The overarching word ‘respect’ is paramount in the UZ Brussel’s philosophy.
To read about the UZ Brussel’s mission and values, go to:Link to mission and values
Christophe and nurse An are just seeing pregnant patient Marianne when an inspection takes place to check that hospital hygiene and the safety regulations are being correctly implemented. These safety rounds were initiated in 2012.
It’s going to be an exciting year for Christophe. He hopes to make the switch.
Overall quality is key at UZ Brussel (the University Hospital of Brussels). The safety rounds—which were started in 2012—are one of the concrete manifestations of this. This was also why the UZ Brussel decided to seek accreditation for the whole hospital in 2012 — a process that will take several years to complete. Accreditation is a process in which a health care facility is assessed by an external and fully independent body to determine whether it meets a number of standards aimed at improving the safety and quality of care. It is a clear indication that an institution constantly strives to optimise the safety and quality of its patient care. This makes quality measurable, reflecting the ambitions of a hospital that wants to be demonstrably different.
In order to promote patient safety, safety rounds have been held regularly in the hospital since May 2012. Safety rounds involve verifying that all rules regarding hospital hygiene and patient safety are being complied with. The safety rounds raise health care providers’ awareness of the issues involved and actually increase patient safety.
What do the teams performing the safety rounds look for?
These observations are recorded electronically. If patients are involved in the observations, then the visit is regarded as part of an audit and they are given a thank you card. The safety rounds identify issues requiring attention which can lead to better quality care.
In the past, patients were often referred to different departments in an uncoordinated way. This meant that a patient was treated separately by each specialist and were themselves responsible for making separate appointments with the specialists. To avoid this, UZ Brussel created additional clinical pathways in 2012. Each pathway makes the patient the focal point of care. Multidisciplinary teams work in consultation on all aspects of the medical issue. In this way the hospital is organised around the patient. For example, if a patient is admitted with a stroke, a clear pathway is set out for that patient to follow: which doctor or nurse should be involved, what action should they take, and when? In 2009–2011, UZ Brussel created clinical pathways for acute coronary syndrome, stroke care, pneumonia, normal pregnancies and childbirth. Heart failure was added to this in 2012.
Marc De Beukeleer, Quality Coordinator
The health care provider remains the expert. The clinical pathway simply provides the optimal combination of people and resources for a specific complex medical issue. Clinical pathways lead to health care safety, so it’s all in the patient’s interest.
UZ Brussel has been performing safety rounds since 2012. What do these safety rounds teach us? Let’s take a look at some figures…
The majority of the patients who were inspected (89.2%) were wearing an identification wristband. 88.7% of patients had an identification wristband that was legible and had been filled in correctly.
The vast majority (90%) of immobile patients had access to a patient bell, allowing them to call a member of the nursing staff at any time.
Medication may only be accessed by a doctor or nurse. An important issue requiring attention is locking the medication trolleys and removing the corresponding key when they are not in use. Only 36.7% of the trolleys that were inspected had been locked correctly. 46.9% of the medication trolleys were in an unsatisfactory state: either they were not locked or the key had not been removed from the lock. 16.4% of the trolleys were in use at the time of the safety rounds and so could not be inspected.
There are eight basic conditions that must be met to ensure good hand hygiene. If any of those conditions are not met, good hand hygiene will be compromised. The majority of employees that were checked during safety rounds complied with the stipulated conditions. Nevertheless, there were two issues requiring attention: wearing a wristwatch or a ring. The latter, in particular, is a matter of concern that needs to be addressed.
Christophe is in a patient's room, standing by the bed of patient Marianne whom he has just examined. Using his tablet, he gives her access to her electronic patient records and uses these to discuss her test results. In 2012 a pilot phase was launched in which some of the nursing and medical staff were equipped with smartphones (nurses) or tablets (doctors). Along with the applications developed by the information systems department, doctors and nurses are able to use these appliances to consult the Clinical Workstation (CWS) while on the go.
Professor Rudi Van de Velde, director of the information systems department, has twice been voted IT manager of the year. At the end of 2011 the UZ Brussel was the only hospital in Belgium to be awarded the ‘HIMMS stage 6’ label (Health care Information & Management Systems Society), for its clinical workstation (CWS); this is the second-highest quality label that can be gained. These two examples show that the UZ Brussel doesn’t just play a leading role in the medical field, but also in the area of IT. Innovation never stops, however, which is why investments were also made in IT in 2012. This means that in future years, too, the UZ Brussel will continue to be a hospital in which health care and IT go hand in hand, mutually reinforcing each other and creating benefits for both patients and staff.
Prof. Rudi Van de Velde, director of the information systems department
The medical world is changing and the traditional doctor-patient relationship is becoming a lot more complex and multidisciplinary. Various positions and departments must work together in the care of the patient and this opens up new possibilities for process and workflow management.
In 2012 the building blocks were laid for a gradual transition from a traditional, hybrid switchboard to a virtual, central data network for the entire hospital. This makes it easier for the staff of the UZ Brussel to work remotely and to take part in audio or video conferences. Apart from that, however, video conferences are also being used, for example, in multidisciplinary oncology consultations (MOC). A consultation is booked with the GP and he or she is sent an e-mail by the UZ Brussel confirming the appointment. When the GP clicks on the link in the e-mail at the agreed time, he/she (using a webcam) can immediately see the area where the specialists have gathered to discuss the patient. In other words, the GP is involved every step of the way.
Nursing records were previously used mainly for registering health care services that had been implemented, such as parameters, wound treatment, catheter monitoring, etc. In 2012 a significant new feature was added at the hospital level: the scheduling of nursing activities. The electronic nursing records provide nurses with a best practice approach for each health care issue. In this way we ensure that our patients are given the right level of care at the right time.
