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Annual report

Cover: doctor-specialist in training on the Emergency section

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00 VISION 01 CARE 02 QUALITY 03 RESEARCH 04 TRAINING 05 PARTNERSHIP 06 INVESTMENT 07 SERVICES 08 GOVERNANCE

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Caring about people, beyond caring for patients

Jef Peeters, CEO, Ghent University Hospital

Health is paramount. More so in the 21st century than ever before. Today we are able to detect diseases at an increasingly early stage and more and more successfully, often before any real symptoms develop. As a result we are surviving many diseases and conditions that would have been fatal twenty years ago. This means that people are living longer and longer, but with an increasing number of chronic disorders. Healthcare still focuses on survival, and also more and more on improving comfort and providing a better quality of life. At the same time patients are rightly becoming more articulate, with a strong awareness of their rights, and the quality of care is growing and becoming more sophisticated. As a pioneer in health, Ghent University Hospital is constantly evolving. Together with our partners and almost 6000 employees, our aim is to develop in terms of excellence. For us, excellence means an outstanding level of care and comprehensive medical expertise. It also means: providing care to everybody according to a broad, all-encompassing approach. Excellence is also providing care that is accessible in all respects, and therefore a customer focus in all services that we offer. In this annual report we present UZ Gent as it is today: a dynamic organisation that is preparing in all areas for a highly ambitious, healthy future. On 1 October 2010 I took over the management of Ghent University Hospital from Professor Francis Colardyn. I have come to know UZ Gent as an institution that excels in the field of patient cure and care. Our leading status is also thanks to our very close working relationship with the Faculty of Medicine and Health Sciences of Ghent University, which is also located on our campus. We are also working more and more closely within a growing network of regional hospitals.

It is our mission not just to increase our high quality of care, but also to make this visible both on and off campus. We are doing this by investing in people, research, infrastructure and a focus on our customers. The principle underlying all these initiatives is the needs and wishes of our patients. This means caring about people beyond caring for our patients. Visitors to our campus will not fail to notice that we are investing large sums in modernising our infrastructure. Every day we receive around 15,000 patients, visitors, staff and students; in 2020 they will be able to stay, work, learn and undergo treatment on a modern and accessible campus. Growing together in excellence is our mission. Our almost 6000strong workforce is on the campus day in day out to turn this mission into a reality. All striving towards a common goal: to provide the very best modern care to every patient.

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Care
Leading expertise Neurophysiological Monitoring Centre
More than 100,000 Belgians suffer from epilepsy, and around 20% of the Belgian population from sleep disorders. From now on, both patient groups are able to attend the Ghent University Hospital Neurophysiological Monitoring Centre (NMC) for diagnosis and treatment. The centre offers a multidisciplinary approach to both children and adults, and is one of the largest of its kind in Europe. Continuous monitoring In the NMC, 27 nurses monitor patients with sleep disorders or epilepsy around the clock using video images, brain signals and other biological signals. This is essential in order to make the correct diagnosis and determine the most appropriate treatment for both groups. Sleep and epilepsy patients used to be monitored at four different locations within the hospital. Now its all under one roof, explains Professor Paul Boon, Neurologist and NMC Coordinator. Just like neurologists, somnologists or sleep experts combine video images with brain signals and other readings in patients complaining of insomnia or extreme drowsiness during the day. This also takes place in the case of children who are at an increased risk of cot death, hence the decision to combine epilepsy and sleep monitoring in children and in adults. We use video cameras to observe the patient and an EEG device records the brain activity using electrodes that are stuck to the skin. This takes place simultaneously. The data is centralised and then analysed. Sleep recording takes around 24 hours per patient. Epilepsy recording is carried out over four days or longer, because we need to monitor one or more seizures. Bundling expertise The NMC has 16 modern and pleasant single rooms and a separate childrens department. The nursing team specialises in epilepsy and sleep recording and is supported by technologists who are first to analyse the signals recorded. This data is then analysed in greater detail by the treating physicians from the various disciplines. The Neurology, Pneumology, General Internal Diseases and Paediatrics sections work together closely and bundle their expertise and equipment for this purpose.

We use video cameras to monitor the patient and an EEG device records the brain activity using electrodes that are stuck to the skin.

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First successful LESS procedures in Urology

January 2010 saw surgeons from the Urology section perform the first successful LESS procedure on a patient. LESS stands for Laparo-Endoscopic Single Site Surgery and is a more sophisticated version of the traditional laparoscopy or keyhole surgery. Just one opening is made for the laparoscope, usually in the navel region. This means that the patient is only left with one scar, recovers quickly and is likely to experience fewer complications such as post-operative pain, bleeding, wound infection or rupture of scar tissue. More and more complex surgical procedures using this technique will probably be performed in the future.

Circus skills applied in rehabilitation

Our younger patients in the Childrens Rehabilitation Centre are learning circus skills such as juggling, acrobatics and tightrope walking, combined with drama. The techniques help them to regain certain skills and vary from easy to highly complex. All children can take part, regardless of their limitations or disabilities. The children were proud to show off their circus skills at the Handelsbeurs in Ghent in May 2010. The chance to demonstrate their abilities boosts their self-confidence and assists with their social reintegration.

Improved follow-up for women with Turner syndrome

In Belgium, almost 1 in 2000 newborn baby girls suffer from Turner syndrome. This means that they are missing all or part of an X chromosome and will be susceptible to various medical problems throughout their lives. Once they have left the childrens clinic, this often also marks the end of all medical follow-up. Women who are not diagnosed with the syndrome until they have reached adulthood often also slip through the net. The Ghent University Hospital Turner Clinic now conducts three-monthly specialist consultations that combine the specialities with which women suffering from Turner syndrome come into contact. These specialities extend from Endocrinology and Cardiology, via Psychology and Ear, Nose and Throat Medicine, to Gynaecology and Genetics. By coordinating its approach in order to offer a comprehensive care package, the Turner Clinic aims to encourage women with Turner syndrome to undergo as much follow-up as possible.

