ‘’the executive process’’, the constituent task of the board is in deciding what the mission of the organization is, deciding on the hierarchy of values, the 11.

(12) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. internal code of conduct, and the organization of the system of corporate governance. The board is and stays accountable for: 1. Organizing and safeguarding the developed routines, knowledge, and skills in such a way that the social capital of the corporation is not endangered; 2. Organizing by active surveillance how the performance, productivity, and functioning of parts of the corporation is doing. The board is required to be meticulous towards the corporate person when taking initiatives, being diligent, prudent, and vigorous. The standard model for achieving an administration that is in-control has emerged in the last century and is applied in most large long-standing organizations. The organizational model is recognized by the ‘M’ form in which the structure is strict and important for the assumptions held mainly financially but that may no longer fit the current time and goals of organizations. Some of these assumptions were: each unit has its own production function, and can be organized in a self-contained manner; tangible resources are unique for the products or customers, no cross-selling opportunities exist, information has high costs, bottom-up initiatives are not impaired by unit-management being both responsible for managing market opportunities and resource utilization, communication is costly and slow, and channels have limited capacities. In both the AMC and VUmc, the ‘M’ form structure seems to have been applied with the core task of ‘care’ in mind and a divisional structure as pillars. In every division, departments with common ‘care activities’ form most of the divisions. This structure is used by the administration for appraisal, planning, and coordination. In each division, several (mostly clinical) departments take part but one department is only part of one division. Because of the time allocation model of core tasks united within resources in the academic medical centers, this structure seems not to fit the other core tasks (education, research) ideally, although departments are the smallest unit and the departmental heads organize and coordinate care, education, and research. In the present structure, and from the planning dimensions point of view, the administration could add ‘infrastructure’ parts to the organization that will provide the necessary information. In this way also, strategic research themes or a more central research organization can become a planning entity, a kind of virtual organization that works as a reportable dimension for the administration (personal communication with J.Strikwerda). 12.

(13) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Most of the above-mentioned assumptions underlying the ’M’ structure have been refuted in the present day but larger organizations still need additional models in order to meet cross-selling opportunities, organize information-sharing, allow for bottom-up initiatives across departments and divisions, and to organize channels with unlimited capacities. The institutional context of a model with coordination instruments as part of the governance described by Merchant & Van der Stede (2003) and was elaborated upon by Strikwerda (2014, p.139). In figure 1, this coordination instruments model is shown.. Moral O S. context Stories. Mission Statement Recruitment Criteria. exemplary behavior. assessment remuneration promotion. reserved powers Policy Standards. Operational Planning. Coordination. Performance review Decision criteria Physical layout. information cause-effect relations. Organizational Socialization Psychological. Management control. Explicit Coordination. Routines. Open Standards. Trust Confidence. Experiences Dominant logic. context. Task-structure. Professional Standards. Climate. Cultural. Budgets Target setting Resource allocation. Decision rights Instructions. professional training training management Implicit development. Organization Culture. context. Communicated Strategy. programmed decisions. Stories. Institutional. Imposed Coordination. (process-teams). Peer-group Control. Self Coordination. Knowledge context. Figure 1. Model of coordination instruments (adopted from Strikwerda (2014, p.139). This model uses two axes in terms of coordination: imposed vs. self-coordinated, and implicit vs. explicit coordination. On the right side, instruments for explicit coordination are 13.

(14) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. shown. The institutional context is the construct of the upper right corner with imposed coordination and explicit coordination. Here, content like the communicated strategy, the physical layout, resource allocation and budgets/target settings, performance review, and instructions are included. The lower right corner is the knowledge context of explicit coordination and self-coordination. Instruments inside the knowledge context include: routines, professional standards, open standards, and (process) teams. The left side of the model contains instruments with implicit coordination. In the upper left part we see the moral context, which I will not elaborate upon. The cultural context is the construct of the lower left corner with implicit coordination and self-coordination. Here, the instruments inside the cultural context include: organizational socialization, stories, organization culture, psychological climate, trust, confidence, and peer group control. The upper right part of the model is used typically for in-control, but as is stressed in Strikwerda (2014), the lower left corner should certainly be involved (see figure 1). Finally, something that is relevant for the overall AMC-VUmc alliance level, a multidimensional framework for alliance structures was recently proposed by Albers and colleagues (2013, p.3). They unbundle the alliance governance into five key design components. The five dimensions of the strategic alliance structure are interface (network of interpersonal ties), intra-face (ties between boundary spanners within the two organizations), specialization (the degree to which alliance activities are differentiated from other organizational activities), formalization (the specification and standardization of rules, procedures, plans and documentation to guide alliance activities), and centralization (the locus of decision-making rights – those who hold the authority to make planning and implementation decisions for the alliance). The emphasis on connectivity is between interface, intra-face and specialization, and jointly they determine the social capital. The emphasis on steering is between specialization, formalization and centralization, and these three jointly determine how effectively the alliance can be directed (Albers et al. (2013)). Returning to the ‘research’ business unit only, the question emerges as to whether this core task in the new organization demands more emphasis on connectivity or more emphasis on steering. 14.