* procedures and work processes
The Clinical Workstation (CWS) contains more than 1.5 million patient records. It is therefore a potentially very interesting source for academic research. In 2012 the information systems department developed a search engine which allows doctors to browse the data in the CWS. The search engine enables doctors to create lists of all files on the basis of a particular disease, treatment, etc.
Obviously, the necessary security features are installed in order to prohibit unauthorised access to the system and to protect patient confidentiality. A doctor can therefore only access the details of files linked to patients he has been treating. All the other files remain anonymous, unless the researcher is given approval by the medical ethics committee.
* procedures and work processes
In 2012 a completely new and much more user-friendly version of the existing laboratory guide was developed for doctors both inside and outside the hospital. The laboratory guide includes both text and images and retrieves its information from the laboratory information system. As this information can be supplemented, updates can be kept to a minimum. This function also includes traceability and version management.
1 March 2012 was Compliments Day: the UZ Brussel distributed a card to employees that made it easy to give each other a little pat on the back. No matter how high-tech health care becomes, it is still primarily a matter of people doing something for other people. Christophe also expresses his appreciation. As a PhD student, he knows how that can help a person’s motivation when faced with a big challenge.
Working in a hospital is very rewarding, but it also involves the necessary responsibility and sometimes stress. This makes it essential to have a sophisticated Human Resources policy which focuses on both the professional and human aspects of working in a hospital. As in previous years, a number of initiatives were taken in 2012 to respond to this need.
As a nurse, nursing auxiliary, or midwife, your career can take several different paths. In early 2012 the UZ Brussel created a visual representation of all possible professional development opportunities for employees in the Department of Nursing and Midwifery: the Metro Plan.
Katelijne De Koster, head of nursing
The idea behind our Metro Plan is that a diploma is simply an entry ticket to a career as a nurse, nursing auxiliary or midwife. Several pathways are possible both within the job itself and within the UZ Brussel.
In 2012, the UZ Brussel put together a working group that focused on how and under what conditions working from home can be introduced and encouraged within the hospital. The aim is to formally support and manage working from home.
Caring for others, that is what the UZ Brussel does every day. But what if employees are faced with situations in the workplace, such as severe aggression, threat or the death of a patient, and find it difficult to cope with this? If caregivers experience a traumatic situation, it is important that they are cared for too.
The UZ Brussel has had an internal victim support team for many years, but since 2012 the hospital has also been working with POBOS, a counselling centre for social welfare within organisations. POBOS provides psychological care and support.
In collaboration with CAW Mozaïek and POBOS, the UZ Brussel offers its employees a varied range of counselling and support,
both in their private and professional lives:
Raf Vandenbussche, HR and Communications Director
Professionalism and humanity go hand in hand at the UZ Brussel. This is based on the maxim that the better employees feel about themselves, the better the care we can provide to patients. We weren’t awarded the ‘Top Employer’ label for the fourth year in a row for nothing!
Good patient care is a direct result of committed and satisfied caregivers. Over 3,400 employees are busy every day at various levels - from technicians to administrative staff and from nurses to senior surgeons. In 2011, 3,365 people were employed at the UZ Brussel, and that figure had increased to 3,405 by 2012. The theoretical number of full-time equivalents is 2,965.
The vast majority (39%) of the staff consists of nurses, followed by doctors (16%) and administrative staff (17%).
Health care is pre-eminently a sector in which many women work. The UZ Brussel is no exception in this regard.
The UZ Brussel is preparing for the future by recruiting young people and establishing a recruitment reserve list in order to respond effectively to the retirement of the baby boomers.
Our employees come from all over the country. All Belgian provinces, with the exception of Luxembourg, are represented in the hospital. There are even employees who commute from the Netherlands to Brussels to work at the UZ Brussel.
The UZ Brussel is a melting pot of nationalities. Over 40 different nationalities work at the hospital, making it a multicultural environment. Belgians are not included in the above graph.
The UZ Brussel’s absenteeism figures are lower than the health care sector’s benchmark. Apart from overall absenteeism, which is much lower (UZ Brussel: 5.26% - sector: 6.44%), the hospital also scores better on the aspects that make up this figure: illness (UZ Brussel: 4.77% - sector: 5.82%), accidents at work (UZ Brussel: 0.19% - sector: 0.21%), authorised absence (UZ Brussel: 0.29% - sector: 0.37%) and unauthorised absence (UZ Brussel: 0.01% - Sector: 0.04%).
The oral and maxillofacial surgery and ear, nose and throat departments require specific imaging devices. Two new Cone Beam CT scanners were purchased in 2012. Quite apart from that, however, 2012 also had quite a few innovations in store for Christophe, including the opening of a brand new IVF laboratory cleanroom.
Innovations do not always have to come in the form of large projects. Innovation can sometimes be found in small things, such as the timely replacement of depreciated equipment, a critical review of laboratories... whatever helps to treat patients better and faster.
The CRG (Centre for Reproductive Medicine) is constantly expanding. More and more foreign patients from the Middle East started to come to Brussels and, with just one IVF laboratory at its disposal, the CRG was no longer able to cope with demand. In order to manage this growth more effectively a hub was opened in Kuwait, which meant that the many patients from the Middle East no longer needed the services of the laboratory in Brussels. At the same time, the decision was taken to centralise all the Brussels-based laboratories on the same floor, to build a second IVF laboratory cleanroom and to renovate the existing IVF laboratory so that it complies with the amended legislation that makes cleanrooms a statutory requirement.
The renovation of the existing IVF laboratory will be completed in 2013, while the new, second IVF laboratory came into use in 2012. The aim was to expand to a capacity of 5,000 ovarian pick-ups.