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Multidisciplinary approach to life-threatening allergic reactions

Every year, around 50 people present at the Emergency Section with a life-threatening allergic reaction. Patients also report to other sections with serious allergic reactions to food, medication and bee or wasp stings. In such cases it is essential to lose as little time as possible. Once the allergic reaction is under control, the search starts for the cause and an appropriate treatment. This is a complex puzzle to which UZ Gent takes a multidisciplinary approach. To streamline this search and ensure that it runs smoothly, the hospital has developed an anaphylaxis care pathway. Established procedures The aim of a care pathway is to improve the quality of the care, explains emergency doctor Professor Peter De Paepe. One way that we do this is by coordinating all the steps that the patient goes through as effectively as possible. We have produced a series of flow charts for this purpose that ensure the care is consistent and set out in concrete terms for all care providers. In the Emergency Section our first concern is of course to stabilise patients who are experiencing a life-threatening reaction by administrating medication. This takes place according to established procedures for both children and adults. Aftercare is also provided according to a standardised approach. For instance, we will use fixed criteria to determine whether the patient needs to be given an EpiPen to take home on discharge from the Emergency Section. An EpiPen is an emergency pen that people can use to give themselves a shot of adrenaline if they experience another life-threatening allergic reaction. Allergy Network Based on their symptoms, patients discharged from the Emergency Section are referred to the appropriate section for further diagnosis and follow-up. Professor Philippe Gevaert, Coordinator of the Allergy Network, explains: A number of sections deal with different types of allergies: Ear, Nose and Throat Medicine, Pneumology, Dermatology, Paediatric Pneumology and Paediatric Gastroenterology. Finding the right specialist with the right experience is not straightforward. To make it easier to identify the cause of an allergy, all these sections, including the Emergency Section, work together within a unique Allergy Network. The network has a central allergy telephone number that both general practitioners and patients can call if they have any questions or are looking for information. A specialist allergy nurse is available to offer help and support. A detailed referral procedure is also in place so that patients know which specialist they need to contact and do not needlessly end up going round and round the hospital. On being discharged from the Emergency Section, each patient is given an information leaflet about the Allergy Network and an allergy card stating guidelines to follow in the event of anaphylaxis. The anaphylaxis pathway has been in place since Summer 2010. Peter De Paepe: All care providers within the Emergency Section now work according to a uniform approach. Patients receive clear information about the steps they need to take and find their way around more easily.

Central allergy telephone number: +32 (0)9 332 67 08

We have a central allergy telephone number that both general practitioners and patients can call if they have any questions or are looking for information.

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Click here to order your copy of the annual report.

Top quality care for people with paraplegia

UZ Gent has started to develop a paraplegia (paralysis of the lower limbs and torso) care pathway. The purpose of this pathway will be to streamline the route that the patient follows from admission to discharge, and to provide all therapists in the workplace with clear guidelines. To make sure that the patient receives the right care at the right time. Listening to patients Dr. Annick Viaene, Centre for Locomotor and Neurological Rehabilitation explains: The care pathway is designed for patients with paraplegia, but other disorders that cause symptoms of paralysis, such as multiple sclerosis, also qualify. We are focusing on patients aged 15 or over who present in the Emergency Section with a new injury, however we are also looking at patients with an existing injury who come to the hospital at a specific point in time to undergo a procedure. It is important for care providers to ask these patients detailed questions so that their habits at home, for instance with regard to urine and stool patterns, can be respected wherever possible. A lengthy process Patients who are admitted to the Emergency Section need to be referred to Intensive Care or to a surgery area as quickly as possible. They later end up in patient admissions, usually in Orthopaedics, Neurosurgery or Pneumology. The process ends with the patients discharge to the Rehabilitation Centre, home or to another institution outside the hospital. The patient often goes through a lengthy process and it is important that the care provided in the different departments is coordinated, states Dr. Viaene. Fellow therapists and patients also confirmed the major need for uniform guidelines. The main problem areas are bowel movement, catheterisation and pain policy, decubitus prevention and psychological support.

A patient often goes through a lengthy process and it is important that the care provided in the different sections is well coordinated.

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Click here to order your copy of the annual report.

Home haemodialysis for kidney patients

The Medical Kidney Diseases sections home haemodialysis project has been in full swing since 2010. Experienced nurses teach patients how to carry out haemodialysis and look after themselves fully independently at home, just like at the hospital. The patients must meet a number of requirements in order to take part in the project. They must be physically stable, have the right mental attitude and must not have undergone a transplant. The advantage is that patients can carry out dialysis at a time that suits them, and they are not dependent on the hospitals schedules. They can also carry out dialysis more frequently and/or for longer than allowed for in the traditional hospital schedule. Home haemodialysis takes some of the weight off the hospitals dialysis department, leaving greater capacity to admit patients who cannot carry out dialysis on themselves. Both patients from UZ Gent and from other centres can follow the training programme.

The admission nurse explains how the patient can prepare for admission, where the prescribed preoperative tests can be performed and provides detailed information about the procedure and the period of admission. The nurse assesses the patients care needs in order to draw up an appropriate timetable and coordinate effectively with the surgery schedule and set out the range of care options. He or she will also identify any care problems and restrictions in the patients home situation that could impede a smooth discharge from the hospital. These can include: a need for medical aids, home care, rehabilitation at another care institution and so on. If necessary, the Social Service is called in to help to prepare for the patients discharge, sometimes even before he or she is admitted. Patients have been found to be very satisfied with this additional assistance. Their time in the hospital goes more smoothly, particularly in the period between admission and surgery. Their expectations are realistic and, where needed, the Social Service has sufficient time to support the discharge planning process.

Clearer pictures of brain tumours

The Neurosurgery section is using an innovative method to get an even better picture of certain types of brain tumours during surgery. Three hours before the procedure, the patient is given a drink containing 5-aminolevulinic acid. The tumour tissue converts this product into a fluorescent substance. When the tumour is then examined under ultraviolet light using the surgical microscope, it lights up flesh-coloured. This makes it easy to see the border between tumour and normal tissue, which in turn enables the neurosurgeon to remove the tumour even more precisely, saving as much of the healthy brain tissue as possible. This technique is used in combination with other systems to ensure that surgery is carried out as effectively and safely as possible, in particular neuronavigation and intraoperative neurophysiological monitoring.