(15) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Research in the two associated universities of the academic medical centers: UvA and VU The core values of an organization prescribe the attitude, behavior, and character of an organization (Kaplan & Norton (2008)). The University of Amsterdam (UvA) has adopted the following core values: innovation, determination, and engagement (www.uva.nl/about-theuva, July 2015). The VU core values that are inextricably linked to how VU defines outstanding research and teaching are: being responsible, open, and personally engaged (www.vu.nl/about-vu-amsterdam, March 2015). The dean of a faculty within the UvA is appointed to establish a ‘faculteitsreglement’, and to establish general guidance for practicing science and set up a yearly research program in the faculty (UvA (2012, article 13 a-d)). The dean is appointed to lead the management in the faculty, and the governance and organization of the faculty with respect to the scientific research performed. Deans are appointed for five years and can immediately be reappointed (UvA (2012, article 16)). Deans are responsible for a durable development of the personnel, the (sub)fields of science, and the knowledge development in those fields (UvA (2012, article 20)). Departments in the university are responsible for the research in their field. Professors appointed to the university/UMC are responsible for the development of the scientific subfield and focus of research belonging to the topic of their professorship, as well as for the associated content of educational activities in the faculty. In the ‘UvA-reglement’ (UvA (2012, article 21)) it is regulated that each faculty can appoint three types of institutes, one of which is a research institute. It is the task of the research institutes to see that the programmed themes for a certain period are researched. When included in the faculty regulation, the board may decide on research, to start research institutes or research schools, and these should be evaluated every 10 years. The dean sees how departments and their members contribute to the activities in the research institutes. The dean is responsible for the governance and organization of these parts of the corporation (UvA (2012, article 23)). The UvA regulation also describes how interfaculty research institutes can be formed although only one faculty is designated as main applicant/secretariat of the institute (UvA (2012, article 35)).. 15.

(16) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. In the ‘Bestuursreglement van de Vrije Universiteit ‘(VU (2015, paragraph 3), research is organized as follows: research that is not part of interdisciplinary research institutes is organized and coordinated by one appointed member of the faculty-board. The rest of the research is organized in interdisciplinary (interfaculty) research institutes. The deans of the associated faculties are on the board of these interfaculty research institutes. The appointed director of these interdisciplinary research institutes is appointed to be responsible for the organization and coordination of research in that institute. The two universities of AMC and VUmc thus have to deal with the same law which describes the role of the boards although they have somewhat different policies regarding research institutes and the main roles of their deans in research. Research evaluation: the national picture For quite some time, the Royal Dutch Academy of Sciences (the KNAW) followed a national research institute policy, up until 1-2 years ago. Currently (2015), criteria for starting or running national research institutes can no longer be found on their website. In the protocol for research assessments in the Netherlands, the Standard Evaluation Protocol 2015-2012 (VSNU (2014)), the methods and criteria are described which should be used to prepare the 6-yearly assessment which is obligatory for every university or research institute. Primary target groups are researchers and the research group leaders; “they need to know how the quality of research, societal relevance and their unit’s strategy will be assessed, and how these aspects can be improved’’ (VSNU (2014,p.5)). Secondary target groups are the boards of the institutions because they take full responsibility for the 6-yearly assessments of every unit in the organization and follow up the assessments by which the protocol can impact their research policy. Boards take procedural decisions concerning the aggregate level at which the assessments are to be carried out. SEP is seen as a quality assurance system that should reveal the quality and relevance of academic research. The assessment criteria are threefold: research quality, relevance to society, and viability, meaning “the extent to which the unit is equipped for the future’’ (VSNU (2014,p.6)). The criteria are listed in box 1.. 16.

(17) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Box 1. Criteria and categories of the Standard Evaluation Protocol 2015-2021 (VSNU, 2014, p.7) Research quality. Relevance to society. Viability. Quality of the unit’s research. Quality, scale and relevance of contributions targeting specific economic, social or cultural target groups. Strategy of the research unit to pursue in the years ahead. Contributions that research makes to the body of scientific knowledge The scale of the unit’s research (scientific publications, instruments, infrastructure developed, other contributions to science). Advisory reports for policy Contributions to public debates, etc.. Extent to which the unit is capable of meeting its targets in research and society Governance and leadership skills of the unit’s management. The assessment is qualitative in nature, resulting in four categories: world leading/excellent, very good, good and unsatisfactory. Each unit is assessed according to this categorization. Two further aspects are taken into account in the SEP assessments: the PhD programs and research integrity (VSNU (2014, p.8-9)). For the PhD programs, relevant aspects during the assessment are: supervision and instruction, selection and admission procedures, program content, and the structure, supervision and effectiveness of the program and supervision plans, guidance of PhD candidates for the job market, duration, success rate, exit numbers, and career prospects. For research integrity, relevant aspects during the assessment are: policy on research integrity and preventive measures of violation, how is research data dealt with, data management and integrity, how an independent and critical pursuit of science is made possible within the units. Aside from the three categories of criteria for research units, these two topics should also be taken into account although probably at the organizational level, when the planning of activities concerning research in the alliance organization is performed. In summary then, AMC and VUmc share the responsibility to conform to the SEP protocol in order to evaluate their research activities in 2021. This will require some new evaluation instruments. A common research integrity product already exists. A shared institutional PhD program will be an important topic of attention.. 17.