Lieve Decaluwé, CRG Manager
The Centre for Reproductive Medicine is world famous. Investing in the new cleanrooms is necessary to continue to meet the demand from both domestic and foreign patients, to keep waiting lists as short as possible and to keep up with the latest techniques.
In 2012 two new cone-beam CT scanners were purchased to support the Ear, Nose and Throat (KNO) department and the Oral and Maxillofacial surgery (MKA) department. The new equipment consists of a single underlying system (for KNO indications and radiology purposes) and a single standalone system (for MKA and dental displays). The devices allow the creation of very high resolution 3-D imaging.
In addition, old appliances were replaced with new ones:
A device was purchased for the oncology department which uses laser therapy to co-treat the extensive oral mucosal effects (oral mucositis) caused by chemoradiotherapy. The device looks like a laser pen and can be used at the patient’s bedside. The treatment is free for patients. Patients experience an objective improvement and their pain reduces very quickly. The UZ Brussel was one of the nominees for the Belfius Foundation’s “Colour your hospital” project that helped to finance the device.
In Brussels’ Boudewijnpark, where Christophe and his wife take their two children to play, a proud, old lady sits on a bench reflecting on the past. She has questions about the end of her life. Where can she go? In 2012, the UZ Brussel opened its ‘End of Life Clinic’ in Wemmel, an information centre where patients and their families can obtain guidance, counselling and mediation for a dignified death. The UZ Brussel started to make the transition to becoming a hospital of the future in 2012. But its core value remains respect, including respect for everyone’s right of self-determination. Christophe likewise believes it's very important that the UZ Brussel continues to retain its strong distinguishing features as a hospital that respects humanistic values.
Seriously ill patients with questions about the end of their lives can now seek a secondary care consultation in Wemmel where TOPAZ (the UZ Brussel’s homely day centre for people with terminal illnesses) is located. This new initiative, which was launched in 2012, is called ULTeam, or ‘Uitklaring Levenseindevragen-team’ (‘Clarifying End-of-life Questions Team’).
Since 2002 Belgium has had three laws concerning the end of life: the Patients’ Rights Law, the Palliative Care Law and the Euthanasia Law, which ensures the patient’s autonomy in medical decisions, including those concerning the end of life. Ten years later, according to information from institutions such as LEIFartsen, it turns out that the general public is still unaware of these legal possibilities.
Furthermore, it also appears that many incurably ill patients are very intractable where the treatment they receive is concerned, that they often seek supportive and palliative care at too late a stage, and that issues regarding euthanasia among non-terminal patients and mentally competent psychiatric patients, for example, are not always dealt with effectively. This is partly because the euthanasia request is not listened to or because the doctor or health care facility sets additional conditions.
As a result, the patient is faced with a miserable situation that should be avoidable. This means that, at least for the time being, these patients need an effective secondary care consultation service, useful advice and, potentially, efficient monitoring/hospitalisation.
In order to meet these needs, since 2012 seriously ill people with questions about the end of their lives have been able to turn to Wemmel for a secondary care consultation.
The ULTeam team can be consulted when patients have nowhere else to turn. This may include patients who want to stop their treatment, for example, or who no longer want to live. Support is also provided to people who want to stop their treatment but have not dared to do so because they are afraid that they will no longer be able to see their doctor.
In order to come for a consultation, patients must first make an appointment. A multidisciplinary team considers their request and tries to give feedback to the attending physician. The team primarily has a mediating role. The consultation can be initiated at the patient’s initiative or at the request of his/her family (for example, in the case of mentally incompetent patients) or on referral from a doctor/health care professional. Subject to the patient’s consent, these questions are always channelled back to the doctor. The ULTeam is co-sponsored by the VUB ‘Dignified End of life’ Chair at deMens.nu and is supported by an advisory board which oversees the quality of the social services, provision of care, training of professionals and scientific support. All activities are reported to the Ethics Committee of the UZ Brussel.More info
The Vrije Universiteit Brussel and the UZ Brussel are frequently mentioned in debates within society surrounding the beginning and the end of life. This is not surprising because at both of these key moments our society tends to impose its values and standards on individuals. The Vrije Universiteit Brussel (Free University of Brussels) and its hospital, UZ Brussel, have included the right of self-determination as a key element of their philosophy. Even in cases where this goes against prevailing social values, the VUB and its hospital have always taken a stand on issues such as abortion, fertility research and euthanasia and thus made their mark on society’s perspective on such issues.
Anne-Marie Moens, head nurse in patient support
The UZ Brussel matches my values and standards and my way of working and thinking very closely. I really don’t like patronising. People should think critically for themselves.
The philosophy of these two organisations is also evident in their day-to-day care. Patients are treated with respect, regardless of their language or outlook on life and religious persuasion. Students feel less distance between themselves and their professors than elsewhere. Employees also notice that their opinion is welcome, even if it is critical.
The overarching word ‘respect’ is paramount in the UZ Brussel’s philosophy.
To read about the UZ Brussel’s mission and values, go to:Link to mission and values
2012 was a special year for Christophe. However, he finds that gaining his doctorate was just the beginning. In order to continue to do research, he needs to find funding. In December 2012, the Friend for Life Fortnight was organised at the UZ Brussel. In the staff canteen Christophe is given a folder and a promotional cookie. This initiative also helped to finance the Apple Garden, a unique living, learning and play area for young cancer patients and other sick children at the UZ Brussel. Christophe believes that Friend for Life is a solution to this issue. 2013 provides new perspectives... The ‘switch’ has only just begun.
The health care sector’s financial needs are increasing while the available public resources are shrinking. A university hospital is structurally underfunded and needs to look for alternative financing. This applies all the more to a university hospital, because apart from providing health care it also has a duty to provide training and carry out research. This is why the UZ Brussel decided to professionalise its fundraising policy in 2012. UZ Brussel’s response includes ‘Friend for Life’.