Psychosocial support for cancer patients

Around 1400 new cancer patients are admitted to Ghent University Hospital every year. Naturally these patients receive the most appropriate medical care. Over the past few years, this care has also been accompanied by better and better support services. Ten psychologists, eight nursing consultants and three social workers support patients during their time at the hospital. However, patients can still rely on support from their regular care providers later on during the outpatient follow-up period. In the last few years, UZ Gent has done pioneering work in the organisation of oncological care in Belgium and in doing so has consistently highlighted the importance of psychosocial support. Politicians have picked up on this message and have launched the National Cancer Plan. The majority of psychosocial care providers are funded by this Cancer Plan. This additional support for patients means that Belgium ranks amongst the top countries in Europe in the field of cancer treatment. Also within the Paediatric Haematology/Oncology section, the leading centre in Belgium, the medical team has been supplemented in the context of the National Cancer Plan with additional nurses, psychosocial staff and paramedics.

Well-prepared to the hospital and back home

Admission nurses have been introduced in the Orthopaedics outpatient clinic. Their task is to prepare patients as well as possible for their admission to and discharge from the hospital. Taking a detailed nursing case history in the outpatient clinic, after the medical consultation and the admission planning, and starting the preoperative preparations helps to improve the quality of admission.

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Jan van Meerbeeck: new CMO & Chief Physician

Professor Jan van Meerbeeck was installed as the new Chief Physician at UZ Gent on 1 December 2010. He is attached to the Pneumology section as a Pneumologist/ Oncologist, and over the past few years has focused on the organisation of thoracic oncology at the hospital. The ambitions and goals of the new Chief Physician integrate seamlessly with the vision of the CEO and the management. Key areas At an academic level, Jan van Meerbeeck is committed to raising the bar even further. We have selected four key research areas in which we already play a leading role and in which we want to improve our performance further still and achieve world-class status: genetics, oncology, immunology/inflammatory diseases and neurosciences. These research groups receive 250,000 on top of the standard investment budget, enabling them to recruit additional staff and leave their hands free for their research activities. In addition, the new Chief Physician also wants to further strengthen the links between the hospital and the Faculty of Medicine and Health Sciences in order to develop new cooperation agreements. Satisfied patients The medical care that we as a hospital provide must be of a high quality both now and in the future, that is beyond question, Jan van Meerbeeck explains his vision. But the preconditions also play an important role, and we are working hard in this area. Waiting times, accessibility, the cafeteria, and so on are all elements that have an impact on patient satisfaction. A much-needed effort is underway to recover lost ground in the field of building infrastructure. But throughout all this we must never forget that quality is primarily determined by the staff: doctors, nurses, paramedics and various support staff. In the long term, I foresee a shift in the tasks of doctors and nursing staff. Both are currently sometimes performing work for which they are overqualified. This cant continue, due to the future shortage of doctors and nursing staff. Nursing staff will take over the more routine tasks currently carried out by doctors. Auxiliary nursing staff and care professionals will take over part of the nursing staffs workload. Transmural care models As a university hospital, UZ Gent focuses on tertiary and quaternary healthcare. But according to Jan van Meerbeeck, the task of secondary hospital can also take on an academic dimension. There is currently a need for research into transmural care models in which the patient experiences a smooth transition between primary, secondary and tertiary care. After all, the care doesnt end on leaving the hospital. We need to play a leading role in the development of these care processes. This type of academic research is just as relevant in social terms as purely medical research.

The medical care that we provide must be top quality both now and in the future, but also the preconditions play an important role, an area of keen focus today.

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2010 in numbers: more day-clinic admissions

2010 saw the trend of an increasing number of one-day admissions continue. The total number of one-day admissions was 48,534: a 3.1% increase compared to 2009. This figure is remarkable for a university hospital that treats many severely to very severely ill patients. The development is all down to the massive progress achieved in surgical capability, medical technology and drug treatments. To guarantee patient comfort during one-day admissions, the hospital significantly increased its capacity for day surgery and inpatient day care in 2010. The number of overnight stays lasting at least 1 night rose by 3.4% to 35,952. There was also a rise in the number of surgical procedures and consultations, by 4.2% to 33,279 procedures and by 0.3% to 427,852 consultations. The number of bed days fell slightly (294,241 in 2010 compared to 294,306 in 2009). Transplant activities were similar to 2009. A total of 135 transplants were carried out: 8 heart transplants, 45 liver transplants (including 4 from a living donor), 3 pancreas transplants and 79 kidney transplants (including 11 from a living donor).

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Quality
LEAN management reduces waste, like waiting times, in the Dermatology outpatient clinic
Until recently, the busy Dermatology outpatient clinic had to contend with long waiting times to the frustration of both patients and staff. Head of Department Professor Jo Lambert introduced the technique of LEAN management in order to tackle the problem areas together with her staff. And with success: the lean way of working has significantly reduced waiting times, improved the quality of care and restored efficiency and calm within the department. Quality improvement Jo Lambert: The principle of LEAN management comes from the world of production. The aim is to make small changes in order to achieve a process improvement that benefits quality without making large investments. Our guiding principle are the patients needs: what does he want, what activities are useful for him during a hospital visit and what is waste that can be thrown out. A doctor making a diagnosis is valuable time. Waiting for half an hour before the doctor can see you is wasted time. Urgent consultation Jo Lambert worked with all her staff to closely examine the processes within the department. They came to the surprising conclusion that they themselves were partly responsible for the waiting times, but also came up with their own solutions to resolve the situation. In the past, all doctors started their surgery hours at the same time. This meant that a large group of patients arrived on campus and came to the outpatient clinic at the same time, leading to pressure and queues at the desk. By arranging for each doctor to start at five minute intervals, we have succeeded in eliminating this chaos. We have also started to work with more standards, often very visually. Following established procedures means that we dont waste time looking for materials, and the process is clear. These standards work. The argument that every patient is unique is to some extent a false analogy: most consultations follow established lines. Urgent cases are also not as unpredictable as they seem. We discovered that we see an average of around ten patients every week that require urgent attention. Now it is standard procedure to keep some time free so that we can attend to these people quickly without disrupting the rest of the schedule. Satisfied patients Other small changes have also led to greater efficiency and less time wasting: setting up printers closer to the consultation rooms, arranging appointments by telephone with the doctors at set times, improving the laboratory layout to name but a few. All these small changes have a phenomenal impact. We see patients two weeks after making the appointment in the general surgery hours, where previously this took six weeks. We see patients with urgent problems within the space of a week. Punctuality has also improved: patients spend much less time in the waiting area, which means they are happier. In the long-term we will not need such a large waiting area, which will give us more space for things that are useful to the patient. We held around 23,000 consultations in 2010, a record number for our department. And yet we didnt feel as though we were struggling to keep our heads above water.