(18) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Research policy at the sector level The final party of the external context of institution is formed by the federation of UMCs (‘NFU’), which is the official sector in the Netherlands, since both AMC and VUmc and the management of both organizations take part in the activities of the NFU. For this thesis, cooperation in the NFU is thought to be important from three perspectives: 1. Together, the eight academic medical centers perform and publish policy reports on the topic of research; 2. Together, the employers and employee representatives of the eight academic medical centers decide upon the content of the collective labor agreements or for the NFU sector, the ‘CAO-Academische Ziekenhuizen’; 3. Collectively, decisions are made concerning the infrastructure for research facilities From the first perspective, in 2014 a position paper of the NFU concerning EU health research beyond 2020 was published to present the collective vision on relevant health themes and the grand (societal) challenges (NFU (2014a)). With sustainable health as a common focus theme of 2020 in which“…a future healthcare paradigm comprises a team approach with all relevant stakeholders in the delivery of patient-centered care with research and innovation integrated as a continuous process, supported by technology and data exchange” (NFU (2014a,p.1)), the academic medical centers “…need the network of partners in all phases of generating, disseminating and translating knowledge into sustainable solutions… strongly depending on a value chain which consists of curiosity-driven and clinical research into fundamental processes, culminating in best practices, products and services applicable to health and care” (NFU (2014a,p.1)). This requires collaborative research with all kinds of partners in the patient value chain. The academic medical centers are thought to be at the heart of multidisciplinary, interdisciplinary, and trans-disciplinary research and should be complemented by excellent research infrastructure facilities and a single public finance mechanism for health research. They should create regional synergies within national programs and international collaborations. For every one of the five 2020 topics (total budget EU health is 7500 million euros), it describes what the centers can offer in terms of strength, partnerships, and infrastructure. 18.

(19) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. From the second perspective, the recently agreed new collective labor agreement “CAO2015-2017” by employees and employers of the eight academic medical centers will have major implications for the chances of young researchers without fixed contracts because the new Dutch law “Wet Werk en Zekerheid, WwZ (2015)” that was recently implemented changes the possibilities for employers to offer more than two research contracts or one contract longer than a 24-month period to a worker without having to convert the contract to a fixed one after this period. If no permanent contract is offered after such a period, the researcher must leave the organization for at least six months. This may be seen as a threat for the alliance organization in terms of lower chances of retaining the tangible resources with essential acquired capabilities that are required to become and stay an excellent organization. For all researchers, the employer should allow an extra monetary reservation to provide the researcher with some seed money when the contract is finished. For PhD students it will still be possible to offer one contract for the period of four years but this will not allow them to become a post-doc researcher immediately. An interesting European development has been the drafting of a European Charter for researchers with general principles and requirements applicable to employers and funders. Employers and/or funders should “…ensure that the performance of researchers is not undermined by instability of employment contracts, and should therefore commit as far as possible to improving the stability of employment conditions for researchers, thus implementing and abiding by the principles and terms laid down in the EU Directive on Fixed-Term Work.” (http://ec.europa.eu/euraxess/index.cfm/rights/europeanCharter) Although the aim of the Charter is to ensure that the nature of the relationship between researchers and employers or funders is conducive to successful performance in generating, transferring, sharing and disseminating knowledge and technological development, and to the career development of researchers, the Dutch law (‘’WwZ’’) will not allow smooth career developments. From the third perspective, one example of the built common NFU infrastructure for the eight centers is reported on the NFU website (www.NFU.nl, July 2015). The ‘Parelsnoer Institute’ is a chain of bio-banks with data and material of patients with the aim of research 19.

(20) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. into specific diseases. A second mentioned collaboration between the centers is provided through cohort research databases on the topic of genetics and bioinformatics. A third common activity concerns the Technology Transfer Offices in which researchers are helped with knowledge valorization in the form of patents. A fourth common activity concerns the making of model contracts with pharmaceutical companies concerning drugs research. A fifth common activity concerns establishing the end terms for the examination of the basic course for young clinical researchers (“BROK-cursus”). Finally, all centers started Graduate Schools for the PhD researchers in the academic medical centers and designed a guideline for the PhD projects. If the most important infrastructure aspects for research are shared, it may become more difficult to stand out and become the leading academic medical center in the Netherlands. A-2. The internal context of institution: alliance research ambitions and the ideas behind the formation of alliance research institutes In the AMC, the ‘bestuursreglement’ (AMC, 2015) is a combination of the ‘faculteitsreglement’ and the ‘bestuursreglement of the organization’ and was updated in March 2015. The mandated authorities should take the implementing orders and/or instructions of the Board of Directors (‘the board’) into account when fulfilling their duty (article 1.2, p.3). The board decides which departments and associated medical fields form part of the organization. The division boards are mandated to appoint the heads of department (article 4.2.3, p.6), and research is executed in the departments (article 3.1,p.5). The head of the department is responsible for the research executed in the department (article 4.2.5, p.6). The board has mandated the responsibilities with respect to education of PhD students to the chairperson of the AMC Graduate School for Medical Sciences (article 5.1.19, p.9). For research, an advisory body on the policies concerning research is established by the board, called the Research Council (article 7.2, p.11). The board can establish research institutes for the medical faculty with the aim of conducting (medical) scientific research (article 6.1, p.11). When a research institute is established, the detailed regulations are to be determined with regard to the management of the research institute and its relation to the Research Council (article 6.2, p.11). 20.