Linda Sonck, Friend for Life manager
Friend for Life is more than just an alternative source of funding. ‘Friend for Life’ gives people the opportunity to express their thanks and to show their commitment to all the work that is done here at the UZ Brussel. That’s why we prefer to talk about ‘Friend-raising’ at the UZ Brussel.
Argenta offices have made a commitment to raise one million euros by 2015 to fund the construction of the Apple Garden. The Apple Garden is a cosy and safe place at the children’s hospital where children can be children again. They can play and learn and put the worries they encounter every day aside for a little while.
Support the UZ Brussel or a specific department or doctor of your choice at www.friendforlife.eu:
People can also choose to include the UZ Brussel or any of its departments in their will. Testament.be deals with all requests.
* French version
The UZ Brussel ends the year 2012 with a profit of 3.7 million euros. This is an increase compared with the 2011 profit (2.8 million euros). The profit is immediately reinvested in the hospital but it is still not enough to realise all of the UZ Brussel’s projects. This is why the hospital is also tapping into alternative sources of funding, for example through gifts and bequests.
In 2012 hospital operations grows as follows: +1.1% in terms of classic hospitalisations, +6.4% for day hospitalisations, +2.9% for technical services, and +3.5% in terms of consultations. The number of procedures decreases with -1.2%. However, this is not a hospital-wide phenomenon. Evolutions in certain departments play an important role. The decrease in procedures is mainly due to the transfer of activities from the operating theatre to the outpatient clinic.
The operating income, which is related to the actual operations, is 5.7 million euros or 1.6% of operating revenues.
It is important to continue on the same path in the coming years: everything is being done to strengthen our positive operating income. Different elements require an improvement in the operating margin: the relentless pressure of cutbacks in health care, the financial coverage of pension liabilities, financing the spatial plan, ongoing investments and financial risks associated with certain government plans (in compliance with the law on public procurement in the area of medicines, new hospital financing systems, etc.).
|Operating income / revenues||+1,3%||+0,8%||+1,6%||+1,0%||+1,6%|
|Profit of the year||-14,0||6,5||2,9||2,8||3,7|
Christophe sees it every day: a lot is changing at the UZ Brussel. Several projects are already underway to help us work more efficiently. One of these is the ‘Lean’ project which encourages employees to continuously improve their daily operations. Small changes often provide the biggest benefits. One example is storing clothing at the most accessible place according to people’s height. Christophe is experiencing first-hand how much simpler and more efficient this is.
The UZ Brussel is shaping the future with numerous large projects. Prioritising, planning, monitoring, reporting… all this is essential to ensure the ultimate completion of these projects. The hospital is professionalising its project development under the name ‘Nexus’. Part of Nexus is Lean working, in other words continuously working together to improve daily operations by addressing small issues step by step. After all, improvement doesn’t only come about through large projects, but also in daily work.
The Nexus project methodology was further consolidated in 2012 and implemented in medical and support departments.
The objectives are:
Over the past year the focus was on the implementation of the hospital’s priority projects and the further implementation of Lean principles.
In 2012, the concept of ‘Lean’ work was further implemented across the UZ Brussel. Lean is not about working harder or faster, but about working in a ‘smarter’ way. The starting point is situated in practical issues: you scrutinise everything you do and look at how it could be done better. Then, if there is a problem, you identify the cause and look at who can do what to solve it.
Since its introduction the application of Lean principles and methods has really taken off in the health care sector. The reason is obvious. Correctly implemented, Lean can lead to a sustainable improvement of quality, safety and efficiency. The Lean principles help the hospital to:
During the past year all head nurses completed a training course on the principles of Lean working. And it didn’t stop there. The departments that participated were provided with guidance and given a number of tools to use. The operating theatre at the Centre for Reproductive Medicine, Bioengineering, the Logistics Department, the Pharmacy and the Traumatology Nursing Unit were among the first to attend the workshop and brainstorm with the whole team.
Inge Cooreman, orthopaedics head nurse
It's often just a question of using your common sense and having the courage to think out of the box. Minor changes allow our department to function much more efficiently and you can sense that there is a more pleasant atmosphere among staff.
Low PC chairs were introduced in the department so that midwives do not have to stand all the time when entering data in the electronic nursing records in the corridors.
Lean working allowed phone calls to be answered more quickly at the consultation reception desks. The proportion of missed calls fell from 26.6% of calls in 2009 to 22.7% in 2012. Over the same period, the average time to answer a call fell from 45 seconds to 24 seconds. In 2009, 60.2% of calls were answered within 100 seconds; by 2012 this figure had improved to 82.9%.
In order to shorten the waiting time for patients who wish to register for admission to the hospital in the morning and to optimise their transfer to the ward and the operating theatre, the relevant departments have modified the operation of the Cashier-Registration-Admission department: extra staffing, earlier opening hours, more effective collaboration across the departments... With success.
In the operating theatre of the Centre for Reproductive Medicine the laboratory clothes were arranged from large to small. The smallest suits were stored on the top shelf and the largest at the bottom. This was not very logical, because smaller people were not able to reach their suits very easily and taller people had to bend unnecessarily. Thanks to the Lean principles the suits are now stored differently: the smallest at the bottom and the largest at the top. A small but important change that will benefit employees’ backs.
The Harmonia project aims to establish a purchasing platform between hospitals. In order to cope with rising commodity prices and changes in our suppliers’ markets, the UZ Brussel is collaborating with two other hospitals in Brussels (Chirec and Sint-Jan). By increasing purchase volumes, the hospital can negotiate better prices and expect a higher level of service from its suppliers.