Our guiding principle are the patients needs: what does he want, what activities are useful for him during a hospital visit and what is waste that can be thrown out?

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Click here to order your copy of the annual report.

Curse of the catheter

It is a global problem that far too many hospital patients undergo unnecessary urinary catheterisation. An equally common problem is that catheters are not removed quickly enough, and care providers are not sufficiently practised in inserting and looking after them. To remedy these problems, UZ Gent has launched an awareness-raising campaign: Curse of the catheter. Reducing infections As well as the question as to whether or not a catheter is indeed necessary, the duration of urinary catheterisation is also a crucial concern, emphasises Professor Willem Oosterlinck, Urologist. For every day of catheterisation, a patient runs a 5% risk of developing a urinary tract infection. This can in turn lead to serious complications and even multiple organ failure. After a month this risk is almost 100%. On an annual basis, all hospital infections combined total more than 80 million euro in healthcare insurance costs. At UZ Gent we focus on reducing the number of urinary tract and bladder infections by half by significantly reducing the use and duration of urinary catheterisation. New procedure The end of May 2010 saw the launch of a new standard nursing procedure at Ghent University Hospital for the insertion of long-term urinary catheters. The procedure specifically focuses on correct practice: the right indications, the contraindications, the materials and the method, explains hospital hygienist Pascal De Waegemaeker. The hospital hygiene committee drafted the accompanying guidelines for the use of long-term urinary catheters. The nurses play a major role in the catheterisation process, as they insert and remove the catheters on the doctors instructions. The most common incorrect indications for use cited by nurses themselves are urinary incontinence and patient comfort. Pascal De Waegemaeker: Nurses often insert a catheter out of habit, rather than out of medical necessity. In an ideal scenario both the doctor and the nurse should ask themselves each day whether urinary catheterisation is still necessary. The electronic patient file or EPD can help when making this decision. An updated observation sheet in the EPD is used to record the insertion and removal of long-term catheters, as well as the indication and the probable removal date, Pascal De Waegemaeker continues. This allows us to check on the success of our awareness-raising campaign and the impact in the longer term.

At UZ Gent we focus on reducing the number of urinary tract and bladder infections by half by significantly reducing the use and duration of urinary catheterisation.

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High quality standards for the clinical laboratories

The Medical Genetics, Pathological Anatomy and Clinical Biology laboratories operate according to the requirements of the ISO 15189 standard, a strict quality standard for medical laboratories issued by the official Belgian accreditation organisation Belac. 2010 saw a further rise in the number of laboratory tests that are carried out according to this standard to more than 200. This is evidence not only that the laboratories have an excellent quality system and deliver accurate, traceable test results, but also that they are continuously seeking to make further improvements. In order to obtain and retain accreditation, laboratories must perform internal quality inspections and prove to experts that their quality system meets the standards strict requirements. Whats more, a broad customer satisfaction survey in 2010 revealed that the requesting doctors are satisfied to very satisfied with the service provided by the medical laboratories at Ghent University Hospital.

Ombudsman beyond complaints

Our 6000 employees strive every day to achieve excellence in the services they provide. Nevertheless it can sometimes happen that the care, despite all efforts, does not fully meet the expectations of the patient or his or her family. If discussions with the relevant care provider or responsible party fail to resolve the problem, the patient can submit his or her comments, suggestions or complaint to the Ombudsman Service. The Service will then handle and follow up the complaint professionally and discreetly. In 2010 the Ombudsman Service handled 828 cases. The Ombudsman Service always strives to find a solution to the individual problem, but in doing so also generates valuable feedback on the hospitals performance. Based on this, the Ombudsman Service then formulates recommendations to ensure even better services, with the aim of avoiding similar complaints in future and further improving the care and services provided.

Award-winning purchasing department

In October 2010 our purchasing department won the silver Public Tender Award in a competition between institutions whose purchasing activities are governed by the Act on public procurement. Ghent University Hospital won the award for its professionalisation of purchasing activities, which has led to shorter procedures and savings. The jury assessed the project submitted based on the application of legislation and regulations, compliance, risk control, performance and social relevance.

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Click here to order your copy of the annual report.

Research
Focus areas for our top research: genetics, oncology, immunology and neurological sciences
The philosophy behind UZ Gents policy on determining aeras of toplevel research is to set priorities and invest in them. The scientific context has shifted from the regional to the global plane. Consequently, making choices in order to be able to operate at the highest level is essential. Ghent University Hospital has therefore selected four areas of research which will receive extra funding to further develop their position: genetics, oncology, immunology and neurological sciences. Ghent University Hospital already excels in all of these areas. The aim is to reach the top European or even global level within a few years thanks to the additional financial resources which are to be made available. Application of the results of research These four research areas were selected in consultation with Ghent Universitys Faculty of Medicine and Health Sciences on the basis of objective criteria: leading position recognised by peers, number of A1 publications, and involvement in current trends in epidemiology and healthcare needs. The translational nature and social value of research are also essential factors: rapid application of the results of research to provide better patient treatment. After all, the intention is that the policy of focusing on key areas should in the relatively short term lead to better, sophisticated treatments. This is the primary concern of a university hospital. Each of the four key areas will receive 250,000 euros in addition to their normal budget. These additional funds will allow departments to hire extra staff, freeing top scientists for more and better research. This extra funding does not mean that research groups in other areas will be disadvantaged. Ghent University Hospital invests in a broad range of research activities and continues to produce highly-trained professionals in all medical disciplines. It is merely making additional resources available for those fields in which it wants to reach and retain a leading position. Ghent University Hospital and Ghent Universitys Faculty of Medicine and Health Sciences share a campus. This promotes smooth cooperation. Advanced scientific research is combined with tertiary medical care on a single site. Researchers are working close to the patients they need for their work, and patients in turn can count on the most recent insights in medical care. Ghent University Hospital encourages a climate that promotes translational research.

