2016ANNUAL REPORT

2016ANNUAL REPORT

2

01 THE YEAR IN FIGURES

03 MAKING QUALITY VISIBLE

04 WARM CARE

Content

p. 22

p. 30

02 INNOVATION & SCIENTIFIC RESEARCH

p. 6

p. 10

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09 MANAGEMENT

06 CARE FOR STAFF

p. 62

05 CLIENT-FRIENDLY

HOSPITAL

08 AWARDS AND

RECOGNITIONS

p. 46

07 SHARING KNOWLEDGE AND EXPERTISE

p. 52

p. 60

p. 38

“THE EXCELLENT SCORE WE ACHIEVED

IS THE MERIT OF ALL OUR 6000 EMPLOYEES.

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Preface

2016 was a key year for UZ Gent: our permanent quality efforts were rewarded with the NIAZ label for quality care. The icing on the cake of four years of hard work to set up a quality culture supported throughout the hospital. The excellent score we achieved is the merit of all our employees, and I thank them very much for that. With the accreditation we give our patients and referrers a clear message: our hospital is a safe and well-organised institution.

New technologies and digital medicine are changing health-care at a fast pace. Our hospital remains a leader in medical innovation. With the Platform for Medical Innovation and the Innovation Fund, we support doctors and researchers in turning an innovative idea into a useful application. This is how we evolve towards even more advanced and personal-ised care.

The healthcare sector is under pressure and the care land-scape is undergoing significant changes. In this context our hospital also acknowledges its responsibility: we continue to build a sustainable network and develop new models of cooperation.

Despite the savings in the healthcare sector, we made a lot of efforts in 2016 to provide patients with the best possible care and services. Our oldest outpatient clinics were restored in their former glory and now offer all modern comfort.

The tight budget also affects our employees. This did not, however, prevent them from providing the same warm and dedicated care, and responding to the needs of our patients, each and every day. In order to ensure that they can continue to do so in the best of circumstances, we are more than happy to invest in their well-being, health and education.

We are not only driven by a common mission, there are also a number of positive core values that connect us. Together with the strategic goals these are the pillars on which our hospital is built. We are pleased to give you a better insight in those foundations in this annual report.

Prof. Dr. Eric Mortier Chief Executive Officer

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01 The year in figures

CONSULTATIONS

474,000

BED DAYS

283,900

ADMISSIONS

• Several days 36,600• One day 52,600 • At the Surgical day hospital 9100

• Outpatient emergency admissions 21,900• Multiple day emergency admissions 11,900

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AVERAGE ADMISSION PERIOD

8 days

SURGICAL PROCEDURES

30,900

• At the Surgical day hospital 9780

• Robot-assisted procedures:

• Urology 285• Women’s hospital 31

• Thoracic and vascular surgery 40• Hepatobiliary surgery 2

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TRANSPLANTS

158

• Liver 45

• Kidney 99

(Liver from living donor: 3)

(Kidney from living donor: 11)

• Heart 11

• Pancreas 3

STEM CELL TRANSPLANTS

87• Autologous 45 • Adults 39 • Children 6

• Allogenous 41 • Adults 26 (9 from family donors)

• Children 15 (7 from family donors)

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UZ GENT STAFF

TRAINING OF PERSONNEL

• Hours of training 121,216• Internal training offer 4853• Enrolments for internal training 23,290• External training registrations 5437• Number of employees who followed

at least 1 hour of training 5420• Number of training hours for annual courses 13,189

FACULTY OF MEDICINE AND HEALTH SCIENCES OF GHENT UNIVERSITY

PARTNER HOSPITALS

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4519 1570 449 1185 2583 592 912 817

17• Number of students 8137 (academic year 2015-2016)

• A1 Publications 809

• PhDs 86

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02Innovation & scientific research

Remain a leading

player in medical

innovation

New technologies and digital medicine accelerate the innovation in

the healthcare sector. UZ Gent has the ambition to continue to adopt

a leading position in that area.

M edical technology is becoming increasingly advanced. ICT applica-tions generate a constant flow of medical information. Health apps

and the internet of things allow the patient to monitor himself. Robotics, 3D-printing, nanotechnology, big data, artificial intelligence and virtual reality make sure revolutions take place in all kinds of domains. Chief physician Prof. Dr. Renaat Peleman: ‘A hospital like UZ Gent is gradually becoming a centre of expertise for advanced care, where patients can get innovative and personalised treatments’. By building hospitals around us we are setting up an integrated care continuum, where prevention, chronic and acute care ade-quately interact. In that continuum a university hospital ensures scientification and advanced expertise.’

Detecting new trends

This means UZ Gent needs to keep close track of medical innovations, detect trends and invest in things that are really relevant and really make a difference for patients. ‘That is what we are already doing’, says Prof. Dr. Johan Decruyenaere. ‘Our doctors keep up with the developments in their own discipline, thus ensur-ing permanent medical innovations take place. In addition, we also work closely together with other actors like UGent, the VIB, imec and the business world. A few years ago UZ Gent also set up the Institute for Training and Clinical Inno-vative Technologies (ITCIT). This centre is a kind of ‘skills lab’ where doctors can practise complex surgical skills and where innovative surgical techniques can be investigated. Vascular surgeons, for example, use a ‘virtual reality’ simulation environment based on patient-specific CT images. Therefore aortic surgery procedures can first be rehearsed and improved by the surgical team right before it is performed on the patient.

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“THE PLATFORM FOR MEDICAL INNOVATIONS IS MAINLY INTENDED

TO HELP DOCTORS AND RESEARCHERS TURN AN IDEA INTO

A USABLE APPLICATION.

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given to NucleUZ, an initiative of the Centre for medical genetics which, besides genome and exome analyses will also offer liquid biopsies, a non-invasive alternative for tissue biopsies: tumours can be detected on the basis of RNA in blood or urine.’

A part of the innovation fund is put aside by the Platform for bottom-up innovation projects organised by the hospital. ‘We mainly want to encourage projects which offer innovating solutions for a concrete care problem. Many doctors and researchers do have innovative ideas, but they can often use a little support in the process towards a prototype or a product.’

UZ Gent is also a pioneer in e-health: the CoZo platform was rolled out, for example, which allows dozens of care institu-tions and hundreds of doctors to communicate with each other. It also contains the Digi-Onco-Platform (DOP), a portal for digital communication with cancer patients, which makes it possible to monitor their clinical parameters. UZ Gent also recently invested in a new state-of-the-art and high-end elec-tronic patient file. This system created lots of new possibilities for decision support and personalised medicine and therefore also for real-time support of the quality of care.

Platform for Medical Innovation

At the end of 2015, the Platform for Medical Innovation, presided by Prof. Dr. Decruyenaere, was set up to give an additional boost to innovation at UZ Gent. The Platform wants to help doctors and researchers to turn an idea into a usable application.

‘An innovation fund is also linked to the Platform’, says Prof. Dr. Decruyenaere. ‘We use it to support a new ‘germ free mouse facility’: a special sterile environment where mice initially remain completely bacteria-free, to allow investigators to study the influence of the microbiome, the population of bacteria and micro-organisms in the body. Financial support was also

“UZ GENT IS GRADUALLY BECOMING A CENTRE OF EXPERTISE FOR

ADVANCED CARE, WHERE PATIENTS CAN GET INNOVATIVE AND

PERSONALISED TREATMENTS.

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Cancer Research Institute

Ghent (CRIG) stimulates

cancer research

On 25 October 2016 the Cancer Research Institute Ghent (CRIG) was launched. The CRIG is a joint initiative of

UZ Gent, UGent and the Flemish Institute for Biotechnology (VIB). As a virtual research centre it joins more than

350 investigators in the fight against cancer. It consists of medics, but also mathematicians, chemists, biologists and IT people. They share knowledge, technological plat-forms and resources and work in a multidisciplinary team.

Both UZ Gent and UGent and the Flemish Institute for Bio-technology (VIB) have a strong tradition in cancer research. Until recently their expertise and activities were scattered among different campuses. The Cancer Research Institute Ghent (CRIG) changes this and combines top investigations with clinical practice and the industry. This should stimulate and accelerate fundamental, translational and clinical cancer research.