(21) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. For VUmc, no ‘faculteitsreglement’ exists but a ‘bestuursreglement’ of the Board of Directors seems to exist but is not publicly available. When requested through the secretary of the board of executives, they were not able to share this document. The ‘bestuursreglement voor de raad van toezicht’ is a public document but was thought to be of less relevance. In May 2014, the AMC and VUmc boards and the alliance program committee published a report “Op weg naar excellentie” in which at the level of the strategic business unit of ‘research’ the ambition was stated to “realize centers of excellence in research for and by top researchers” (Alliantie AMC-VUmc (2014,p.6)). It was envisioned that top-referent care should be closely connected to fundamental, translational and applied research. In addition, the alliance UMC could… “create centers of excellence on the European top level by unique concentrations of care and research expertise, forming large research consortia, with an innovative research infrastructure and technology for specific diseases. This would lead to a greater contribution to health care, larger fund-raising capacity and better valorization” (Alliantie AMC-VUmc (2014, p.6-7)). Strategic objectives for ‘research’ were described in the same document (2014, p.7) as: “On UMC level, we will become the structural number 1 in the Netherlands. We are selective and set the tone in research: we focus on, or invest only in research if we are number 1 or 2 in the Netherlands as far as impact factor and H-index are concerned. We can be proud of at least 25 researchers who belong to the top 10 in their research field worldwide. We will use at least 10 million euros of our budget for innovation (research & development). We will scoop at least 35% of the Dutch part of European biomedical research budgets for top research. We will enter into three master contracts with multinationals to the benefit of public or private cooperation”.. 21.

(22) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. In June 2014, as a result of a conference on the topic on research, the alliance administration decided to start up alliance research institutes (ARI), and start organizing a common research organization and advice committee (research board with research council) to guide strategic and policy decisions on the topic of research. In March 2015, a letter was sent by the two deans of the UMCs (Letter Deans (2015)) to the frontrunners of five of the intended eight common alliance research institutes (ARIs) to be established. In this letter, the tasks and aims of the ARIs in development were described and quite specific instructions were provided. The objective of the ARIs were described as “to increase the visibility and quality of our scientific research in order to be better able to show the added value of scientific research for public health and medical care”. In the next sentence it was stated that “...all means that will be allocated to facilitate and organize research in the alliance should be used to serve the aforementioned objective”. The assignment to the frontrunners in this letter was: “to make a project plan and describe how research for the core themes will be embedded in a joint ARI with the aim of starting per January 2016, and to establish an integration and migration plan for the period 2015-2019”. In the first enclosure of the deans’ letter, more detailed instructions were provided to the frontrunners (one from each UMC per alliance research institute). The ARI is defined there as “a network organization of researchers who perform scientific research on a certain common theme” (p.1) and “in an institute, the complete translational chain from fundamental to practice research is practiced. Researchers from different departments and divisions are brought together’’. The core of the ARI is formed by AMC and VUmc researchers; in some ARIs, researchers from other VU and UvA faculties or other strategic partners may be included.” It is additionally stressed in the enclosure that “… in all phases of ARI development, the objectives should be kept in mind and it should be tested if the plans enhance the quality of research and the visibility as a European top center”(p.1). The administrative points of departure were formulated in this enclosure (p.1) as: “ARI is a network organization and the majority of resources (people and money) will stay in divisions and departments 22.

(23) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. The ARI is managed by one director The AMC and VUmc board will provide monetary resources to finance a limited ARI organization, weighted through the size of the ARI Within ARI, the steering of research is done through Principal Investigators/research group leaders” Furthermore, the administrative in-control roles of the alliance board/deans, the research board (central board, over ARIs), and the ARI (director) were distinguished at the level of focus, incentives policy, talent policy, quality policy, core facilities, and strategic cooperation. At the board level, the focus of research was described to appoint the ARI director; the incentives policy at board level would mean supporting the most important personal funding options and EU tenders and facilitating stimulatory instruments; the talent policy at board level would mean deciding upon criteria for recognizing talent and establishing criteria for promotion; the quality policy at board level was to establish the quality policy for performing research and to decide on the periodical evaluation of researchers through the PI score; the core facilities policy would mean at board level facilitating core facilities; the strategic cooperation policy would mean at board level cooperating between boards and offering a frame for strategic cooperation. Per ARI, innovation budgets for the forming of research institutes have been made available by both AMC and VUmc boards per year of 250,000 euros, starting in 2016, for three years. This means that the boards should have made a reservation in total of 16 million euros for this specific purpose since every ARI (currently, August 2015, eight are planned for) would receive that amount for a period of four years if the ARI plan is endorsed. These budgets “..may only be used for research that will help form the ARI and/or the cooperation between AMC and VUmc researchers, and/or must be used for research for which it is very difficult to find external acquisition, and/or the research must be typified by innovation and excellence through which future acquisition chances of the ARI will increase”. At the ARI level, the focus of research is described as a deliberation issue between director and Principal Investigators that will lead to subthemes for ARI research activities; the 23.