These additional funds will allow departments to hire extra staff, freeing top scientists for more and better research.
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New leukaemia gene discovered

Researchers at the Medical Genetics Centre have discovered a gene that plays a crucial role in the development of a form of acute leukaemia, T-cell acute lymphoblastic leukaemia. The disease occurs in both children and adults. The gene lies on the X chromosome, which goes some way towards explaining why more men are affected than women. The gene also has a defect in almost half of all patients. This indicates that the gene plays a crucial role in the development of this type of blood cancer, and the finding may offer prospects for new treatments. The results of the research have been published in the authoritative journal Nature Genetics.

Scientific awards in 2010

The British Medical Journal Lifetime Achievement award for 2010 was granted to Prof. Dr. Marleen Temmerman, head of the Gynaecology section. She was praised by the BMJ for her outstanding and socially important scientific work which has won her an international reputation. Prof. Dr. Dirk Elewaut of the Rheumatology section won the InbevBaillet Latour Fund prize for clinical research. Dirk Elewaut was selected by the jury for his outstanding scientific research in rheumatology and immunology, in which he concentrates on investigating new strategies for the treatment of chronic joint conditions. Prof. Dr. Guy Brusselle won the COPD Research Award given by the European Respiratory Society. The prize, worth 50,000 euros, was awarded for his project on the Interrelationship of systemic inflammation, pulmonary inflammation, lymphoid neogenesis and airway remodelling in the pathogenesis of COPD. Prof. Dr. Bart Lambrecht of the Pneumology section received the ERS Maurizio Vignola Award on innovation in Pneumology, worth 20,000 euros, for his article House dust mite allergen induces asthma via Toll-like receptor 4 triggering of airway structural cells, published in Nature Medicine. Dr. Martine Cools of the Paediatric Endocrinology section won the Young Investigator Award of the European Society for Pediatric Endocrinology for her work on The molecular genetics at the interface between dysgenetic and streak tissue in gonads of patients with gonadal dysgenesis.

Invisible consequences of traffic accidents

Scientific research in the Paediatric Psychiatry section has revealed shortcomings in the way that traffic accidents are recorded in Belgium, and showed that accidents can have major but invisible psychosocial consequences. A written survey among more than 3,000 pupils in secondary education found that 6.2% of the young people questioned had already been involved in a traffic accident. 2.7% of them said that they had been injured in the accident. These figures are four times higher than official statistics. The research also found that 10.5% of the young people suffer mental problems after a traffic accident, such as posttraumatic stress disorder, anxiety or depression.

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Training
Ghent University Hospital as a training centre
Training students is one of Ghent University Hospitals main tasks. Future medical specialists and dentists receive high-quality training with a strong emphasis on practical work at UZ Gent. 87 doctors received their specialist qualifications in 2010. Students at the Faculty of Medicine and Health Sciences are also trained at the Ghent University Hospital campus. Training is given in various fields: medicine, dentistry, speech therapy and audiology, biomedical sciences, physical education and sports sciences, medico-social sciences and rehabilitation sciences and physiotherapy. Over 6,600 students were registered with the Faculty of Medicine and Health Sciences in the 2009-2010 academic year. The number of doctoral theses submitted to the Faculty is increasing year on year. More than 60 theses were submitted in 2010, an average of just over one a week.

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Click here to order your copy of the annual report.

Partnership
Partnerships with tangible results
UZ Gent is involved in far-reaching joint ventures with thirteen hospitals in areas such as care provision, scientific research, training and logistics. One feature of the partnerships is that the partner hospital is the first choice for patient referral, and that specialists from the partner hospitals can approach each other for advice or specific care. Trainee medical specialists can undertake part of their training in a partner hospital, and the hospitals also work closely together in scientific research. Network coordinator Prof. Dr. Koen Vandewoude: We want to bring care as close to patients as possible, and therefore we make academic consultants available to our partner hospitals. We all gain in terms of quality and efficiency by coordinating our activities better. And thanks to the good relations between doctors at partner hospitals, we are able to optimise medical care provision and exchange standards of care and good practices. New partners One of the new partners in 2010 is the AZ Nikolaas general hospital in Sint-Niklaas. We organise specialist consultations in human genetics and rare diseases at AZ Nikolaas general hospital, in the context of prenatal advice and care for patients with oncological conditions. We also help each other in fields such as cardiology, human body material, organ donation and organ transplant. We are also starting joint clinical research projects, especially in oncology, cardiology, nephrology and endocrinology-diabetology. Since 2010 we have also been working with AZ Sint-Elisabeth general hospital in Zottegem, AZ Sint-Lucas general hospital in Ghent, AZ Nikolaas general hospital in Sint-Niklaas and H.-Hartziekenhuis Roeselare-Menen hospital on the removal and supply of reproductive cells, stem cells and bone and tendon grafts. Ghent University Hospital also concluded around fifty cooperation agreements at section level in 2010 with hospitals in East Flanders, West Flanders, the Dutch region of Zeeuws-Vlaanderen, Brussels and Antwerp. Under these agreements, UZ Gent is the preferred partner for highly specialised care and provides advice where necessary. All the cooperation agreements entered into by Ghent University Hospital are open and non-exclusive.

We want to bring care as close to patients as possible.

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Healthcare of the future

Ghent University Hospital, Ghent University and Living Tomorrow have joined forces to present new medical technologies to the general public at the House of the Future in Vilvoorde. Health and well-being have a prominent role in this activity, as health information, awareness-raising and preventive health care have a great impact on general health and quality of life. In the guided tour on My health today and tomorrow, UZ Gent took a fresh look at topics such as healthy diet, diabetes, epilepsy, allergy, genetics, deafness, blindness, remote rehabilitation and ICT. On 22 September 2010 UZ Gent was one of the participants at the Future Health Care Event, at which representatives from business, government, the medical profession and academics came together to discuss the future vision of health care.