For a regular and correct follow-up of revenues, budget preparation and ready access to sufficient liquid assets, it is essential that the services performed and products consumed are invoiced in full and on time. Clear agreements were made on how the various departments involved in the invoicing process (financial services, pharmacy, information processing and patient administration) would collaborate in order to achieve this. The process is monitored on a weekly basis using various critical performance indicators. In 2012 the invoicing period was limited to one month after the end of the month in which the service was performed. The completeness of cost recovery of the monthly invoicing increased by 20% and the percentage of invoices containing an error decreased by almost 30%. At the end of 2012 the outstanding receivables for services performed had decreased by 23.5%, or more than 37 million euros.
Requests for medical imaging are entered electronically in the EMR by the requesting department, rather than on paper. This allows the medical imaging (radiology) department to consult the requests in the EMR. It also avoids mistakes being made due to illegible handwriting or forms getting lost. Furthermore, it is a much faster process for all concerned, staff as well as patients.
During the defence of his doctoral dissertation the jury didn’t exactly make things easy for Christophe, but he defended his research with gusto. “Life begins now” his supervisor, Professor Paul Devroey, had told him beforehand. A slight exaggeration, perhaps, but the doctorate that Christophe was awarded in 2012 is in any event the well-deserved reward for four years of intensive research. This was a ‘switch’ that formally makes him an accredited researcher.
In addition to health care and education, research is one of the core missions of a university hospital. Many people are engaged in research at the UZ Brussel.
And that pays off...
Alongside health care and training, academic research is a fundamental task of any university hospital. The level of success in conducting academic research also largely determines how the hospital and university are financed.
Academic research is one of the hospital’s tasks as well as that of the faculty of Medicine and Pharmacy at the Vrije Universiteit Brussel. Researchers often work physically in both places. One of the reasons why the University Medical Centre (UMC) was established was actually to optimise the interaction between the faculty and the hospital in the field of academic research and other areas.
Providing guidance to researchers when applying for and acquiring research funds is the mission of the Research Management Department. In 2012 a UMC research manager was appointed as the central point of contact for any questions related to academic research within the context of the UMC. Information about external financing and funding channels now reaches researchers more effectively. Furthermore, the procedures, opportunities and benefits of knowledge transfer/technology transfer have also been made more widely known within the hospital.
Aude Bonehill, UMC research manager
It’s my job to help researchers with the financial side of their research activities.
The Queen Elisabeth Medical Foundation (GSKE) awarded the “ING prize”, to a value of 15,000 euros, to the research team headed by Professor Ilse Smolders and Professor Ann Massie of the VUB for the research project “Unveiling the role of the cystine/glutamate antiporter (system Xc) in hippocampal functioning, mechanisms of epilepsy and its comorbidities: a new era for future drug treatment”.
Professor Wim Distelmans has received the Lucien Steinberg Prize for his activities concerning palliative care and euthanasia. The prize is awarded by the Antwerp Masonic Lodge and honours academic medical research every year. This includes a cash prize to fund further research.
Cardiologist Pedro Brugada was awarded a gold medal by the European Cardiology Society in Munich for his academic research. As the person who discovered the hereditary syndrome which can cause sudden cardiac death, Professor Brugada is one of our country’s most important cardiologists. These medals are awarded each year for outstanding careers in cardiology and are considered to be one of the most important awards in the field.
Thierry VandenDriessche is Head of the Department of Gene Therapy and Regenerative Medicine at the VUB. He has been active in the field of gene therapy since the early 1990s and, earlier in his career, worked with pioneers Dr Michael Blaese (National Center for Human Genome Research, USA) and the late Dr Marshall Nirenberg, who received the Nobel Prize in 1968 for unravelling the genetic code. Along with his colleague and partner Marinee Chuah, Thierry VandenDriessche became the first to cure haemophilia in experimental animals.
Professor VandenDriessche recently received two awards for his academic research: the “Outstanding Achievement Award” presented at the 20th annual conference of the European Society of Gene and Cell Therapy, and the Professor Baron Marc Verstraete Prize. This prize is given for original academic work in the field of haemato-angiology and is awarded by the Royal Academy of Medicine.
Inge Mannaerts (Liver Cell Biology Laboratory, LIVR) was awarded the BASL research grant for her work entitled “Modulation of liver fibrosis by liposome-mediated selective targeting of hepatic stellate cells”. This prize is awarded annually by the Belgian Association for the Study of the Liver. That fund was established with the aim of supporting young researchers in the field of clinical and/or basic liver research.
During the latest meeting of the American Society of Hematology in Atlanta USA, two young researchers from the Faculty of Medicine and Pharmacy at the VUB, Brenda De Keersmaeker and Els Van Valckenborgh, received a Junior Award (US $ 50,000 each) from the International Myeloma Foundation.
Brenda De Keersmaeker’s project will carry out an in vitro evaluation of a new immunotherapeutic strategy to combat multiple myeloma. Els Van Valckenborgh’s project will examine how tumour cells can regulate the generation, expansion and function of myeloid-derived suppressor cells (MDSCs). Unravelling these mechanisms will help us to better understand the development of myeloma and to develop new therapies to improve the treatment provided to patients.
In 2012 the UZ Brussel opened a renovated dialysis unit in the AZ Jan Portaels (General Hospital Jan Portaels). A general hospital is not an island. Once again, in 2012 several collaborative projects were established in a variety of areas, both at home and abroad. At the time of the opening, Christophe was travelling around India with his colleague Dominic to lecture on fertility problems. After all, the UZ Brussel is an authority on that subject. For Christophe and Dominic it’s only logical that they share their expertise, while at the same time expanding their own store of knowledge.
Mutual cooperation between hospitals is essential. On the one hand, it allows patients to transfer more smoothly from primary to secondary or tertiary-level treatment. On the other hand, this is due to the fact that the government encourages collaborative projects since they are in keeping with the aim of optimising health care programmes. In 2012 the UZ Brussel established several new partnerships. A few examples are given below.
