University Gynaecology and Obstetrics, quo vadis? A Department of Women's Health-University Women's Hospital of the future?

Abstract

Purpose: Numerous changes in society, science and health care challenge gynaecology and obstetrics. These challenges include the maintenance of excellence in research, commercial potential and clinical innovation, as well as the maintenance of adequate human resources, new standards for patient orientation and individualised medicine.

Methods: Based on a SWOT analysis of the status quo, of local and national quality data, a search regarding national conceptions and of international best practice for women's health centres, the model of a Department of Women's Health was developed.

Results: The Department, consisting of a University Hospital and a Research Institute, should interlink clinical care and science. With the establishment of the department, a pool of expertise is achieved which encompasses gynaecology and obstetrics from basic care to the high-technology segments, as well as all the scientific areas relevant to the medical discipline and women's health, including health services research. Preservation and attraction of personnel resources are based on the department's excellence, on reliable perspectives and the flexibility of job profiles, which also result from the close connection between care and research and the expansion of perspectives on women's health.

Conclusions: Methodological diversity and inter-professionalism build the appropriate base for the further development of research fields. At the same time, the Department creates space for the consolidation of the core areas and the integration of sub-disciplines (clinical and scientific) to maintain the unity of this discipline. Via the scientific monitoring of the implementation, suitable elements can be highlighted for transfer to other facilities.

Fig. 1

Functional diagram of the Department of Women’s Health: complementary interlocking of clinical unit and research unit

Fig. 2

The activities of the Women's Health Research Institute at the University of Tuebingen act synergistically for the multidimensional promotion of women's health and offer the basis for translation and communication of expert knowledge for the layperson and expert groups. The methodical diversity and the interprofessional work groups of the research institute offer a suitable foundation for the further development of fields of research. It simultaneously creates space for setting individual priorities in sub-disciplines and for their integration into the department’s network

Fig. 3

Internal structures of the Department of Women’s Health and external networking: The core clinic incorporates Obstetrics and Gynaecology, represented by professors. The areas of the speciality which require a special qualification complement the core clinic as well as the related sections. Research posts for experts and research professors in specialist areas substantially extend the department’s portfolio (for a more detailed explanation, see “Challenges of individualised medicine” and “Health and health literacy in focus”)

Fig. 4

Research topics from the Tuebingen Faculty of Medicine and corresponding research priorities in the University Women’s Hospital centres and in the Women’s Health Research Institute: Immunology/oncology, vascular medicine, infection biology and neurosciences are at the centre of the research priorities in Tuebingen, reflected in four Helmholtz Association health centres. Health research at the Helmholtz Association, in which 18 natural science-technological and medical-biological research centres have merged, is addressing the causes of cancer, cardiovascular and metabolic disease, lung disease, neurological disease as well as infectious disease. This takes place in alliance with partners from University Medicine and Universities, of which the University of Tuebingen is also a representative for the depicted (sub-)specialties. Medical technology serves as linking scientific basis. Women’s health and obstetrics and gynaecology as medical disciplines are integrated accordingly into these topics. (Abbreviations: see index)