A close look at patients suffering from severe trauma

Once a month emergency doctors, intensive care specialists, anaesthetists, surgeons, orthopaedic specialists and neurosurgeons meet to discuss patients who have been admitted to the hospital with severe trauma. During these multidisciplinary consultations they conduct a detailed analysis of trauma care and the treatment trajectory which these patients are following. The aim is to detect and eliminate avoidable errors. From one minute to the next Prof. Dr. Oswald Varin is the coordinator of these MAT (Medical Audit Trauma) consultations. Treating patients with severe trauma is a complex undertaking, and their care and treatment require the input of many individuals. Bringing these people together at regular intervals enables us to improve the quality of care for these patients. This is how we analyse the trajectory that patients are following from one minute to the next: how much time elapsed between the accident and their admission to the Emergency section, what diagnosis and treatment was given, how quickly were they transferred to the operating theatre, when was the patient admitted to Intensive Care, etc. The first MAT consultations took place in 2009 and they are starting to bear fruit. Communication between medical practitioners involved in caring for trauma patients has been improved. We try to appoint permanent contacts and specialists from various disciplines who examine patients while they are still in the Emergency section. Good communication is vital. We have a checklist in the Emergency section which medical practitioners have to complete when a patient is brought in. This prevents us losing crucial pre-hospital information. Rapid transfer to operating theatre Our analyses had also shown that the process of transfer from the Emergency section to the operating theatre could be improved. For that reason we have devised a system to make it easier to free up a theatre for trauma patients requiring emergency surgery. Speed is of the essence in emergency medicine. That is why we also use standards that describe procedures step by step and leave no room for doubt. In 2010 the MAT team has started to discuss patients who did not recover after a serious accident. In these cases it is useful to find out whether death could have been prevented. Patients who have suffered a severe trauma have a good chance of survival in Ghent University Hospital. But we can still strive to improve quality by working on communication, logistics and the transfer of knowledge.

Bimetra promotes translational research

Bimetra was set up in 2010. It is a clinical research centre focusing on the translation and valorisation of biomedical research as part of a joint venture between Ghent University Hospital and Ghent University. Translational biomedical research is the process by which new insights or hypotheses (from clinical observations or fundamental or strategic basic research) are translated into new or improved preventive, diagnostic or therapeutic applications. The patient is at the centre of this research. Translational research always has a social and/or economic objective in improving preventive or curative medical practice. It is intended that Bimetra will eventually become a central point of contact for translational biomedical research on Ghent University Hospitals campus and liaise between specific sections and centres of excellence. To this end Bimetra is developing support platforms such as a central biobank, a platform to facilitate research, valorisation and monitoring of clinical studies.

Treating patients with severe trauma is a complex undertaking, and their care and treatment requires the input of many individuals.

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Better support for haematology patients

A haematology nursing specialist and consultant were appointed to the Haematology section in 2010. They work together to ensure that the treatment of patients with conditions such as leukaemia, who often require prolonged, intensive care, is better aligned to their needs. The nursing consultant works from the Oncology Centre and supports patients throughout their entire care trajectory: he gives patients more information about their condition and its treatment, accompanies them when they are having tests or treatments, or picks them up afterwards and, in consultation with the department nurses, ensures continuity of care and after-care. The consultant is the point of contact and advocate for patients, not only within the hospital but also throughout all the treatments they undergo. The nursing specialist is responsible for quality assurance and the development of haematology patient care by bringing scientific research into direct patient care. He also conducts internal and external training courses, and is jointly responsible with the head nurse for the organisation of haematology care. They are currently working together to develop a nursing consultation session for patients who need to undergo allogenic stem cell transplant. This will be an easy-access session that complements the medical consultation.

Ghent University Hospital is a Top Employer

Ghent University Hospital was officially recognised as a Top Employer in 2010. This status was granted following independent investigation by the CRF (Corporate Research Foundation) Institute, which recognises employers that stand out in five HR criteria: terms of employment, training opportunities, working conditions, corporate culture and opportunities for internal promotion. The hospital is therefore very attractive to young, highly-trained professionals in particular. To find out more about working at Ghent University Hospital, go to www.uzgent.be The workforce expanded to 5,707 in 2010, compared with 5,607 in 2009. The hospital offers an innovative working environment with good working conditions. Employees have great opportunities for continuous professional development.

UZ Gent had a delightful day out

Every two years UZ Gent organises a family day out for its employees and their families. The trip in September 2010 was to Planckendael zoo in Mechelen. The sunshine and blue skies helped to make the day a great success for the 4,000 participants.

D.R.U.G. has sister in the Netherlands

The Drug Research Unit Ghent has set up a sister department at Maastricht University Centre in the Netherlands. It deals with the early stages of clinical drugs research. Prof. Dr. Luc Van Bortel is the head of the Ghent D.R.U.G. and director of the D.R.U.M in Maastricht. The two centres complement one another. They are both capable of carrying out sophisticated drug research by cooperating with other specialist sections in their own hospitals. But they can also help each other: both groups can explore new areas of research by having access to each others expertise and specialists. In addition, economies of scale help even out the research workload when the centres are under extreme pressure. One of the first joint ventures carried out by the two groups is a Ghent-based glaucoma study in which patients from Maastricht are taking part.

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Click here to order your copy of the annual report.

Investment
New Surgical Day Care Facility
The hospitals brand new Surgical Day Care Facility came into use in mid-November 2010. Minister Jo Vandeurzen was present at the official opening ceremony in March 2011. Patients attending the Surgical Day Care Facility are welcomed as guests to a bright, non-clinical facility that from a visual point of view has little in common with a hospital. People who attend the Surgical Day Care Facility are not ill in the strict sense of the word. They are coming for a small procedure and so do not want to be treated as if they were ill, comments Philippe Boucherie, head of the Surgical Nursing and Post-Anaesthesia Care Unit section. We have done everything in our power to eliminate the hospital ambience: no cold, white corridors, but rather a curved wall with photographs of a birch forest running like an aorta through the department. The waiting room has picture windows with a fabulous view over the city. The unit has a number of attractive relaxation rooms, and ten single en-suite rooms. Walking to theatre Dr. Marc Coppens, head of department at the Surgical Day Care Facility: We want to guide patients smoothly through their stay so that they can return home after a short while. We have our own admissions facility where the paperwork is handled. This is immediately followed by a pre-operative check by our nurses. We keep patients away from a hospital ambience as long as possible, which is why they stay in the waiting room until the theatre staff tell us that they are ready for them. Then patients get changed into a dressing gown and slippers, and walk to the theatre under their own steam. We use short-acting anaesthetics for the operation, and apply the least invasive surgical techniques possible. Surgery is followed by optimum pain control which promotes recovery and ensures that patients can leave the recovery room sooner. Stretcher beds Once patients have been discharged from the recovery room, they can stay in a relaxation room or single room for a short time. We have decided to use stretcher beds here, explains Marc Coppens. This is a kind of seat that can be gradually raised as the patient regains consciousness. This helps them wake up and recover from the anaesthetic more quickly. As a result, they can be allowed to go home after a short time and in comfort. A patient who comes to the day surgery unit at eight in the morning is already on the way home at two p.m. The new Surgical Day Care Facility is the result of a merger between two former surgery day clinics. The number of patients that can be handled has risen from 36 to 52. The Surgical Day Care Facility also treats children who need an operation and who would formerly have been admitted to the Paediatric Day Clinic. The facility sees around 10,000 patients a year, including 2,000 children. The number of day admissions has risen sharply in recent years, and this trend is set to continue. The Surgical Day Care Facility is fully equipped for this growth thanks to improved efficiency.