The collaboration with the General Hospital Jan Portaels in Vilvoorde aims to maintain a recognised care programme for children. Paediatricians from the UZ Brussel are responsible for areas such as on-call duty in the paediatric ward of AZ Jan Portaels. This also enhances the UZ Brussel’s role as an academic paediatrics department.
Since 2012 dialysis patients from the Vilvoorde area can make use of a renovated haemodialysis (kidney dialysis) unit at the UZ Brussel. This department is located on the site of the General Hospital Jan Portaels.
Geneticists at the Centre for Medical Genetics provide a number of prenatal genetic consultations at the Brugmann University Hospital (CHU Brugmann), Brussels.
The UZ Brussel and CHU Brugmann were recognised by the Flemish government as the Flemish Centre for the Detection of Congenital Metabolic Disorders (VCBMA). The VCBMA was launched in 2012.
Due to a number of nephrologists leaving the CHU Brugmann, the UZ Brussel has stepped in to provide the neighbouring hospital with support in order to address this acute problem. Professor Wissing from the UZ Brussel is the temporary head of the nephrology department.
The UZ Brussel is providing temporary support to overcome the shortage of diabetologists at the Sint Maria Hospital in Halle.
The Centre for Reproductive Medicine (CRG) has had a hub in Kuwait for several years. The CRG has also been active in Abu Dhabi since 2012. These initiatives were taken to meet the needs of the many patients who came to the CRG from the Middle East, without compromising the services provided to Belgian patients.
A summary of the collaboration to date:
Hospitals also share expertise through a network of professional associations. To name one example: in 2012 general administrator Jan Beeckmans was appointed as Belgian representative in the ‘Governing Council’ of the International Hospital Federation (IHF).
Christophe gained his doctorate in 2012 and was later appointed clinical professor. All medical heads of department at the hospital also teach in their area of expertise at the faculty of Medicine and Pharmacy of the Vrije Universiteit Brussel, to which the UZ Brussel belongs. The university and hospital work closely together, both in terms of research and teaching. This provides advantages for both patients and students. It is precisely this combination of health care, research and training that appeals to Christophe and explains why he enjoys working in a university hospital.
Along with health care and research, training is one of the three cornerstones of the UZ Brussel’s operations. In order to perform this core task, the UZ Brussel works closely with the faculty of Medicine and Pharmacy at the Vrije Universiteit Brussel to which it belongs. Both are located on the green campus in Jette
Prof. Paul De Knop, rector of the Vrije Universiteit Brussel
Universities can only function as places where scientists can think and work in an independent and unrestricted way, if there is enough academic freedom in the universities.
The further expansion of the University Medical Centre was an absolute priority for the Faculty of Medicine and Pharmacy in 2012. The aim of the UMC is the development of an integrated policy for an academic and professional training centre, a scientific and translational research centre and a highly regarded medical care centre on the Jette Campus. In preparation, a strategic seminar took place at the beginning of 2012. The new agreement between the faculty and hospital for the period 2013–2017 was finalised at the end of 2012 by both Boards of Directors. Likewise at the end of 2012, a UMC Committee was established under the chairmanship of Dr Guy Peeters.
The growth in the number of students at the faculty of Medicine and Pharmacy confirms that both the faculty and the Jette Campus are attractive to potential students. The faculty has experienced a significant increase in the number of students in recent years. The total number of students enrolled at the faculty continued to grow in 2012–2013 by almost 6.8% (from 1,751 to 1,870). The number of first generation students increased by 17.2% (from 192 to 225). The number of students of pharmacy has grown considerably in recent years (with 95 students entering the first year Bachelor of Pharmaceutical Sciences programme this year) and there was also a growth in the number of students studying Social Health Sciences and Gerontology. The number of students in the first year Bachelor’s Degree in Biomedical Sciences increased over the past three years from 94 to 233. Every effort will be made to attract more first generation students of medicine.
One of the training programmes is for the Medicine Degree, which has recently undergone a metamorphosis. This is due to a recent European directive which stipulates that the number of years to complete a Medicine Degree has to be reduced from seven to six years at all Belgian universities. This means that the Medicine Degree course of the Vrije Universiteit Brussel looked completely different at the start of the 2012–2013 academic year.
HThe new study programme is divided into consecutive biennial programmes. In the first and second bachelor years the main focus will be on the basic sciences, the structure and design of cells in the body. The next two years will focus on providing students with clinical training, building on the basic sciences. Lastly, the second and third Master’s years focus on developing clinical skills in an academic context, in which the clinical and academic internships will be combined with seminars and courses. Numerous opportunities for internships will be provided during the Master’s years of the updated Medicine Degree programme at the VUB. Full clinical and academic internships in which students have to perform tasks (not just observe them being performed) are undertaken as early as the second Master’s year. The transition from the old to the new curriculum is taking place gradually. However, students who are still in the old curriculum already find themselves facing a change: they will also have more internships in their second and third Master’s years.
Professor Nicole Pouliart, training manager and internship instructor
Our wide range of internships remains the big difference between us and other institutions. There is also a strong emphasis on individual guidance during these internships.
The green campus of Jette also hosts students who are studying nursing and midwifery at the UZ Brussel in order to learn hospital practice. The UZ Brussel hosts nursing and midwifery interns from the Erasmus University every year, as well as from various colleges in Flanders and Brussels.
The number of applications for nursing and midwifery internships is increasing: from 320 in the 2008–2009 academic year to 725 in the 2011–2012 academic year. Given the Department of Nursing’s specially developed internship policy at the hospital this is not surprising. For example, there is a mentoring system in place which requires every nurse at the UZ Brussel to offer support and provide guidance to students. Student brochures are also being developed with information on all of the hospital’s internship opportunities. As this shows, the UZ Brussel’s aim is to create a personal welcome package for its interns.