(24) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. incentives policy at the ARI level would mean organizing exchanges between researchers, identifying chances for external funding options and organizing support during tender writing; the talent policy at the ARI level would mean organizing the scouting of young and midcareer research talents and advising on promotion chances; the quality policy at the ARI level was described as testing and supporting the quality of research applications, monitoring and auditing research projects, and organizing self-evaluation of the ARI; the core facilities policy would mean starting partnerships with core facilities; the strategic cooperation policy at the ARI level would mean starting and maintaining strategic cooperation. (Letter Deans (2015)) Because of the strategic choice made in August 2015 to form eight ARIs in the coming period, the strategic business unit ‘research’ has eight theme units that require new infrastructural ways through which the executive board of the alliance will be able to coordinate, appraise and plan this part of the alliance organization.. ARI plans (version June 2015) Four of the five of the planned eight ARIs had completed the first versions of the ARI in June 2015. The content of these ARIs was analyzed and checked against the mission and strategic goals as provided by the alliance executive board to the researchers (tables I and II). The plans were analyzed according to the in-control aspects seen from the perspectives of the boards/deans, the department heads and the professors.. As can be seen in the analysis of Table I, several gaps in the current ARI plans are found in the sense that they probably will not help in reaching the mission and strategic goals set since no explicit attention is given in the plans to these goals. The largest gaps are seen in: Are all planned means used to serve to show the added value for public health and medical care? Do the plans mention the forming of large research consortia that are Centers of Excellence at European top level by unique concentrations of care and research? Does the plan show how to become the structural no.1 at the National UMC level? Does the ARI focus on, or invest only in, research if we are number 1 or 2 in the Netherlands as far as impact 24.

(25) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. factor and H-index are concerned? Do at least a proportion of the 25 researchers mentioned belong to the top 10 in their research field worldwide? Does the plan show how to scoop at least 35% of the Dutch part of European biomedical research budgets for top research? Does the plan mention going for one or more of the three master contracts with multinationals to the benefit of public or private cooperation? Table I. Content of the ARI plans (version June 2015) compared to the mission and strategic goals set by the AMC-VUmc boards and alliance organization. . (√=described; ≈= mentioned but not explained further; ? =unclear; - = no) UMCA strategic goals. R&D. CVD. neuroscience. PH. In plan ARI: Does the plan mention increasing the visibility and quality of our scientific research in order to better be able to show the added value of scientific research for public health and medical care? Are all planned means to be used to serve to show the added value for public health and medical care? Is the ARI a network organization of researchers who perform scientific research on a certain common theme? Are researchers from different departments and divisions brought together? Do the plans show that they enhance the quality of research and the visibility as a European top center? Do the plans realize Centers of Excellence in research for and by top researchers? Do the plans mention the forming of large research consortia that are Centers of Excellence at European top level by unique concentrations of care and research? Does the plan show how to become the structural no.1 at National UMC level? Does the ARI focus on, or invest only in, research if we are number 1 or 2 in the Netherlands as far as impact factor and H-index are concerned? Does at least a proportion of the 25 researchers mentioned belong to the top 10 in their research field worldwide? Does the plan tell how to scoop at least 35% of the Dutch part of European biomedical research budgets for top research? Does the plan mention going for one or more of the three master contracts with multinationals to the benefit of public or private cooperation?. √. √. (‘stuck’ at the bedside). √. √. (> 6 FTE). (>10 FTE). (>5 FTE). √ (innovative) √. -. √. -. √ (shown) √. √ (shown) ≈ (not how). √ (shown) -. √ (4). ? (research programs). √ (1). ≈. √ (not how). -. -. -. ≈ (not how). (ist: the best, unique). -. -. -. ≈ (ist:citation). -. -. √ (ist). -. -. -. -. -. -. -. ≈ (ist). ≈ (ist). -. ≈ (focus on EU topics) √ (1). 25.