The website www.crig.ugent.be joins the expertise within the CRIG allowing researchers to find each other faster and to exchange their knowledge and experiences on a digital plat-form. The CRIG also acts as a unique point of contact for the government and other stakeholders, for domestic and foreign research groups and for the industry.

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Glycomics:

new diagnostic markers

for liver diseases

A fruitful line of research at UZ Gent searches for diagnostic markers for liver disease, based on glycomics

or glycobiology. That discipline studies glycoma – the whole of sugar structures (glycans) in an organism.

Simple blood tests measure the risk of liver cancer

In 1 in 3 patients liver cirrhosis results in hepatocellular carci-noma (HCC). If this malignant tumour is detected in time and can be surgically removed, the chances of survival are very good. That is why patients with liver cirrhosis undergo a liver ultrasound every six months.

UZ Gent has now discovered that the GlycoCirrhoTest is also a biomarker for the risk of HCC. The test analyses the gly-coma of the blood and was developed in 2004 as a blood test for liver cirrhosis by Prof. Dr. Hans Van Vlierberghe (UZ Gent) and Prof. Dr. Nico Callewaert (VIB). The Glyco CirrhoTest was applied to blood serum samples of 132 patients with liver cirrhosis. Their medical condition was followed up for an aver-age of six years. In patients who developed a liver tumour the test showed significantly higher values. The test can therefore classify patients in a high risk group and provide a follow-up scheme tailored to patients needs.

Predict whether the liver will hold up

Due to the relative shortage of liver transplant donors, less suitable donor livers must also be used. This increases the risk that the new organ will not function properly after the sur-gery (primary non function, PNF). Glycoma-analysis of perfu-sion fluid can predict the PNF risk even before transplantation. In the study 66 liver transplants were studied. Before the transplantation one glycane was significantly higher in the perfusion fluid of the 3 patients who developed PNF after transplantation. Dr. Xavier Verhelst (Gastrointestinal and Liver

Disease department): ‘With this test, those PNF patients could be identified 100 percent accurately. It could therefore enable us to remove high risk donors from the ‘donor pool’.

Probability of donor liver failure after transplantation

After a liver transplant there is a risk that the new liver will not function (graft failure). There are no reliable biomarkers to predict patients with such a graft failure. It was investigated at UZ Gent whether the analysis of the glycoma in the blood was a solution. To this end, glycoma profiles were analysed in 127 transplant patients, both before and after transplanta-tion. Two glycans (NA3 and NG1A2F) were found to be strongly associated with the loss of the transplant liver and the death of the patient. Dr. Verhelst: ‘If we do that GlycoTrans-plantTest on day 7 after transplant, we can predict with great certainty whether the patient and the graft will survive the first year after transplant.’

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Next Generation Sequencing in

Haematology Oncology

For the treatment of patients with acute myeloid leukaemia (AML), the physician can use a wide range of therapies. In order to choose the optimal treatment, UZ Gent intro-

duced Next Generation Sequencing (NGS) in 2016. This technique makes it possible to provide an overview

of all gene defects in the tumour cells of a particular patient in one analysis. That is a big step forward:

before, a separate analysis had to be carried out for each gene. Because some gene defects have a high

prognostic value, NGS enables the physician to determine the most suitable therapy for each individual patient.

For example, patients with high risk of relapse will be selected for stem cell transplantation. Other gene abnor-malities can be used to monitor the patient with molecular

tests or may be the target of specific therapies.

The Molecular Diagnostics Platform UZ Gent was set up (MDG) to detect gene defects in tumours. It combines the expertise of the Laboratory for Medical Microbiology, the Lab-oratory for Clinical Chemistry Haematology, the Pathological Anatomy department and the Centre for Medical Genetics.

In 2016 two analyses were already used for the diagnosis of various haematological-oncological disorders (leukaemia and other haematological tumours). Others are in development. The method used builds on the years of experience with NGS analysis which was developed in-house at UZ Gent. It enables us to respond quickly to new insights into these conditions. The doctor will therefore get high-quality and cost-effective results. The validation of these NGS panels took a lot of time, but UZ Gent can now – as the only centre in Belgium – offer a complete and reliable analysis of genes that are crucial to AML.

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Nuclear medicine

New tests

in the arsenal

After a major relocation and renovation operation, the Nuclear Medicine depart-ment is now slowly but surely offering all

conventional nuclear imaging studies. All activities are concentrated in building

P8. The cyclotron of UZ Gent was already located in the basement there.

That is where the light radioactive tracers are created for SPECT/PET imaging.

SPECT / CT scanner

The Nuclear Medicine department has a SPECT/ CT scanner at the new loca-tion. This hybrid device combines the benefits of two imaging techniques in one test: the functional information provided by SPECT is combined with the CT’s anatomical information. This produces a very powerful diagnostic synergy. For the patient this combination saves time and reduces the burden caused. Because the patient’s positioning remains the same for both scans, the images can also be compared very well, so that a maximum of information can be derived from both studies.

“THE HYBRID DEVICE COMBINES THE BENEFITS OF TWO IMAGING

TECHNIQUES IN ONE TEST. FOR THE PATIENT THIS COMBINATION

SAVES TIME AND REDUCES THE BURDEN.

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Radium-223

From now on UZ Gent also offers patients radiotherapy treatment with Radium-223 (brand name Xofigo™). This treatment is especially suitable for bone metastases in different places of the body: Radium-223, a particle with alpha radia-tion, attaches itself to the areas in the bone where bone metastases develop, thus ensuring a powerful and highly effective radiation of these metastases. However, the sub-stance must be brought to the right place very quickly. That is why Radium-223 is administered intravenously. Because the substance has a very short range of action, the damage to the surrounding healthy tissue remains limited.

This treatment is added to the existing therapy range for bone metastases in addition to hormonal therapy, external radiotherapy and chemotherapy. Incidentally, those treat-ments can also be combined. UZ Gent is currently conduct-ing a multicentre study to verify whether the combination of Radium-223 with hormonal therapy is more effective than hormonal therapy alone.

More powerful PET-MR scanner

A fast and simultaneous PET-MR scanner was taken into use at UZ Leuven. The device was co-funded by the Flemish Hercules Foundation for scientific research. Thanks to the inter-university cooperation, doctors and researchers from UZ Gent and UZ Antwerp can also use the scanner. The hybrid scanner provides added value for the diagnosis and follow-up of tumour formation, e.g. in patients with intestinal, breast and prostate cancer. The device will also be used to study the origin and effects of diseases in the heart, the brain and other organs.

“THE TREATMENT WITH RADIUM-223 IS ESPECIALLY SUITABLE FOR BONE METASTASES.

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The SAMMSON gene is present in more than 90 percent of the melanoma cells. Melanoma cells appeared to be highly dependent on this gene. When the researchers reduced the presence of SAMMSON, the cancer cells died quickly and massively. The hypothesis is that SAMMSON plays an important role in mito-chondrial biogenesis, which is responsible for the energy production in the cell. Cancer cells need more energy for their rapid growth. Turning off SAMMSON immediately stops the energy production in the cancer cell, causing it to die.

The discovery – published in Nature in March 2016 – opens up perspectives for the diagnosis and treatment of melanomas and simultaneously reveals a promising new field of research. With the long non-coding RNA genes cancer research is presented with tens of thousands of new pieces of the puzzle, and as many potential points of action for diagnosis and therapy.

Medical genetics

Link found between melanoma

and non-coding RNA

The research group of Prof. Dr. Pieter Mestdagh (Centre for Medical Genetics), together with colleagues from VIB-KU Leuven, revealed a

remarkable link between melanoma, the most aggressive form of skin cancer, and the SAMMSON gene. The link is remarkable because

SAMMSON is part of the non-coding RNA. Until recently, it was assumed that this so-called ‘litter DNA’ does not contribute to the structure of the

organism. However, recent studies show that it plays an important role in biological processes and diseases, such as cancer.

“TURNING OFF SAMMSON IMMEDIATELY

STOPS THE ENERGY PRODUCTION IN

THE CANCER CELL, CAUSING IT TO DIE.

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Molecular diagnostics:

faster to the patient

Molecular diagnostics uses DNA and RNA sequences to detect pathogens in the patient’s body material.

For example, a virus or bacterium can be identified in infectious diseases or tumour-specific DNA and RNA sequences can be detected. Molecular diagnostics is

used not only to diagnose, but also to control and monitor the treatment. It is becoming increasingly

important due to new insights and techniques, especially in microbiology.