The UZ Brussel provides a personal welcome for the students on the very first day of their internship. They are given a badge, their own locker and computer login information. On their first day, they are not expected to arrive at their allotted place until 10 a.m. after the first busy period has quietened down and the head nurse or mentor is able to devote sufficient time to their introduction and induction. All students are visited weekly for a feedback session. The evaluations have shown immense satisfaction among the interns.
In 2012 the Specialist Medicine programmes in Flanders were put under the microscope by a review committee. The Master’s Degree in Specialist Medicine (Specialist Doctor Training) at the VUB was the only course in Flanders to receive a positive final assessment from the review committee. The European Master’s Degree in Disaster Medicine was even rated as excellent. These positive evaluations were not a coincidence. The VUB has seized the opportunities provided by the introduction of the Master’s Degree in Specialist Medicine, together with the UZ Brussel, to implement some changes and thereby further optimise the specialist training. A substantial expansion of the medical staff has led to excellent guidance being provided during on-the-job training. At the same time, it has given us the scope to provide training to both specialist doctors in training (Specialty Registrars) and traineeship supervisors.
In recent years the faculty of Medicine and Pharmacy has established a good collaborative relationship with its alliance partner, the faculty of Medicine and Health Sciences at Ghent University. In 2012 both institutions took stock of the cooperation between the departments as well as the hospitals. The result of this evaluation was extremely positive and both parties reiterated their intentions to continue the cooperation, including a possible expansion to include the faculty of Medicine at the VUB and even the Erasmus University Hospital as a third partner.
Internationalisation is another important objective of the faculty of Medicine and Pharmacy. The faculty has already achieved an internationalisation standard of 20/20. This standard, which was issued in April 2009, states that “in 2020, at least 20% of those graduating in the European Higher Education Area must have either studied or completed an internship abroad.” This has financial implications given that the Flemish government will have to give more weight to credits earned elsewhere. The faculty will therefore seek to encourage visits abroad by lecturers, assistants and students, and especially try to acquire more Erasmus grants. This increases the international visibility of research centres, further develops international networking and attracts more foreign researchers. The number of courses taught in English will also be increased in the coming years.
The faculty of Medicine & Pharmacy has a good collaborative relationship with the faculty of Physical Education and Physiotherapy. In 2012 an interdepartmental working group was established to examine how anatomy training, provided jointly by the two faculties, can be streamlined even further.
The Centre for Reproductive Medicine (CRG) where Christophe works was expanded in 2012. By 2020, however, the hospital will have been completely modernised, making it a pleasant place to be cared for and to work. The UZ Brussel has three major construction projects in the pipeline. In 2012 the large temporary building housing the Casualty Department and other units was completed and taken into use. Christophe believes that this is an extremely exciting time to be working at the UZ Brussel, helping as he is to build something new.
The UZ Brussel currently has a lack of space, with departments situated at numerous locations around the hospital. Furthermore, the infrastructure in some departments is outdated. Since the hospital was opened in 1977, health care has evolved and the hospital must evolve too. That is why the UZ Brussel is continuously working to improve its infrastructure. The long-term goal is to create a completely modernised hospital on the existing campus by 2020. The timing of the implementation depends on the funding.
The UZ Brussel’s Spatial Plan envisages three major construction projects to expand and reorganise the existing hospital into a modern, logically structured hospital. The building must meet the needs of patients and care providers.
The core aim of the spatial plan is to cluster departments together, to develop growth scenarios, to separate circulation routes (patients, staff and logistics) and to expand the surface area. In implementing these projects, the work is carried out in phases and planned in such a way that operational disruption and relocation activities are limited and medical continuity and quality can be guaranteed.
The Spatial Plan consists of three major construction projects, designed according to the concept of CARING architecture.
By developing the concept of a ‘healing environment’, the UZ Brussel aims to create a fresh, restful environment which contributes to the patient’s recovery process. Buildings must be easily accessible and comfortable while providing the patient with privacy and support. A survey of patients and visitors indicated that access to the hospital, clear signage and rest are perceived as important.
Buildings must support care programmes and departments. They must create a positive work environment for our employees so that they can fulfil their duties under optimal conditions.
The UZ Brussel is located in a green environment. Creating green areas between the buildings helps them to blend into the surrounding nature. The landscape architects agency OMGEVING (“ENVIRONMENT”) is developing a strategy for this, as well as various procedures involving the landscape.
The Spatial Plan is divided into two main phases, VIPA 1 and VIPA 2, each consisting of a number of sub-projects/construction phases.
In order to create VIPA 1, the hospital builds temporary constructions for instance for the Casualty Department and Oncology.
In 2011 an application was submitted to the Flemish government to subsidise the construction projects included in VIPA 1. Depending on the allocation of grants and permits, these projects would be completed by 2021.
Closing the building structure at the rear of the hospital complex to obtain a more concentrated building structure. The UZ Brussel’s centres of expertise will be located and expanded in this new building.
The hospital is now 35 years old. It is in urgent need of renovation so that patients can be given the best possible care. This is why we cannot wait for phase 2 to carry out certain aspects of the work. A number of temporary structures to house the casualty department, the oncology centre and other units have therefore been built to ensure proper care for patients.
The UZ Brussel is relying on financing from the Flemish and Federal governments in order to complete this project. 60% of the construction costs should be funded through grants from the Flemish Infrastructure Fund for Personal Affairs (VIPA).
Christophe is in Room 206 of the UZ Brussel’s maternity ward visiting his cousin and neighbour Nathalie, who has just given birth to a healthy baby boy called Julien. Nathalie is one of over 29,000 patients hospitalised for a number of days in 2012. The UZ Brussel regularly asks patients whether they are satisfied and what they think can be improved. GPs and specialists are also asked to share their views. And the UZ Brussel scored very highly in the 2012 survey of the Belgian consumer organisation 'Test Aankoop/Test Achats'. And ofcourse the UZ Brussel also listens to its patients.
