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Research on stem cells is as important as patient-related research

Nasim Bergman Farrokhnia is a chief physician in internal medicine and a researcher. For six years, she was head of Sweden’s largest emergency room. During that time, she developed an organization where patient-related research was a natural part of work. She is now moving on to new challenges, developing a future care concept that creates measurable value and improves the health of vulnerable people.

It is still morning when we hurry down the corridors, past the coffee room to Nasim Bergman Farrokhnia’s office. She quickly looks at her smart watch; an incoming call vibrates discreetly and she quickly decides that it can wait for later. She praises the watch for all its features and apps.

– But this morning when I forgot my cell phone at home, I wish it had alarmed and reminded me. Then I would not have had to cycle half-way to work before turning around and then hurry back to work again.

More efficient working methods

For more than six years, she was head of operations at the emergency hospital at Södersjukhuset with about 450 employees, a complex assignment that puts heavy demands on committed, clear, and patient leadership. Every day, 300 patients pass through or more than 100,000 visitors a year.

– The mission was to produce healthcare, which requires a knowledge management with prerequisites for process development, leadership, quality assurance and research. Otherwise, it is difficult to do the right thing.

A large proportion of patients who come to the emergency room at Södersjukhuset are older, many with one or more chronic diseases. The longer they remain at the emergency room, the larger the risk for infections and other complications.

– I am proud of how we managed to create a modern organization where constant improvements and measurable results led to faster processes and flow through the emergency room.

”You’ve got a lot of energy”, her colleagues and her husband say to her when she rushes through everyday life. Most of the time she cycles to work, and a couple of times a week she rises early to lead training sessions at SATS.

– I get positive energy from training and from leading groups. It is inspiring to support each other through a physically challenging workout session. It is similar to the work of an emergency room; it is as much about dismissing mental obstacles and seeing the opportunities and strength of teamwork.

Conducted stroke research

Nasim Bergman Farrokhnia was 18 when she came to Sweden from Iran. She started the medical programme with research focus in Uppsala in 1994 and began experimental research early on.

– Briefly, it was about developing a method for improving wound healing in connection with burns. The project was a good example of interaction between preclinical and clinical research and how they fertilize each other. What we did in the lab had a direct link to patients with burns

After a few semesters, she changed her direction. She studied internal medicine and ended up in a stroke unit where she started working on her dissertation.

– I really enjoyed it, the environment was inclusive and I was given the responsibility to work independently. Furthermore, everything we did was evidence-based.

In 2005, she got her MD at the University of Uppsala. The dissertation was about the effect of high blood sugar following ischemic stroke.

Knowledge management

After her dissertation, she intended to continue her scientific work at Cochrane Collaboration in England, but an attractive offer from SBU, Swedish agency for health technology assessment and assessment of social services, prompted her to reconsider.

– I led a project on patient flow, working methods and patient safety in the emergency room, and published a report on triage and flow processes in emergency rooms in 2010. It showed how we could shorten waiting times and stays in the emergency room. I also learned that there are major knowledge gaps and that many of the treatment methods we use in healthcare are not evaluated. I identified an important task.

When she started as head of operations at Södersjukhuset in 2011, she used the experiences from SBU and introduced a method for continuous and systematic improvement work; Plan – Do – Study – Act.

– This led to the introduction of more efficient working methods and so-called modules with interprofessional learning in teams around the patient.

Paths for research

Nasim Bergman Farrokhnia has stubbornly worked for clinical resarch to run in parallel with the daily activities.

She is herself a researcher at the Department of Clinical Research and Education, Södersjukhuset/Karolinska institutet.

– Thanks to the patient-related clinical research, we have learned more about efficient processes, safer healthcare and a better working environment.

Nasim is supervisor for chief physician Jenny Liu, PhD student and project leader for the New emergency room at Södersjukhuset. In her dissertation work, Jenny Liu has collected and processed a large amount of data that shows that inter-professional teamwork in smaller units (modules) in the emergency room results in shorter stay time for the patients, compared to triage processes led by either a doctor or a nurse. An inter-professional teamwork shortens the waiting time for medical assessment by 42 minutes, compared to nurse triage. Preliminary data also show that working methods affect the working environment; the proportion of employees who rated their workday in a positive way increased from 50 per cent to 80-90 per cent.

Hierarchy

Nasim Bergman Farrokhnia finds that clinical research does not have the same status as preclinical research, with its Nobel Prize winners and large research grants.

– Unfortunately, there is a hierachy also in research. Stem cell research is important, but we also need to transfer the results from basic research to healthcare, and therefore patient-related research is equally important. They are both needed and they depend on each other.

She refers to two major researchers who have been important for her personally: Marie Curie, awarded twice with the Nobel Prize for her research on radioactivity and for the discovery of the elements Radium and Polonium, as well as Hans Rosling, Professor of international health, founder of Gapminder and appointed one of the 100 most important thinkers of our time.

– They are my idols. They worked hard, were passionate and driven by knowledge and curiosity. They have done incredibly important efforts and demonstrated that both preclinical and clinical research are needed to move forward. They inspire me.

In early October she left her assignment as head of operations at Södersjukhuset to begin her next ”journey”. With all the knowledge she brings with her as a clinician, researcher and manager, she wants to work on long-term sustainability issues.

– I will continue to be connected to Södersjukhuset as a clinician and researcher. But I want to focus more on issues related to prevention efforts, to develop quality-driven concepts in healthcare and welfare. My strong driving force is to create measurable results that improve the health of vulnerable individuals.

About Nasim Bergman Farrokhnia

Age: 45

Lives: Stockholm

Family: Large. Relatives in Iran och Sweden, five children (of which three bonus children) between 11 and 16.

Work: Chief physician and researcher. Has recently left the assignment as head of operations at the emergency department at Södersjukhuset.

Most proud of: All my ”journeys” in life; as an 18-year-old newly arrived in Sweden, as a single parent of premature twins or as head of operations of the largest emergency room in Northern Europe. Is in constant learning.

Enjoys: Hiking in mountains and instructing martial arts. But also to just be.

Worries about: Racism and fear of the unfamiliar.

Clinical research is important in order to: Fill knowledge gaps, perform knowledge management and to create the greatest possible value for the tax money.

As Minister for Higher Education and Research I would: Focus on research environments where different professions and perspectives work together. Create meeting points for academia and young people from socially vulnerable areas that need hope as well as role models.

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