The UZ Gent Laboratory for Medical Microbiology offers more, faster and more complex molecular diagnostic tests, even though they are not always refunded. The costs of the tests are weighed against the medical benefits they provide. A great advantage of molecular diagnostics is the speed: the doctor quickly gets answers to questions that are crucial to the further treatment process. A faster diagnosis also means faster treatment, and shortens the patient’s stay at the hospital. In case of conditions such as influenza or RSV, the emergency room can perform a test to verify whether a

patient is or is not infected. In case of those infectious dis-eases, the patient can be isolated more quickly, thus reducing the risk of transmission.

In UZ Gent, the Laboratory for Medical Microbiology uses commercially developed detection methods. It also develops and validates such tests in-house. The service also focuses on more complex diagnostics, for example, to analyse microbiomes (mixtures of bacteria). To this end new tech-nologies like Next Generation Sequencing are used. All this in the context of the UZ Gent Molecular Diagnostics Platform, which consists of the Laboratory for Medical Microbiology, the Laboratory for Clinical Chemistry Haematology, the Pathological Anatomy department and the Centre for Medical Genetics.

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Zebrafish as a

model organism

The zebrafish facility at the UZ Gent Centre for Medical Genetics houses

some 6000 zebra fishes. The zebrafish (Danio rerio) is used as a model organism for research on hereditary diseases such

as cancer, cardiovascular disorders, mental retardation and osteoporosis.

In early 2017 UZ Gent organised an international symposium on cancer

modelling in zebrafish and on the latest research results on neuroblastomas,

paediatric leukaemia and melanomas.

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Robot assists

in kidney transplant

with living donor

In the summer of 2016 UZ Gent performed the first robot-assisted kidney transplant

in Belgium. The robot was used to remove the kidney from a living donor

and to implant the same kidney in a patient with severe renal failure.

The team of Dr. Decaestecker (urologist) and Dr. Desender (thoracovascular

surgeon), completed the operation in close cooperation with the Nephrology

department of UZ Gent.

KOF grants stimulate

clinical research

One of the core tasks of UZ Gent is clinical research. The Clinical Research Fund (KOF) was set up in 2008 to promote this task. Promising young staff

members of UZ Gent are given the opportunity to do clinical research, for four years, which must result in a doctorate.

In 2016 four researchers received a scholarship from the Clinical Research Fund. They conducted research in relation to the cardiovascular and metabolic health impact of sleep apnoea, care reflection as a compass for tailored care for elderly patients, the dose of antibiotics in children and the obstetric brachial plexus injury.

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03Making quality visible

Keeping quality

dynamics alive

In July 2016 UZ Gent obtained the NIAZ label for quality care – a milestone for

the quality and safety policy of the hospital. The accreditation released

quite some dynamics, which will be built on to take on new challenges.

I n the preparation phase for international accreditation a solid quality struc-ture was set up at UZ Gent, with internal audits and security rounds. The

goal: to organise the care even better and to visualize its quality.

New challenges

‘We have also been strongly committed to communication, awareness raising and education’, say Prof. Dr. Kristof Eeckloo (Director of the UZ Gent Strategic Policy Cell) and Kathleen Bogaert (Integrated Quality Coordinator). ‘Support was given to departments and services to work on concrete improvements. This is how we were able to generate a momentum in the entire organisation – which also received a lot of praise from the auditors. We now want to use that dynamic to focus on some remaining points of attention.

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These issues are also the 9 quality and safety challenges UZ Gent shall be dedicated to in the period 2016-2019:

1 Assuring the quality system at UZ Gent, including by keeping the electronic document management system up-to-date and recording internationally benchmarking outcome indicators.

2 Make quality visible to the outside world, including through scientific research and communication.

3 Further develop patient participation policies: raise awareness among healthcare providers to take full account of patient needs and to work on patient-friendly basic attitudes.

4 The medication policy: focus on medication verification upon admission, transfer and discharge.

5 The transmural care: in all networks UZ Gent is a part of we want to increase quality policy to a higher level, by exchanging procedures and by screening contracts: are the quality criteria clearly described and are we doing what it says?

6 Training policy and performance interviews: organise training on aggression, emergency situations, infusion pumps, etc.

7 Patient-related communication: to provide quick, efficient and structured patient-related information, healthcare providers use the ISBARR (Identification, Situation, Background, Assessment, Recommendation and Readback) method. From 2018 focus will be on the quality of written communication, e.g. through training and specific actions.

8 Quality of the patient file: optimize the quality of discharge letters and record essential patient data such as allergies.

9 Safe care: continue to pay attention to patient identifi-cation, infection prevention, fall prevention, safe surgery, and traceability.

Aiming a little higher

‘We want to keep up the things that are going well’, says Prof. Dr. Eeckloo. ‘And at the same time, make some adjust-ments when needed. We want to keep the quality goal alive and raise the standards even further, for example using even more indicators. Indicators are ideal to make quality visible and they are indispensable for careful quality management.’

“INDICATORS ARE IDEAL TO MAKE QUALITY

VISIBLE AND THEY ARE INDISPENSABLE FOR ACCURATE

QUALITY MANAGEMENT.

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UZ Gent is granted

NIAZ-Qmentum quality label

UZ Gent achieved the NIAZ label for quality care in 2016 with flying colours. The cherry on the cake after

four years of hard work on a hospital-wide quality culture. The accreditation gives patients, visitors and referrers

a powerful signal that UZ Gent is a safe and well-organised care institution.

In 2012 UZ Gent decided to voluntarily seek recognition from an independent accreditation institute, the Dutch Institute for Accreditation in Care (NIAZ). In 2013, the NIAZ decided to start working with the international accreditation program Qmentum. This resulted in a new standard: NIAZ 3.0 Qmentum.

In May 2016 external auditors came to UZ Gent to test the quality of care to more than 2300 standards. They gave UZ Gent an excellent report. On the standard sets to be met by the hospital in order to be granted accreditation – including domains such as infection prevention or oncology care – UZ Gent scored an average of 98 percent, while 81 percent was required. There were no negative peaks.

‘This is not an isolated story of abstract standards’, says chief physician Prof. Dr. Renaat Peleman. ‘All 6000 UZ Gent employees have adopted and assimilated the standards. It was very encouraging that the doctors also fully cooper-ated during the entire accreditation process and that the aim for quality was also tangible in all business support depart-ments. The enthusiasm of all employees to demonstrate their high-quality work proves that our motto ‘Making Quality Visible’ is truly supported throughout the hospital.’

Learning from complaints

High-quality and patient-oriented care is what matters most at UZ Gent. But there still may be occasions when patients are not entirely satisfied. In 2016 the Ombuds-

man service recorded 801 reports, a sharp decline compared to 2015 (1201 reports). The reporters are asked

to first discuss the complaint with the healthcare providers personally. If it proves difficult to find a solution

the Ombudsman service can then mediate.

Careful attention to questions, complaints and concerns is part of hospital culture. The Ombudsman service raises awareness among employees and patients by organising regular information sessions on patient rights. Patients are entitled to high-quality services and should be able to choose their healthcare provider freely. They are entitled to information and consent in relation to the treatment, and to a carefully maintained and securely stored patient file. Under certain circumstances they can also consult their medical records and get a copy of it. They also have a right to the protection of their privacy and to mediation by the Ombudsman service.

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The Ombudsman service does not only mediate in case of complaints but also works on complaints prevention. By formulating recommendations the service tries to keep a complaint from repeating itself. These recommendations are aimed at improving the quality of care and thus achieving a higher patient satisfaction. A complaint is after all a learning moment: it can be used to screen and, if necessary, adjust the hospital’s functioning and organisation and to help improve the care.

Master Specialist Medicine

(MSG) made ‘quantum leap’

In 2016 the external review commission spoke very highly about the quality improvement made by the Master of

Specialist Medicine at the UGent.

The Master of Specialist Medicine (MSG) intends to train competent physicians-specialists and combines academic education with workplace learning. During the previous education review in 2012, the Education Commission had negatively assessed some aspects of MSG training and formulated suggestions to improve. Following this review UGent and UZ Gent stakeholders elaborated a thorough recovery plan.