In mid-2011, Test-Aankoop/Test-Achats conducted a study among GPs and specialists into the reputation of Belgian hospitals. The results were published in the organisation’s magazine Test Gezondheid ('Health Test') (No. 108 - April/May 2012).
Test-Aankoop/Test-Achats study focused on 13 specific areas which are very serious and complex in nature. The UZ Brussel has a good reputation in the treatment of these conditions. Furthermore, the UZ Brussel is one of three institutions which GPs and specialists in Flanders and Brussels consider to be one of the best and is even ranked second overall. Compared with a similar survey conducted in 2005, the hospital has made significant progress in 8 of the 13 disciplines surveyed. The poll is not an academic evaluation of medical care, but it does give an impression of how GPs and specialists view the medical care provided in the UZ Brussel. Nonetheless, that perception is a positive indication. After all, a GP or specialist’s perception grows over time and is based on his or her experience with the health care provided and the personal observations of his or her patients. In September 2012 a new Health Service Ombudsman was appointed: Professor Denis Schallier. He is the head of the Medical Oncology Department.
Professor Denis Schallier, Health Service Ombudsman
Any GP who has a complaint is welcome to contact me. I will listen, consider whether or not the complaint is well-founded, and attempt to respond to the complaint.
In 2012 a total of 1,080 cases were handled by the Ombudsman Liaison Unit at the UZ Brussel, a slight increase compared with 2011 (1,010 cases). This trend is noticeable in all Belgian hospitals and is undoubtedly the result of information campaigns run by the government for several years to raise awareness of ombudsman services in hospitals.
628 of the 1,080 cases involved complaints. Some complaints led to internal procedures being reviewed and improved. Besides handling individual patient complaints, one of the aims of the ombudsman service is to recommend improvements in the provision of care. For example, complaints related to the lack of clarity in respect of invoices have led to improved communication regarding issues such as the fees charged by doctors and other providers. As a result, patients are now visited in their rooms with a portable PC, for example, in order to give them details about the cost of their hospitalisation. Patients are then given a detailed overview of the elements that make up the total cost. Another example, related to the health care itself, is the fact that concerns expressed by family members regarding the fixation (a surgical procedure) of a patient in 2012, have led to the development of a fixation procedure and an information leaflet for patients’ families.Contact the ombudsman
The number of hospitalised patients increased to 23,692 in 2012, an increase of 1.1% compared with 2011. This increase was primarily in scheduled admissions (+1.6%). The admission of emergency cases increased by 0.6%. In the year under review, 47.8% of patients were hospitalised from the casualty department (2011: 48.0%).
A significant increase in the number of admissions was recorded by the pneumology department (+365 or +17.6%), oral and maxillofacial surgery (+126 or +262%), heart surgery (+111 or +30.2 %) and plastic surgery (+97 or +32.3%).
The number of day hospitalisations (excluding minimum flat rates) increased to 29,239 (+6.4%). The proportion of outpatient care in the total number of hospitalisations amounted to 44.8% in 2012 (2011: 43.5%). The departments with the greatest increase in outpatient care were anaesthesiology (+1053 or +36.2%), gastroenterology (+418 or +30.5%), clinical haematology (+301 or +20.4%), oral and maxillofacial surgery (+290 or +103%), neurosurgery (+224 or +188%) and orthopaedics and traumatology (+147 or +37.1%).
The number of surgical procedures performed in the main operating theatre, the CRG and the ophthalmology operating theatre, fell by 1.2% to 18,295. The decline in the number of procedures was only found among ambulatory patients (-7.0%) (hospitalised patients: +2.8%). The number of scheduled procedures decreased by 1.5%, while the number of urgent procedures increased by 4.6%. The credit note value per operation increased by 9.9%.
Classified according to the site where they were performed, the number of procedures in the central operating theatre remained stable (+0.5%). Taking into account the transfer of colonoscopies to the outpatient clinic, there was an increase in the activities in the central operating theatre (+3.7%). The number of operations conducted in the CRG decreased by 4.3% (due to renovation of the lab).
An increase in the number of procedures was noted in oral and maxillofacial surgery (+257 or +93.5%), orthopaedics and traumatology (+149 or +6.3%), plastic surgery (+144 or +21, 1%), neurosurgery (+109 or +12.0%), urology (+86 or +10.3%) and cardiac surgery (+81 or +12.3%).
The number of consultations, excluding emergencies, increased by 3.5% to 288,335 (compared with 278,593 in 2011). In absolute figures, the fastest growing departments are plastic surgery (+1,727), anaesthesiology (+1,666), physical medicine and rehabilitation (+1,631), oral and maxillofacial surgery (+1,547) and dermatology (+1,073).
In the year under review, 64,734 patients presented themselves at the casualty department (+0.1% compared with 2011); 21.6% of these patients were hospitalised (2011: 21.5%). The number of triaged patients was 37,383 (compared with 31,328 in 2011; +19.3%), which is 57.7% of the total number of patients (2011: 48.4%).
The number of technical services, excluding operating theatres and clinical biology, was 897,265 in 2012. This is an increase of 2.9% compared with 2011.
Christophe appears as a recurring theme in this annual report. When UZ Brussel’s Communications Department asked him to act as the main character, he hesitated. In 2012 UZ Brussel started its ‘switch’ to a modernised hospital and the Communications Department thought that Christophe symbolised that transition very well, partly because Christophe was in the process of making a switch of his own. This was why he finally agreed to take part. What ‘switch’ was he making? Follow his journey throughout the annual report.