(26) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Table II. Content of the four available ARI plans (June 2015) compared to the in-control aspects for UMCA board, deans, department heads and professors in the organization. (√=described; ≈= mentioned but not explained further; ? =unclear; - = no) Are the in-control aspects for UMCA board / dean taken into account? Organization of research: •ARI is a network organization and the majority of resources (people and money) will stay in divisions and departments •Within ARI, the steering of research through Principal Investigators/ research group leaders Coordination of research: The ARI is managed by one director Coordination of research: Attention to building a new research culture? Appraisal of research: in accordance with SEP Planning of research: The AMC and VUmc board will provide monetary resources to finance a limited ARI organization, weighted through the size of the ARI Talent policy: Is talent policy mentioned and at what level is talent policy taken into account?. Innovation budget plans: Has it been shown that budget will be spent on research that will help form the ARI and/or the cooperation between AMC and VUmc researchers, and/or must be used for research for which it is very difficult to find external acquisition, and/or the research must be typified by innovation and excellence with higher future acquisition chances? Are the in-control aspects for department heads taken into account? Department head is responsible for research in their department. Are the in-control aspects for professors (PIs?) taken into account? Responsible for research in their subfield in a department. Let the focus of research fit with the professorships available in the ARI. R&D. CVD. neuroscience. PH. √. ?. √. ?. √. √. √. √ (chair research board). √ (+team). √ (+team). (other controls) √ (+ executive board). ≈ (PI score). √. √ (+5 quality committees). √. √ For communication √ ‘Spotting’ talent +training. (>6 FTE). (>10 FTE). (> 5 FTE). √ Identify, coach, manage time Train Msc, PhD. √. √. √ Although 3 M€/yr is needed. √ Although 1.8 M€/yr is needed and half is spent as asked. R&D. √ Funding schemes, travel funds, PhD grants, P-D grants CVD. Neuroscience. PH. -. √. √ (involved in consensus meeting). R&D. CVD. Neuroscience. (in structure: but ARI decides on admittance criteria) PH. √ Research board for specific proposals. √. √. -. √. -. -. -. √ Interaction researchers PhD Scholarship. 26.

(27) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Table II shows an analysis of how the ARI plans compare to the in-control aspects for the UMCA board, the deans, department heads and professors in the organization. The main gaps in the current version of the plans are on the topic of coordination of research, planning of research, and the in-control aspect for appointed professors. No attention is given in either plan to the need to build a new research culture, and the content of talent policy is restricted to a very small part of the researcher population in most plans. There is a large variation in what is seen in a limited ARI organization, and in the expected needed budgets in the coming years. This may lead to large unforeseen costs at the corporation level. Some gaps are seen in the organization of research and the in-control aspects of the heads of the departments. B. Comparing the historical choices made in AMC and VUmc to organize and structure research: retrospective data analysis Current research cultures In general, and following Schein (1990), organizational culture constitute groups of workers who develop consensus on external adaptation tasks like knowing what the core mission, functions, and primary tasks of their organization in their environment is, what specific goals are to be pursued by (part of) the organization, what basic means there are to accomplish the goals, what criteria are used for measuring results. In addition, consensus has been developed about internal integration tasks, like a common language and conceptual system to be used, knowing what group boundaries are and what the criteria for inclusion in the group are, and what the criteria for the allocation of status, power, and authority are. In the context of research, these examples constitute the ‘research culture’. One assumption might be that a difference between the two UMCs with respect to their research organization has led to different social systems and behaviors of individual researchers. In the AMC, a major change in research organization and structure was introduced when research institutes were ended almost one decade ago and one corporate research council was appointed as advisory committee for the Board of Directors. The research culture changed in the sense that Principal Investigators were ‘assigned’ as the 27.

(28) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. most important responsible unit of research. The quality of research of the (new) PIs was rated by the Research Council and their advice would let the dean decide which PIs are appointed. A few years later, the AMC PI score was introduced that allowed monitoring, benchmarking between PI groups and monitoring of progress in PI quality. Several aggregated levels for the quality assessment of research have been applied in recent years: at the PI level, departmental level, division level and corporate level. These levels are used during evaluation moments. The consequence of this system is that PIs started behaving in accordance with the criteria set and it is assumed that their behavior will be seen as an example for researchers in their group. The AMC chose to introduce centrally organized internal support groups for important funds at the individual researcher level from ZonMw (Veni, Vidi, Vici) and for EU grants. At the research theme level, PIs associated themselves with one of the defined themes: AMC research themes allowed PIs to choose which themes they thought their research fitted best. The interaction, collaboration and networking of researchers and PIs within themes, however, was not organized in the same way throughout the organization. In the VUmc, research institutes in the faculty of medicine were introduced long ago. For the past 6-7 years now three interdisciplinary (inter)faculty) research institutes (I)OZI have been formed and two on faculty level with strategic themes as starting point. Institutes were autonomous in organizing research. In some of these institutes, the infrastructure for researchers has been defined in handbooks with strict procedures around research projects (e.g. setting up RCTs). There are also committees in some of the institutes that check all research proposals. Other institutes have chosen differently. The unit that was used for research evaluation has been chosen to be the thematic programs within the research institutes and, from an administrative perspective, control is exerted on the (I)OZIs as aggregated unit. In addition to the research culture in both faculties of medicine, the shared cultural aspects of the associated universities (VU and UvA) may also account for part of the differences because employees are known to make active choices when deciding about starting working for a certain type of organization. This choice has to do with “congruent goals, norms and 28.