In December 2016 an external committee audited the program again. Congratulations were in order for the ‘quantum leap and cultural change’ that was achieved, while 90% of the recovery plan had also already been implemented. The com-mission was also very pleased with some good practices introduced by the MSG training in recent years, including the ‘train the trainer’ training, the integration of theoretical and practical training, Medbook, a user-friendly electronic portfolio which registers the progress of the specialist training, and the Charter of the study programme, which makes it clear what the various parties can expect from each other.

‘For all those involved in the MSG and contributed to the recovery plan, this positive feedback is of course very motivat-ing to continue’, says Prof. Dr. Martine De Vos, chairman of the training committee.

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‘Together we have been working on the text for more than three years’, says Prof. Dr. Rietzschel. ‘My contribution was the lifecourse concept as a guideline to fix recommendations onto. If you use this guide, you are obviously committed to prevention and health promotion, from childhood on, to keep people healthy as long as possible. Inevitably, however, some people will develop high blood pressure: effective diagnosis and treatment then requires an efficient structure.’

The vision text is expressed in 10 recommendations, with goals and priority actions to realise them. These include prevention and changes in the environ-ment, better diagnosis of high blood pressure, improved pharmaceutical pre-vention and follow-up and strengthening the healthcare system. ‘For Flanders it is relevant to make health education a priority, so that our education provides “health-literate” adults. For GPs we would like to develop a standardised and comprehensive directive. And with the eHealth platform we want to set up a structure to gather data about the long-term effects of medication.’

A broad global

approach

for hypertension

Develop a vision to prevent, detect and cure hypertension globally: this assign-ment was received by 20 experts from

all over the world from the renowned medical magazine The Lancet. The only Belgian who was also invited was Prof.

Dr. Ernst Rietzschel (Cardiology depart-ment) of UZ Gent. In September 2016

the Lancet Commission on Hypertension presented its vision. The Commission

tried to combine two perspectives: the clinical approach, which addresses the treatment of the individual patient,

and the perspective of public health, which develops measures at the level of

the population.

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Building

hospital-wide traceability

More and more hospitals focus on the traceability of medical devices. This increases patient safety and quality of care and enables hospitals to work more efficiently. In addition, accreditation institutions are now focusing on traceability as an important issue.

This also applies to the accreditation program NIAZ-Qmentum which certified UZ Gent.

Therefore, the ICT department at UZ Gent developed an architecture to set up a hospital-wide traceability platform. That architecture is based on two pillars. First of all, the bar codes and RFID tags used must be based on current stand-ards. In this context GS1 was chosen, an international standard for identifying, registering and sharing data. These GS1 codes are linked to EPCIS (Electronic Product Code Information Services), a standard to track products and product-related items throughout the chain.

In addition, process-driven work methods were adopted: the different steps of all medical-logistic processes in the hospital will be recorded to optimise workflows. This will be done on the basis of a BPM engine (Business Process Model): a framework in which processes can easily be defined, managed, executed and monitored.

The administration of blood products at the emergency department – a complex chain that is under heavy pressure and involves many people and actors – was selected as a ‘proof of concept’ for the traceability platform. To this effect a consultancy assignment was awarded to two companies. In October 2016 the project was successfully completed. UZ Gent now wants to purchase a traceability platform to accommodate all traceable processes step by step.

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UZ Gent leads OPAT

pilot project

Patients who require long-term intrave-nous antimicrobial therapies will usually

receive them at the hospital. However, that treatment can often be continued

safely at the patient’s home: Outpatient Parenteral Antimicrobial Therapy (OPAT).

There are many advantages: patient comfort, prevention of hospital infec-tions, cost savings, an optimal use of

hospital beds, etc.

Physical Medicine and

Rehabilitation

Ex-patients score

at Paralympic Games

Three paralympians who went through rehabilitation at UZ Gent after a major accident did very well at the Rio Paralympic Games. Wheeler Peter Genyn scored

gold twice, handbiker Jonas Van de Steene got bronze in the team relay and cyclist Diederick Schelfhout became 9th in the individual pursuit on the track.

In Belgium, UZ Gent has been a pioneer in OPAT for 15 years, especially with prosthetic infections and chronic osteomyelitis. The OPAT program protocol has now been standardised and optimised. The patient receives the first dose at the hospital. After that, the home nurse is in charge of the administration. The hospital pharmacy and Patient Support department support patients and caregivers, including in terms of dispensation of antibiotics and the necessary materials, repayment and follow-up.

More and more hospitals are interested in OPAT. To facilitate the roll out UZ Gent set up a consortium with a number of other hospitals – AZ Delta in Roeselare, AZ Groeninge in Kortrijk, Sint-Andries in Tielt, Sint-Jozef in Izegem, Jan Yperman in Ypres, Imelda in Bonheiden, Heilig-Hart in Lier and AZ St-Lucas, AZ Maria Middelares and AZ Jan Palfijn in Gent. When the FPS launched a call for pilot projects to reduce the hospital admission time, the consortium submitted OPAT as a proposal. In the beginning of 2017 it was selected by the FPS Public Health. In the pilot project the hospitals in the consortium will compile a quality manual and study the potential of OPAT, the clinical results, safety, patient satisfaction and cost-effectiveness.

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For six weeks, 8 student nurses take over half a department, 24 hours a day and 7 days a week. They write a cover letter and, after a selection interview, get to know the department thoroughly. Then they get a rotating schedule. Each week, an intervision moment is scheduled and they participate in the multidisciplinary team meeting.

The pilot project originated in the awareness that workplace learning offers lots of advantages: in a real-life learning environ-ment the student starts with a real practical setting: the theory is intertwined with the gradually acquired practical experience. Knowledge, insight and skills are optimally integrated.

Workplace learning is obviously not an option in every depart-ment. The department must have enough staff and patients and the continuity of care and guidance must be ensured. An important prerequisite is also that the students themselves and their school can commit to the project. The school pro-vides adequate theoretical education in advance. The intern-ship supervisor serves as a coach for students and nurses and is present at the department.

Royal visit at the

Spina Bifida conference

In October 2016 UZ Gent organised a three-day international conference on spina bifida and hydrocephalus. On the first day of the congress Princess Astrid visited UZ Gent. She launched an international awareness campaign and honoured carers for their dedication. UZ Gent has a multidisciplinary Spina bifida reference center (SBRC), which offers specialised medical diagnostics and treatment.

Workplace learning trial project

At the Rehabilitation and Geriatrics Nursing department, a pilot project is ongoing on workplace learning for nursing students. What is remarkable is that the students are responsible for all work processes. They will obviously receive individual coach-ing from a nurse, who still has the final responsibility.

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Warm and

patient-oriented care

Provide patients with warm and committed care so that they feel safe, listen actively to them and respond to their questions and needs: UZ Gent is

dedicated to the vision of warm and patient-oriented care.

04 Warm care

UZ Gent approaches patients from a holistic perspective: they are not reduced to their pathology, but are treated as persons with

wishes and needs, which they do not leave behind when they enter the hospital.

Increase comfort

‘This is the vision we use as a guideline throughout the entire hospital stay, from intake to discharge’, says Prof. Dr. Rik Verhaeghe, Director of Nursing. ‘It also inspires the actions we take to make our care even more patient-oriented. For example, the reception now opens earlier, it used to be 7 am, now it is 6 am, which allows employees to dedicate more time to each patient. This is more comfortable for the patients and ensures that they are properly informed before going to the department.’

At the departments careful and complete registration of all useful data must guarantee the patient-oriented care. Prof. Dr. Verhaeghe: ‘Everything recorded in the patient file can be considered when providing the care: any sleep prob-lems, nutritional needs, the psychosocial context, and so on. Of course, we are also fully dedicated to correct and safe patient identification.’

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“IN ORDER TO RESPOND TO WHAT THE PATIENT EXPECTS,

AWARENESS FOR PATIENT PARTICIPATION WILL BE

RAISED AT ALL DEPARTMENTS, HOSPITAL-WIDE.

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Better communication

Nothing is ever perfect. In order to respond to what the patient expects, awareness for patient participation will be raised at all departments, hospital-wide: attention and respect for patient rights, proper information of patients and their relatives, readiness to listen, informed consent, etc. ‘Bedside shift reporting’ was also implemented: the shift change of the nursing teams takes place at the patient’s bed, giving the patient the opportunity to ask questions and indicate problems. And for their mutual communication, caregivers use the ISBARR method – Identification, Situation, Background, Assessment, Recommendation and Readback. For example, this avoids that important information is lost when a patient is transferred.