We want to guide patients smoothly through their stay so that they can return home after a short while.
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Day clinics merge

The Haematology day clinic and the Gastrointestinal, Hepatic and Pneumology day clinic have been merged and expanded to form a single Blood, Respiration and Digestion day clinic that can treat 27 patients at a time. Patients due to undergo treatments that do not take a long time to administer have access to beds and comfortable chairs. The 13 nurses offer optimum care to patients with blood disorders or gastrointestinal, liver or lung conditions. Economies of scale have led to further improvements in the quality of care. But the new day clinic is first and foremost a more comfortable setting where patients can spend time in a friendly atmosphere. A day treatment can take several hours, so it is important for patients to feel at home. The OIGO lounge in the new Blood, Respiration and Digestion day clinic offers a comfortable area with easy chairs, multimedia and flat-screen equipment, a library and kitchenette. You wouldnt dream that you were in a hospital. This lounge was created by the OIGO, an association for cancer patients, as a way of allowing patients to spend time with visitors and relatives away from the ward. The day clinic also has a nice room which is used for discussions between medical practitioners, patients and relatives. It was made possible by one patients generosity.

Bunkers for two new linear accelerators

Two new bunkers have been constructed next to the existing bunkers in building K4. They will house two new linear accelerators used by the Radiotherapy section. They are replacements for two older machines. As a result, the section now has access to four modern linear accelerators that are used to irradiate tumours in cancer patients. They can perform around 30,000 radiotherapy sessions a year.

Super-fast CT scanners work with lower doses of radiation

The Radiology and Medical Imaging section has invested in two brand-new CT scanners. These machines are capable of displaying the smallest anatomical details at a speed which has never been possible before and using a fraction of the amount of radiation which older CT scanners needed. Much more accurate two- and three-dimensional images of organs and their blood supply are available for use in examining patients with strokes, pulmonary infarcts and some liver conditions. This is particularly useful when examining elderly patients or children, and can also be helpful when dealing with patients in the Emergency section and Intensive Care. A computer network allows the images to be viewed immediately and shared with colleagues in all other sections. The scanners use less than a third of the radiation dose that older devices used, without any loss in image quality. This combination is unique in Flanders.

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Click here to order your copy of the annual report.

Building for ever better care

Many major building projects are currently in hand on the Ghent University Hospital campus, which will dramatically change the appearance of the campus in the short and long term. New buildings are being erected, while existing buildings are undergoing thorough renovation and expansion. The new infrastructure will enable UZ Gent to guarantee even better care and an improved service to patients and visitors. New Childrens Clinic (K12D): a brand-new building with an interior designed completely with the comfort of children and parents in mind. The new building will come into use at the end of June 2011. The technical block of this building is also set for expansion: four new surgery areas, an enlarged Radiology and Central Sterilisation Section and a link to building K12. Expansion and renovation of the Rehabilitation centre K7: the first phase of construction work on the new Rehabilitation centre has been completed. The new building is finished, and the admissions departments are in use. They have all the comfort needed to make a prolonged stay as pleasant as possible. The rehabilitation centre will have deep-level underground energy storage facilities that act via boreholes: heat or cold, depending on the season, will be stored in an underground energy storage system. The building will be able to use this thermal energy to provide either hot or cold air whenever it is needed. Campus artery: an overground, covered walkway connecting various buildings on the campus. The campus artery will make it safer and more pleasant for patients to move from one building to the next, and will also cut travel time between the buildings. Out-patients and visitors will be able to travel through the campus using the footpath beneath the walkway. The campus artery will come into use in the spring of 2011. Construction of a third floor in the car park to meet the growing demand for parking space on the campus. At the end of 2010 work started on the renovation of the Anxiety and Mood Disorders, Eating Disorders and Psycho-Medical Unit of the University Psychiatric Section on the ground floor of building K12F. Ghent University is also investing on the Heymans Campus that it shares with UZ Gent. Building K3, home to the Faculty of Medicine and Health Sciences, is undergoing thorough renovation.

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Click here to order your copy of the annual report.

Click here to order your copy of the annual report.