(29) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. values that will increase their person-organization fit and associated higher chances for career success” (Ballout (2007, p.750)). Rouzies used the definition of organizational identification in her study as “the perception of oneness with or belongingness to an organization where the individual defines him/herself in terms of the organization in which he/she is a member’’ (Rouzies (2011, p.26)). Analyses on the quality of research on AMC and VUmc level using the CWTS analysis (NFU, 2014b) and the QS world-university ranking (www.topuniversities.com) From the above-mentioned differences between AMC and VUmc, the question emerges if these differences show in the current quality of research. To compare the research quality of AMC and VUmc at the institutional level, data from the bibliometric study (the CWTS analysis) which was performed by the NFU for all academic medical centers were used (NFU (2014)). In this analysis (over the years 2007-2011/2012), a comparison on the output in journals covered by Thomson Scientific in their Web of Science is made at the aggregate level of the academic medical centers. The figures of AMC and VUmc were observed and are reported upon. The MNCS indicator is seen as an important tool when analyzing research performance. The explanation given in the NFU report (2014, p.10-11), is that the MNCS indicator relates the measured impact of a research group or institute to a worldwide fieldspecific reference value and because of this can be seen as a powerful internationally standardized impact indicator. The criteria applied are the following: <0.5= performance is far below the international impact standard of the field; 0.5-0.8= performance is below the international impact standard of the field; 0.8-1.2= performance is about the international impact standard of the field; 1.2-2.0= performance is above the international impact standard of the field; >2.0= performance is far above the international impact standard of the field. When the aggregation level is higher, the volume in publication is larger and the more difficult it is to have an average impact significantly above the international level. This means that when the criterion is > 1.2, for the interpretation it is justified to say that the institute can be considered as a scientifically strong organization. The MNCS indicator for both AMC (1.6) and VUmc (1.7) is > 1.2 and below 2.0, meaning that both institutes can be interpreted as scientifically strong organizations. When comparing this 29.

(30) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. classification to the scores of the other six academic medical centers, it seems that all centers perform the same on this indicator, all scoring as scientifically strong organizations. When looking per field between 2007 and 2011/2012, in the AMC the largest share of output and normalized impact is by far the cardiac & cardiovascular system, followed by gastroenterology & hepatology and surgery. The MNCS indicator in the AMC is above 2.0 (and thus far above the international impact standard of the field) for the fields of general & internal medicine, rheumatology, multidisciplinary sciences and opthalmology. In the VUmc, between 2007-2011/2012 the largest share of output is in the field of oncology, followed by clinical neurology and endocrinology & metabolism. The MNCS field indicator is above 2.0 for clinical neurology, neurosciences, genetics & heredity, and multidisciplinary sciences. Another way of looking into research quality between medical faculties abroad, at the European and world level, is to compare the faculties in the QS world university ranking that has been published annually since 2004.The idea is that the best medical students would choose the best medical faculty due to a couple of criteria in which research quality is included. The criteria included are: In the 2014 QS world university ranking when looking into the subject ‘medicine’, the ranking could be seen for the European continent only. This ranking looks at several criteria in three categories: academic reputation, employer reputation, and research citations per paper. The following European (World) ranking applies to the Dutch academic medical centers: rank 9 (33) for Erasmus, rank 13 (46) for AMC, rank 14 (50) for Leiden, rank 20 (51-100) for Maastricht, rank 39 (51-100) for Utrecht, rank 44 (101-150) for Radboud Nijmegen, rank 60 (101-150) for Groningen and rank 66 (101150) for VUmc. At the Dutch level, Erasmus MC has the best QS rating at the European level, but several UK institutions rank much higher than Erasmus MC. In the top 10, the only nonUK institute occupies rank 3, the Karolinska Institute in Stockholm. (www.topuniversities.com, July 20th 2015). In summary then, the UMCs in the Netherlands are all scientifically strong organizations with the same qualification on the MNCS indicator in the CTWS analysis. AMC and VUmc score above 2.0 in different fields in science. The question of what will happen with these scores when the two scientific outputs are merged is an interesting one because the alliance 30.

(31) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. organization will then be counted as one unit. It could be expected that higher scores will show a shift towards the mean. At the European level, the ambition to be in the top 5, as defined in the strategic goals, seems to be quite a distance from the current rankings, which are no. 13 for AMC and an even lower ranking for VUmc. To learn from higher ranked institutions and given the social system and the fact that English is not our main language, the Karolinska Institute and Erasmus MC could be studied further to see what activities are included in their institute.. Analyses at the AMC and VUmc level using the individually earned important EU grants (starting grants, consolidator grants and advanced grants), and the National important individual NWO grants (VENI, VIDI, VICI 2012-2014) Every year, the Netherlands Organization of Scientific Research (NWO) has a budget of 150 million euros for talented and creative researchers who can apply for an individual VENI, VIDI or VICI grant. ZonMw (health and health care research) is one of seven elements of the NWO. In box 2, the results from recent years regarding the number of earned important grants by individual researcher (groups) are shown. What can be seen is that the AMC was more successful than the VUmc in earning personal grants in terms of VENI, VIDI and VICI grants in the period 2012-2014. The European Research Council has a total budget between 2014-2020 of 13.1 billion euros for excellent researchers. At the EU level, in the same period as for the analysis of NWO grants, AMC researchers were awarded four starting grants, two consolidator grants and two advanced grants. For VUmc researchers, the EU grants earned in the period 2012-2104 were one starting grant and two advanced grants. Box 2 Successful personal grants at the EU level and the national level (NWO) AMC (2012-2014) Zonmw: Veni: 19 Vidi: 13 Vici: 3 EU personal grants: Starting: 4 Consolidator: 1 Advanced: 2. VUmc (2012-2014) Zonmw: Veni: 8 Vidi: 2 Vici: 1 EU personal grants: Starting: 1 Consolidator: 0 Advanced: 2. 31.