The patient’s admission profile also contains important informa-tion for the Patient Support department. Prof. Dr. Verhaeghe: ‘This will allow them to anticipate a smooth discharge and extramural follow-up. Because the hospital admission time is getting shorter, the preparation for discharge usually starts on the first day.’

Towards a Nursing Expertise Centre (VEC)

Nurses play a key role in the warm and patient-oriented care offered by UZ Gent. In order to further professionalise, UZ Gent is setting up a Nursing Expertise Centre together with the University Centre for Nursing and Midwifery UGent. The centre will focus on nursing research and will further professionalise the nursing expert jobs – nursing consultant, nursing specialist and reference nurse. Prof. Dr. Rik Verhaeghe: ‘The idea is to develop uniform profiles for these positions, so that hospital doctors know what they can expect – the collaboration between doctors and nurses is very important in UZ Gent.’

The decision to set up a VEC was taken at the end of 2016. The Nursing Expertise Centre will now be further developed, also in collaboration with other university hospitals.

“NURSES PLAY A KEY ROLE IN THE WARM AND

PATIENT-ORIENTED CARE OFFERED BY UZ GENT.

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Oncology centre

Optimal psychosocial

care for AYAs

Cancer is a serious diagnosis for every patient, but for adolescents and young adults it brings specific

challenges in domains such as studies, career, friends, relationships, sexuality, etc. That is why these

AYAs – Adolescents and Young Adults with Cancer – need age-specific, customised care.

Various initiatives were launched at UZ Gent for this purpose. A cosy leisure room for youths was set up at the Medical Oncology department. In addition, a youth box was developed, with tools to facilitate communication – between the young persons and their network, but also between the healthcare provider and the AYA. The box includes an ‘experience brochure’, which deals with experiences of fellow sufferers with the disease and treatment. The youth box has since been distributed in many Flemish hospitals.

In the period 2016-2017 UZ Gent receives financial support from the Cancer Foundation (Stichting tegen Kanker) to further develop the CARE-4-AYA project. The idea is to optimise existing interventions and develop new psycho-educational initiatives. For example, a French version and an app of the youth box are being made. In addition, UZ Gent develops an experience-oriented brochure for parents. Psycho-educa-tional training courses will be organised in which caregivers learn how to use the youth box and the parent brochure. Finally, psycho-educational sessions are organised for AYAs and parents.

Wellness for

cancer patients

Thanks to the support of the Cancer Foundation, the Oncological Centre has a relaxation room. It is used, among other things, to give patients free wellness treatments.

Many cancer patients get a grey complexion, lose their hair and eyebrows and have tired eyes due to the treatment. The facial care organised at the Oncological Centre in coop-eration with the Cancer Foundation can do miracles. In addition, volunteers from the non-profit organisation ‘n Witte Roos give adapted therapeutic massages for cancer patients under treatment, either at the bed of a patient, or in the relaxation room. And with the support of Kom op tegen kanker, regular group sessions are organised, Look good – feel better, to teach make-up and skin care techniques.

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Care folder for

cancer patients

Many patients are dejected when they are diagnosed with cancer. To give them something to hold onto, the Oncological Centre provides patients with a care folder. It includes infor-mation about the disease, the various treatments, nutrition and medication. Patients can also write down their appoint-ments and keep prescriptions for medication in the folder. The care folder – which is now commonly used – was updated and redesigned, with the support of the Cancer Foundation and OIGO, a non-profit organisation that wants to improve the comfort for cancer patients.

Waiting room

becomes lounge

The patients of the Medical Oncology daycare clinic now receive their chemotherapy in a room with a homely feel to it. The traditional waiting room was transformed into a pleasant and cosy lounge area with a sofa and seats, leaving behind the typical hospital setting. Patients can meet fellow sufferers, have a drink, work on the laptop, just pass the time and forget for a while that they are in a hospital.

“THE TRADITIONAL WAITING ROOM

WAS TRANSFORMED INTO A PLEASANT AND COSY LOUNGE AREA

WITH A SOFA AND SEATS.

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Care reflection project

Really listen

to the elderly patient

Good care starts with good listening. Especially for vulnerable and care-dependent elderly patients this is not easy. The UZ Gent Care Reflection Project encourages healthcare pro-fessionals to listen freely to the story of elderly patients and his family, to ensure that their concerns are taken into consid-eration in the care plan. For this project UZ Gent was awarded the Gert Noël award of the King Baudouin Foundation.

The whole project includes formal training moments, but is actually a continuous process: by integrating the care reflection into the consultations and daily practice a change in culture can actually be brought about. Care staff will receive training

to actively learn to listen and integrate this habit in the daily practice and weekly multidisciplinary consultations about the patient. Those consultations used to be primarily about medical issues, but now also allows for reflection on the care.

The project was launched in the Geriatrics department and is currently being rolled out in other departments where older patients are admitted.

“THE CARE REFLECTION PROJECT ENCOURAGES

HEALTHCARE PROFESSIONALS TO LISTEN FREELY

TO THE STORY OF PATIENTS.

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60 years of Hospital School

In 2016 Gent Hospital School celebrated its 60th anniversary. The festivities started with a big children’s party, and then a study day or other activity took place each day, until the closing academic session at Gent town hall on 24 November.

In 1956 a school for primary education started in UZ Gent. The secondary school department was set up in 1987. Mean-while, the school also offers education in PC Caritas Melle, AZ Sint-Lucas Gent and RKJ De Sleutel Eeklo, both in primary and secondary education. In consultation with the patient’s own school, teachers provide continuity of education aimed at avoiding a learning backlog.

K3 visits the Children’s Hospital

On 15 November the patients at the Children’s Hospital Princes Elisabeth received a visit of K3. A big surprise for the children who enjoyed it to the fullest, just like the staff and the K3 singers themselves. ‘A children’s hospital is not a happy place, but we managed to get the little ones to smile – and that is worth a lot’, says one of the K3 band members Hanne.

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On the road to

a customer-oriented

hospital

Customer-oriented and demand-driven action and solution-oriented thinking

with the patient: this is the thread in the actions set up by UZ Gent to welcome

patients and inform them optimally.

05Client-friendly hospital

‘W e will solve it for you’ – that is the motto adopted by UZ Gent to set up initiatives which will help it to become a customer-focused

hospital. A huge automation wave enables digital innovations and an attitude switch encourages employees to learn about solution-oriented thinking. Chantal Haeck, Director of Business Support Sector (BOS): ‘We expect creativity and innovative capabilities from our staff – they must be able to think with the patients, to empathise with their expectations and problems, and come up with creative solutions.’

Building an omnichannel

In past years we have invested heavily in the physical reception of patients, with self-registration kiosks, information points and patient information agencies where patients can go to with questions about invoices and payments. Patients will get clear information and a detailed cost estimate there even before the first care is provided to them.

In the next phase, the telephone reception will be optimised. Chantal Haeck: ‘In the past, call centre employees would mainly redirect callers. We gradually want to turn the call centre into a real ‘contact centre’. The staff will immediately handle everything they can on the phone: move or cancel an appointment, answer common questions for information, and so on.’ GPs and other referrers will get their own contact number. If the doctor they need is not available, they can make a call back appointment or talk to an on-call doctor immediately.

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“WE EXPECT OUR STAFF TO EMPATHISE WITH THE EXPECTATIONS

AND PROBLEMS OF PATIENTS AND TO COME UP WITH CREATIVE

SOLUTIONS.

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The idea is to complement the physical reception and the call centre with a digital reception which will, for example, also get a chat function. Chantal Haeck: ‘This is how we are building an integrated omnichannel, in which employees can rotate and learn from each other.’ For internal customers, there will be a centre of expertise that will join all existing helpdesks – for example for billing systems.

Digital patient assistance

The digital revolution offers a lot of new possibilities for a complete makeover of the reception and patient assistance at

UZ Gent. Pilot projects with appointments by e-mail and text message are gradually rolled out. Patients can get their appointment confirmation by e-mail. They are also informed about changes and receive a reminder of their appointment by text.