IVF lab moves to brand-new clean room facility

Ghent University Hospitals Department of Reproductive Medicine celebrated its 25th anniversary with a move to a new home in the hospital. As part of this move, the IVF lab transferred to a brand new clean room facility, among the most sophisticated in Europe. It is here that UZ Gent hopes to help up to 5,000 couples a year to conceive. The Department of Reproductive Medicine (ARG) investigates the causes of infertility and treats them by hormone therapy, surgery or assisted reproduction techniques such as IVF. It will from now on be carrying out this work in the renovated Outpatient Unit 4, which has a bright, spacious interior that offers a restful, comforting atmosphere to patients and staff. Ultra-modern A modern, glass structure between Outpatient Units 3 and 4 catches the eye. This is the site of Ghent University Hospitals brand new clean room facility, which is home to a number of operations including the IVF laboratory. A clean room is a room in which staff work under controlled conditions with human tissues and cells, such as sperm cells and embryos. Special infrastructure and equipment ensures that the air quality and air circulation are as good as possible, so that the work can be done in a largely dust-free and entirely bacteria-free setting. This kind of facility is vital to a Reproductive Medicine department, as it is here that the human cells which are reimplanted during IVF treatment are created, comments Prof. Dr. Petra De Sutter, head of the ARG department. The number of treatments given has risen from 67 in 1987 to over 2,400 in 2010. The high-tech clean room which we now use also allows us to work with ovarian tissue and carry out stem cell research. As a result, we should be able to help even more people in the future. UZ Gents clean room facility is one of the first in Belgium to meet the very strict European and Belgian quality and safety standards for handling human tissue. Improvements in service provision The new infrastructure has also led to considerable improvements in service provision. Administration work has been separated as far as possible from consultation and treatment areas, so as to free up more space for clinical activities. Prof. De Sutter: We now have a lot more space, which means that waiting times are shorter and we can see more patients. The architecture radiates calm, and each doctor has a separate working space with two examination rooms and three consultation rooms shared by the doctor and the midwife. Patients go straight to see their doctor and do not have to hang about in a vast waiting room. The distance between medical professionals and patients is cut shorter. Patients then go straight to the midwife. The new infrastructure is very popular with patients, and is also a great advance for staff.

This kind of facility is essential for a Reproductive Medicine department, as it is here that the human cells which are reimplanted during IVF treatment are created.

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Click here to order your copy of the annual report.

Services
Ghent University Hospitals Disaster Planning Coordinator assists the Federal Public Service for Health
Geert Arno, nursing coordinator in charge of disaster planning, has been spending part of his working time assisting the Federal Public Service for Health since the first of July 2010. In his role as emergency planning process manager, he is responsible for creating and monitoring the skills profiles of all medical professionals who would be involved in a disaster scenario, and devises training programmes for them. He also helps draft national emergency plans and is available at any time to help deal with major disasters. After the devastating earthquake in Haiti on 12 January 2010, a number of practitioners rushed to the scene to help the people there who were in such great need. Stefaan Claus, Renal Dialysis head nurse, identified and treated victims with kidney problems as part of an international group of renal specialists coordinated from Ghent University Hospital and in conjunction with Mdecins Sans Frontires. The team performed dialysis on a total of 54 victims. Dr. Patrick Van De Voorde, Paediatric Intensive Care Unit, is a volunteer for B-Fast and also helped the victims by setting up a field hospital as part of the medical team. The field hospital treated around a thousand patients in the first ten days after the disaster. On 2 July 2010 a fuel tanker was involved in an accident and exploded in Bukavu, a village in the east of the Democratic Republic of Congo. Hundreds of people were killed or severely burned. Emergency nurse Mona Clauwaert, working with B-Fast, took basic equipment to the area affected and gave local practitioners at two hospitals basic training in the treatment of burns. The International Centre for Reproductive Health (ICRH), under the direction of Prof. Dr. Marleen Temmerman (head of the Gynaecology section), wants to contribute to improving sexual and reproductive health. The ICRH regards reproductive health as a basic right, and is dedicated to improving the access to and quality of reproductive health care for everyone. The ICRH is active all over the world and is recognised as a research centre by the World Health Organisation. Most of its work is done in Africa, and more particularly in Kenya, Mozambique, South Africa and Rwanda. It focuses on topics such as HIV and sexually transmissible infections, mother and child health, sexual and gender-related violence, and the integration of sexual and reproductive rights in healthcare systems.

Humanitarian work abroad

Many members of Ghent University Hospitals staff are involved in commitments far beyond the boundaries of the hospital. Practitioners have put their medical and nursing skills to use on a number of continents to help the local population. A team of surgeons, anaesthetists and nurses, led by Prof. Dr. Piet Pattyn, Head of Gastrointestinal Surgery, went to Cambodia in December as part of a long-running international aid project in the region. They performed twenty urgent life-saving operations. The team also took badly needed medical supplies such as anaesthetic equipment and pain pumps with them. Prof. Dr. Luc Debaerdemaecker trained 20 anaesthesia nurses from the provinces in a two-day hands-on workshop. Dr. Katrien Franois, Head of the Cardiac Surgery department, and her team treated children with congenital heart abnormalities in the Palestinian territories. In a local hospital they also helped construct a cardiac surgery unit for children, so that eventually local doctors will be able to run the centre without outside help. A cardiac surgery team also travelled to Nicaragua in March 2010 to work on a project with the Chane de lEspoir Keten van de Hoop [Chain of Hope] organisation to treat children with congenital heart abnormalities.

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GOVERNANCE
Management Board
Chairman: Mr Jef Peeters, CEO Members: Prof. Dr. Jan van Meerbeeck, CMO & Chief Physician Mr Filip Demeyere, CNO & Director of Nursing Mrs Chantal Haeck, Director Business Support Services Prof. Dr. Marleen Temmerman, Director Representative of the Faculty of Medicine and Health Sciences Secretary: Mrs Sabine De Smyter

Supervisory Board
Statutory Directors: chairman: Prof. Dr. Paul Van Cauwenberge, Vice-chancellor of Ghent University deputy chairman: Prof. Dr. Eric Mortier, Dean of the Faculty of Medicine and Health Sciences CEO: Mr Jef Peeters Members chosen by the Board of Governors of Ghent University: Mr Bart Ampe Prof. Dr. Geert De Soete Mr Jan Vercamst Members chosen by the physicians of Ghent University Hospital: Prof. Dr. Rik Achten Dr Nadia Den Blauwen Prof. Dr. Simon Van Belle Prof. Dr. Frank Vermassen Secretary: Mrs Sabine De Smyter Attending meetings on invitation: Prof. Dr. Luc Moens, Deputy Vice-chancellor of Ghent University (alsochairman of the Audit Committee)

Supervision
Mr Yannick De Clercq, Government Commissioner Mr Danil Ketels, Inspector-General of Finance (not on the picture)

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Colofon Publisher Jef Peeters, CEO Ghent University Hospital Editing and coordination Ingrid Nelis, Marie-Laure Solie, Bregje Goes, Communication & Events Department, Ghent University Hospital Photography Christophe Vander Eecken Design De Blauwe Peer Printing Stevens Print

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Universitair Ziekenhuis Gent De Pintelaan 185 9000 GENT +32 (0)9 332 21 11 info@uzgent.be www.uzgent.be