(32) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. Retrospective analysis at the individual level within the PI system AMC In a sample of 21 AMC PIs who were selected by the current co-coordinators of four of the new alliance research institutes, the development over time of the A part of the AMC score was retrieved. This is shown in figure 2. What can be seen here is that three out of the 21 PIs decreased in A-scores and 18 out of 21 PIs increased their A-score over time. The decreasing scores were all in PIs that scored between 2 and 3 on the first assessment. This is actually also the range of score where relatively large improvements are possible.. Figure 2.Within-PI comparison of A-scores over time (n=21):A-score over the period 2005-2010 and 2009-2014. On average, an increase was seen in performance on the A-score compared to the individual baseline score: the average increase is 24%, with the worst performance of a decrease of -28% and the best performance of an increase of + 88%. In figure 3, the percentage change compared to the individual baseline score is shown. As can be expected with the possible ranges in scores, low starting scores (<2) allow for relatively large increases after a couple of years while high starting scores (>3,5) allow for a maximum increase of 30%. PIs scoring between 2 and 3 on the first assessment showed the biggest changes in both ways.. 32.

(33) [MBA-HC THESIS JUDITH K. SLUITER]. 17 augustus 2015. Scatterplot of PIs n(n=21) with % in A-score over time 100. percentage-change A-score. 80. 60. 40. 20. 0. -20. -40 1. 2. 3. 4. 5. original A-score 2005-2010. Figure 3. Scatterplot of Pis (n=21) with % change in A-scores over time compared to their absolute A-score over the period 2005-2010. Post-hoc analysis at individual level between research group leaders AMC-VUmc To get an idea of whether the A-scores would lead to comparable ratings for the VUmc as they do for AMC, from a group of 28 VUmc professors and associate professors for whom the A-score was calculated over the most recent period (2009-2014) by the organization recently, a comparable group of AMC professors and associate professors who were PI were matched by the author based on department/research topic. Figure 4 shows that the selection concerned people in a large part of the range that is possible for this A-score, and that the scores were comparable between AMC and VUmc with an average of 3.8 for the AMC group leaders and 3.5 for the VUmc group leaders. This 0.3 difference was also seen in the minimum scores (1.0 vs. 1.3) and maximum scores (4.7 vs. 5.0) for VUmc and AMC, respectively. Boxplot of a-scores samples amc (n= 28) and vumc (n= 28) 5. A-score. 4. 3. 2. 1 amc. vumc. Figure 4. Comparison through boxplot of A-scores 2009-2014 between 28 AMC and 28 VUmc head researchers. 33.

(34) 17 augustus 2015. [MBA-HC THESIS JUDITH K. SLUITER]. C. Theoretical frameworks that can be used from a business or corporate perspective to tackle and analyze the changing research organization 1. How can strategy be executed? Kaplan and Norton (2008) propose a management system with an integrated set of processes and tools that a company uses to develop its strategy, translate it into operational actions, and monitor and improve the effectiveness of both. They propose a management system tool kit with the most appropriate tools and processes in the stages of translating strategy into actions. They stress that different tools and processes are needed in the different parts such as the part of translating the strategy statement into specific objectives and initiatives, and the part of implementation when strategy should be linked to operation. The question is what kind of tool the ARIs are for the executive board of the alliance: is it a tool for monitoring the implementation of research strategy or is it a better tool for translating the strategy statements into specific objectives? An important part in the achievement of the operations, given the specific objectives, is creating a tool for communication and learning these objectives throughout the organization, to all units and all researchers. For this purpose, the tool kit of Kaplan and Norton falls short. The research ambition of becoming a European Top 5 faculty and the number one UMC seems to be one of three vital components of a vision statement, and examples of a so-called ‘stretch goal’ i.e. one that is difficult to reach for the company in its present position (Kaplan and Norton (2008). New shared core values will have to prescribe the attitude, behavior, and character of the alliance research organization. 2. What aspects might be relevant when talking about a new research culture? Before one can decide if and how a new research culture can and should be formed in the UMCA, the concept of culture needs to be examined further. In most publications on culture, the definition of Schein (1990, p.111) is mentioned. Schein’s definition of organizational culture is: “a pattern of basic assumptions, invented, discovered, or developed by a given group, as it learns to cope with its problems of external adaptation and internal integration, that has worked well enough to be considered valid and, therefore 34.

No results found