‘Our ambition is to expand the e-mail and text information, for example with information about congestions and roadworks or about the offer in the cafeteria. We also think of wayfinding apps and want to set up a hospital-wide patient guidance system to guide patients to their appointment quickly.’

Reduce paperwork

In 2016 a large-scale administrative simplification operation was launched. ‘Nurses spend a third of their time on adminis-tration’, says Chantal Haeck. ‘That is why we want to stream-line the administrative processes. Employees in three project groups – hospitalisation, outpatient clinics and business sup-port – performed a thorough screening of all procedures and suggested ideas to untangle and simplify those procedures. Patients will also directly and indirectly benefit from this simpli-fication. For example, we want to better align the telephone accessibility and opening hours of the various outpatient clin-ics so that patients can more easily make several appoint-ments at once.’

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Central information points

Patients and visitors will come across a central info point InkomInfo+ at two central locations where the registration

kiosks set up. They can address these points for questions or requests: call the campus taxi, inquire about a route, help

with the registration, information about public transport. In short, they will get all the info to make their visit to UZ Gent

go as smoothly as possible. Patients from special target groups – wheelchair users, foreign language speakers, socially

vulnerable patients, ... – are easily pointed the way to social services or intercultural mediation.

For questions about cost handling or invoicing patients can contact one of the two patient information agencies. Patients

can drop by for a cost estimate or information about their invoice, to verify payments, for an explanation about the

debtor codes or for a payment plan.

Easy registration

Patients can easily, quickly and correctly register with their electronic ID card at one of the 11 registration kiosks. These guarantee the correct and customer-friendly processing of administrative data. If patients need help, they can talk to a receptionist or they are automatically referred to the correct info point.

In 2016 only 1 in 4 patients had to personally report to the reception. All other patients followed the route indicated on their ticket from the kiosk to go directly to the medical service or department.

Appointment reminders

by text or e-mail

Patients at the outpatient clinic and the Medical Oncology daycare clinic were the first to receive their letters of appoint-ment by e-mail as well. Meanwhile, other departments are also using digital appointment letters. Patients who enter their e-mail address receive an appointment confirmation listing all scheduled appointments. Patients who registered their mobile number will also get a reminder by text four days prior to their appointment. In 2016 a reminder was sent by text for 1 in 2 scheduled appointments.

In the very near future patients who want to can also receive an e-mail reminder. In addition, the application to book, move, and cancel appointments online will be optimised and rolled out. UZ Gent intends to make the appointment management more customer-friendly and efficient, and reduce the number of no-shows.

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Tram 4 to the heart of

the campus

On 13 March 2016 tram 4 drove onto the campus for the first time. The tram

connects Gent-Sint-Pieters station with the hospital and runs every 7.5 minutes

on weekdays. The final stop is at the central car park building. There is a

pedestrian lane which leads patients and visitors to their destination.

Route numbers

show the way

The new route system with entrance and route numbers is almost fully rolled out.

Each building has its own entrance number. When registering at the regis-tration kiosks, patients receive a ticket

with the route number of the ward or department where they are expected.

The system is simple and user-friendly and helps patients orient themselves at

the 40-hectare UZ campus.

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More efficient waiting

room management

UZ Gent also performed a screening of its waiting room management in 2016. As a pilot project two waiting room administrators were assigned to the outpatient clinics in P5-P6. They use a tablet to see when a doctor indicates

in Ultragenda that a patient can come from the waiting room in the atrium to the decentralised waiting room. The screen displays the name and date of birth of the patient

and exactly where he or she is expected. The patient is then picked up by the waiting room manager and taken

to the doctor. Doctors and waiting patients alike gain time and comfort by using this method.

The web-based application which connects the doctor and the waiting room manager was developed in-house. Making use of the waiting room managers is the first step towards an optimised hospital-wide patient assistance system. The waiting room management will also be automated for departments that could benefit from it, and the patients in the waiting room will be able to monitor how many patients are waiting, what the estimated waiting time is and what route they have to follow to see the doctor.

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Refurbished

outpatient clinics

After almost 10 years of demolition, construction and renovating, the work at the oldest outpatient clinics of UZ Gent,

clinics P1 to P6, has been completed. The buildings of architect Henry

Van de Velde were restored in their former glory and now meet the

demands of modern times. Three glass constructions were built between the buildings, serving as central reception rooms for the patients. Related medical disciplines were brought together: this promotes cooperation and consultation between healthcare providers and improves patient care.

In May 2016 the departments of Radiology, Mammography, MR, General Internal Diseases, Head, Neck and Maxillofacial Surgery, Nursing, Otorhinolaryngology, Ophthalmology, Blood Collection and the Allergy Network moved into the renewed buildings P1 and P2. In September and October 2016 the new out-patient clinic for Bones, Joints and Muscles (a collaboration between Trauma-tology, Physical Medicine and Rehabilitation, Rheumatology and Pain Clinic and Paediatric Orthopaedics) opened in building P5-P6.

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Rehabilitation in all comfort and privacy

The Bones, Joints and Muscles outpatient clinic has brand-new exercise rooms where patients can rehabilitate, individually or in group, under the supervision of experienced physiotherapists. Between 50 and 70 patients come to the centre each day. Back patients, lung patients, cancer patients and obesity patients can participate in an exercise programme and also use the power and cardiac training equipment. The exercise rooms are twice as large as before and bathe in natural daylight. The design of the halls, the treatment rooms, the sanitary facilities and the changing rooms largely focused on the comfort and privacy of the patients.

CoZo continues to flourish

Through the Collaborative Care Platform (CoZo) patients, hospitals and general practitioners/physicians exchange

data and information – quick, safe and with respect for privacy. CoZo forms part of the federal eHealth-metahub

project and is the largest hub in Flanders. And CoZo is growing fast: in the last months of 2016 200,000 results were retrieved through CoZo every month on average. End 2016 more than 110 institutions were affiliated to the care platform – including an increasing number of

external labs and private radiology practices – and more than 5000 doctors used CoZo.

CoZo now offers the possibility to discuss patient results via video conferencing. The patient can also be invited to join in, just like any healthcare provider who has no treatment relation-ship with the patient in the context of a second opinion.

The Digi-Onco Platform (DOP) – the CoZo eHealth platform that supports cancer patients and their environment through telecounseling and telemonitoring – was awarded the Agoria eHealth award. CoZo will soon get rid of bulky folders full of questionnaires and treatment info: users will be able to outline online care paths and link diaries to their file. The patient will then get an overview of his care paths, treatment team, diaries and questionnaires, and can provide report information about e.g. side effects online. The healthcare provider will receive a message each time the information is updated. And with CoZo Mobile patients will soon be able to receive support on their mobile devices.

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06 Care for staff

Happy and

healthy staff

The employees are the main capital of UZ Gent. Therefore, the hospital

invests in the health and well-being of each of them and it is also dedicated

to lifelong employment.

‘UZ Gent has very competent and dedicated employees, and we would like it to stay that way’, says Chantal Haeck, Director

of Business Support Sector (BOS). ‘Competent and satisfied employees are happy and feel closely involved with their patients. UZ Gent wants to be a warm employer for all of them.’ We ensure a good work-life balance, offer countless training opportunities and build a positive corporate culture, which is shared by common values.’

Keeping values alive

Employees of UZ Gent behave with respect, integrity and responsibility. The UZ is also sustainable and innovative, and the staff are caring for patients, family and referrers, they are collegial and involved. These common key values were established by a hospital-wide working group and should be the pillars of the corporate culture at UZ Gent. Chantal Haeck: ‘It is, of course, a matter of giving those abstract values a common ground, to make them tangible and present on the work floor. By the end of 2016 all employees received a ‘value book’: this should encourage them to give their own meaning to those values. And we will set up seminars, info sessions and other events for all staff, which is supposed to result in some kind of action plan.’

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“COMPETENT AND SATISFIED STAFF ARE HAPPY AND FEEL CLOSELY INVOLVED WITH THEIR PATIENTS. UZ GENT WANTS TO BE A WARM

EMPLOYER FOR THEM.

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Health and prevention

UZ Gent has been working on an integrated health and wel-fare policy for years. ‘This policy started out when addressing absenteeism, but is now much wider’, says Chantal Haeck. ‘We encourage employees to live healthy.’ If sickness absence has work-related causes, of a physical or psycho-logical nature, the Well-Being team seeks to handle this dis-creetly. If necessary, structural solutions are elaborated. In addition, there are permanent campaigns to prevent back problems and needle stick incidents.

Lifelong employment

UZ Gent outlines an age-conscious career policy to ensure that employees feel well in every stage of their careers. Chantal Haeck: ‘We recruit talented starters and give them the opportunity to grow. We have developed a broad range of training courses to make this happen. For example, if employ-ees have the ambition to lead, they can follow a management development program.’

A relocation policy is in place for those who are unable to do their job due to physical or psychological problems. Chantal Haeck: ‘This allows us to assign them another job where they have no problem performing all tasks. That goes very well, but it is of course meant as the ultimate tool for those who really cannot cope anymore. In addition, we want to think about end-of-career jobs for older employees who can still work, but find their job too heavy. They possess a wealth of knowledge and experience that we still want to make optimal use of, but maybe they could work at a different pace or, for example, coach young nurses? At the moment we are thinking about solutions that create a win-win situation for both the employee and the hospital.’

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Happy and

healthy at work

Preventive health and welfare policy is the key to greater well-being at the workplace. The efforts made by the

hospital were highlighted in April 2016 during the ‘Health Week’. All kinds of activities promoted a healthy lifestyle,

sports and exercise, healthy nutrition and a good work-life balance. The health and well-being policy of the

hospital is also praised outside the hospital walls and is also adopted in the business world.

The hospital is now continuing to work on a good psychosocial well-being policy aimed at preventing and addressing burn-out, excessive stress, and stressful events such as conflict (or aggression). The psychosocial risks within the organization are listed in order to be able to make the necessary adjust-ments on time. There are training sessions about resilience,

Limiting risks

At UZ Gent 182 safety contacts are cooperating to build a safe and healthy working environment for the UZ staff. They are the eyes and ears of the departments and report risks to the Internal department for Prevention and Protection at Work (IDPBW). The safety contacts inform colleagues about (fire) prevention and accidents at work, they perform safety rounds and site visits, and they make suggestions for improvement to IDPBW.

Lifting loads or moving persons are everyday tasks for many UZ employees. In order to avoid that physical stress causes problems of the locomotor system or work accidents, the load handling consultants will teach them lifting and moving techniques. They will also show them how to use tools effi-ciently. The load handling consultants will give their colleagues information and advice and provide support – if necessary, also to patients and their families.

burnout and dealing with aggression. Welfare-related issues are now better reported and addressed. The psychosocial welfare of employees will be further focused on in 2017 to create a working environment in which everyone feels good and continues to feel good.

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UZ staff goes veggie

Days without meat – awareness campaign about the impact of our dietary habits on the environment – UZ Gent was happy to oblige: the hospital won in the category of ‘government institutions’ and with 201 participants saved a total of 59,553 m² on its ecological footprint. That is the same amount of water as 43,553 baths or the same amount of greenhouse gases as driving 83,755 km.

Invest in every employee

An excellent care and service requires caring staff who are well trained. The hospital will therefore gladly invest in the careers of each employee with a broad training offer. In this way, the hospital stimulates individual development and growth, and creates sustainable career opportunities. And more and more employees are using this opportunity, as the number who attend internal or external training is increasing each year.

In addition to the training required to perform daily tasks – with a focus on patient safety, satisfaction and quality care – many courses focus on developing a lifelong career at the university hospital. The training offer also focuses on promoting the well-being at the workplace.

Seven times Top Employer

UZ Gent was also in 2016 granted the certificate of Top Employer. And that for the seventh year in a row. An independent audit showed that UZ Gent offers its staff excellent training and career options, as well as an excellent work-life balance.

Sustainable to work

The hospital encourages its employees to trade in their car for a sustainable alternative. A lot of UZ staff there-

fore request a public transport pass or a bicycle fee.

To make the campus more bicycle-friendly, new safe cycling routes were established in 2016 and additional bicycle park-ing facilities were installed, including three secured places for employees which accommodate 377 two-wheelers. And because not every employee lives at just a stone’s throw from the hospital, the hospital organised a group purchase of elec-tric bikes for the staff.

• 495 UZ staff with an NMBS/SNCB railcard

• 129 with a De Lijn pass

• 1877 employees receive a bicycle fee

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Encourage quality leadership

UZ Gent is the right place for people with managerial talents or ambitions. The hospital offers staff with a

coaching and training program that focuses on self-development and talent development. They therefore get all the support they need to become a manager and grow

in that role.

An introductory program helps starting managers to get set-tled in. For people who have been managers for some time and want to be a coach, leadership development processes have been developed. Employees who want to discover if managing is something they want to do can attend the Aspirant Management Development Program (AMDP). The program brings their abilities and personality characteristics to the surface and gives them a glimpse of their leadership skills. By investing in leadership development, UZ wants to stimulate value-driven leadership.

Students on campus

Training students is one of the core tasks of UZ Gent. Trainee specialist doctors and dentists receive high-quality and practice-oriented training at the hospital.

The students of the Faculty of Medicine and Health Sciences also receive some or all of their training on the

UZ campus, in various basic disciplines.

• 7899 students

• Ten basic disciplines: medicine,

dentistry, speech therapy and audiology,

biomedical sciences, physical education and

kinesiology, rehabilitation sciences and physiotherapy,

nursing and midwifery, management and policy of

the health care, health education and promotion

and occupational therapy.

• Master-after-master: general

practitioner, specialist medicine, occupational

medicine, child and youth care, hospital hygiene,

insurance medicine and medical expertise,

advanced dentistry

• Postgraduate and permanent training

• Doctoral training

• 102 doctors and 15 dentists

earned their accreditation as specialists

in 2015-2016.

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07Sharing knowledge and expertise

Expanding

the network

The hospital landscape is in full swing. Partnerships with partner hospitals

which grew from the bottom up, remain active, in addition, both the federal and the Flemish government are committed

to closer cooperation.

For several decades, hospitals have evolved from independent entities to centres that work together in broader care organisations. UZ Gent has also been work-ing with other healthcare institutions for more than 25 years. Over the years, this network was constantly expanded and strengthened.

No one-way traffic

Since 1988 UZ Gent has concluded various cooperation agreements – for care provision, but also for logistics, training and research. At the moment 330 coop-eration agreements are active, and partnership agreements were concluded with 17 hospitals. In addition, there are 14 international cooperation agreements, 9 of which with Zeeuws-Vlaanderen.

‘All the cooperation agreements have grown bottom-up and ad hoc’, says Prof. Dr. Jan Gerris, Network Advisor at UZ Gent. ‘The content and intensity vary greatly, but with the partner hospitals we always work together on the basis of trust and equity and in open communication. For us, cooperation is not one-way traffic but interaction. As a university hospital we are strong in innovation and in clinical and translational research. Our approach is: how can we share our knowledge and expertise, develop treatment protocols together and make arrangements to pursue the same quality levels?

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“HOW CAN WE SHARE OUR KNOWLEDGE AND EXPERTISE, DEVELOP

TREATMENT PROTOCOLS TOGETHER AND MAKE

ARRANGEMENTS TO PURSUE THE SAME QUALITY LEVELS?

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In full motion

Those partnerships which grew from the bottom up remain active. While top-down initiatives are also added. Both the Flemish and the federal government want hospitals to coop-erate more closely in future. To this end, the Flemish govern-ment develops a Strategic Care Plan for Flanders. This plan intends to redefine hospital care based on care regions. The government wants to develop a solid basic offer, concentrate the expertise on complex pathology and rationalise high-tech care services. Investments will no longer focus on the individ-ual hospital, but will respond to a regional care strategy.

The federal government urges hospitals to set up structural cooperation initiatives, to better divide tasks and coordinate care. The existing legal forms of cooperation and governance models no longer meet these needs. That is why the federal government announced a reform of the hospital act.

‘All these evolutions ensure that the hospital landscape is cur-rently in full swing’, says Prof. Dr. Gerris. ‘What that landscape will look like after the dust has settled down is unclear. In any case, UZ Gent wants to help optimise the offer of medical services in its capacity of a highly specialised centre. By shar-ing our knowledge and expertise, we also want to contribute to the scientification of care.’

Thoughts on networking

On 18 June 2016 UZ Gent organised a closed academic reflection for hospital executives under the heading ‘Quo Vadis – medicine in the coming decades’, which mainly focused on all forms of networking. Five speakers were invited: Dr. Tom Fiers (UZ Gent), coordinator of the Col-laborative Care Platform (CoZo); Frank Robben, eHealth platform manager; Prof. Dr. Fritz Offner (UZ Gent); sociolo-gist Marc Claeys (VUB) and Pieter Van Herck (Voka Health Community).

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As a result, patients with any psychiatric problems can rely on the network, from birth to their life’s end. Chief physician Prof. Dr. Renaat Peleman: ‘As an academic partner, UZ Gent wants to help in the scientification of care: all network partners should be able to offer high-level psychiatric care, according to evidence-based guidelines.’

‘Mother and baby’ care path

Currently, UZ Gent and Sint-Camillus work together to provide a care path for ‘mother and baby’ aimed at mothers with perinatal psychiatric problems and their child. Sint-Camillus has a ‘mother and baby’ unit where mothers are cared for after childbirth and also offers outpatient treat-ment and home care. UZ Gent, on the other hand, specialises in psychiatric care for mothers with prenatal questions or problems, from the wish to become pregnant to shortly after childbirth. By aligning these service offers and embedding them into a coherent care program both the care continuity and quality of care are guaranteed.

Collaborate for

a coherent psychiatric

care offer

In the Ghent region the offer for mental health care is fragmented across various hospitals and other

facilities. In order to rationalize psychiatric care and to develop a coherent care offer for patients,

UZ Gent and the Psychiatric Hospital Sint-Camillus signed a cooperation agreement in 2016.

Scientification

‘We have worked together in the field of mood disorders for a long time’, says Prof. Dr. Gilbert Lemmens (Head of Psychiatry department UZ Gent). ‘For electroconvulsive therapy (ECT) Sint-Camillus patients can call on UZ Gent. They will be followed up there by a psychiatrist and anaesthetist in a top care environment. For innovative treatments that are not yet available everywhere, such as transcranial magnetic stimu-lation or deep brain stimulation, patients of Sint-Camillus can also call on UZ Gent. After the treatment those patients return to Sint-Camillus.’ The cooperation agree-ment provides a framework for exchanging expertise and aligning care programs.

The Psychiatric Hospital of Sint-Camillus and the Psychiatric Centre Caritas in Melle want to merge in 2018. The idea has grown to also include UZ Gent as an integral partner. Indeed, UZ Gent can provide therapy-related matters, so that the institutions can jointly develop a care offer for the whole spec-trum of psychiatric disorders. By reducing overlaps, the offer can be made more efficient and gaps can be complemented.

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Collaborate for

Oral Care practical training

UZ Gent, UGent and Arteveldehogeschool decided to work more closely together in 2016. As a result the stu-dents of the new bachelor program Oral Care at Artevelde-hogeschool get their practical training at the UZ dental infrastructure, just like the dentistry students of UGent.

The three partners also agreed to invest in state-of-the-art infrastructure for dental practice training. For example, all units in the current pre-clinic – where practical training without patient contact takes place – are replaced by brand-new workstations. The actual clinic, where students come into contact with patients, already has about 50 state-of-the-art stations. It will now receive 10 extra units.

“THE ACTUAL CLINIC, WHERE STUDENTS COME

INTO CONTACT WITH PATIENTS, ALREADY HAS ABOUT

50 STATE-OF-THE-ART STATIONS.

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Speed dating with

future doctor-specialists

On 11 June 2016 UZ Gent organised, for the first time, a speed-date event for its trainee doctor-specialists (ASOs)

and the hospital management. Recruiting new doctor-specialists is increasingly becoming a task of the hospital

management. With this event UZ Gent also commits to future-oriented networking with the partner hospitals.

A little over forty ASOs and 21 hospital managers took part. They were given the opportunity to get acquainted during sessions of 20 minutes each. Because the participants responded very positively, a second edition will be organised on 25 November 2017, together with the Ghent Association for Medicine Assistants.

UZ Gent joins

the search for new

collaboration models

The federal government wants hospitals to cooperate more and more closely. New governance models are

needed to this end. In a report for the Federal Knowledge Centre for Health Care (KCE), experts from UZ Gent pro-

posed three governance models.

Today, most of the collaborations are still ad hoc arrange-ments. In the coordination bodies of the numerous partner-ships, the management and board of directors of the partici-pating hospitals are usually represented. That is time-consuming and not efficient. In order to optimise the cooperation, good governance models are required. To this end, the government wants to adapt the existing hospital act. The KCE report supports the policy through a literature review, an analysis of hospital networks home and abroad and a survey of stakeholders.

The KCE report presents three collaboration models, from light to far-reaching: the coordinated network, the autonomous cooperation initiative and the integrated care system. Each of the three models is run by a coordinating governing body. Prof. Dr. Kristof Eeckloo (director of the Strategic policy cell of UZ Gent), who headed the study team: ‘In our proposal the three governance models constitute a growth trajectory. This allows hospitals to gradually choose their own growth path.

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Humanitarian

missions abroad

The commitment of UZ staff reaches far beyond the borders of the hospital. In different continents care

providers use their medical and nursing expertise to help the local population.

In maart 2016 nam een UZ-team deel aan een missie van de NGO Keten van de Hoop – Chaîne de l’Espoir in Managua, Nicaragua. Het team – drie artsen, vier verpleegkundigen, een perfusionist en een biomedisch technieker – voerde hart-operaties uit bij 11 kinderen en screende samen met het lokale team 45 andere patiënten met een hartafwijking.

In April 2016 another UZ team went to Ramallah, Palestine, to launch a paediatric program for cardiac surgery. Four doctors, an ASO, a perfusionist and four nurses participated in the mis-sion organised by the NGO Palestinian Children Relief Fund.

In November 2016 Barbara Matthys, Urology nurse, took part in a foreign mission to Madagascar, organised by the non-profit organisation H.E.L.P. She was part of a multidisci-plinary team that operated on women and men with urogy-naecological disorders in Ampasimanjeva. She provided post-operative care.

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Information and awareness raising

In 2016 the UZ departments also organised quite some information moments for the general public, for care profession-als and referrers. A selection of the offer:

• 18 March 2016 – Symposium of the Heart Centre on the right ventricle

• 11 May 2016 – Formation evening for GPs on the treatment of liver steatosis and chronic hepatitis C

• 6 June 2016 – Evening Symposium on correct use of antibiotics in admitted patients

• 16 September 2016 – Symposium of the Medicines Research department

• 24 September 2016 – Symposium on andrological care, following the setting up of the Andrological Centre

• 30 September 2016 – Symposium about CFS and somatic unexplained medical symptoms

• 1 October 2016 – Symposium on multidisciplinary care for patients with hepatocellular carcinoma

• 21 October 2016 – Symposium on pain

• 28 October 2016 – 27th International Conference for Spina Bifida and Hydrocephalus, Turning Points

• 7 November 2016 – Symposium of Intensive Care about invasive pulmonary aspergillosis

• 7 November 2016 – Evening Symposium of the Transplan-tation Center on tissue donation

• 18 November 2016 – Symposium on oncological child rehabilitation

• 24 November 2016 – Symposium of Intensive Care Paediatrics on pain, stress and anxiety in admitted children

• 1 December 2016 – E-Health in Gent, a symposium on good practice on e-health in the Ghent region

• 5 December 2016 – 25th Day of Infection Prevention

Information evenings and awareness campaigns for a wide audience

• 20 June 2016 – Information about fatigue in cancer

• 27July 2016 – Information stand on head and neck cancer

• 5 September 2016 – Information evening for patients with nasal polyps

• 5 October 2016 – Information evening about the treat-ment of Crohn’s disease and ulcerative colitis

• 8 October 2016 – Symposium on breast cancer: researchers and specialists of UZ Gent and UGent discussed recent developments in cancer research

• 10 October 2016 – Post-transplant information session for transplant patients and their families

• 1 December 2016 – Patient and professional, together strong in care: an information evening about patient participation

Symposia for care professionals and referrers

• 2 February 2016 – Symposium on stroke care for referrers

• 19 February 2016 – Study Day on the care of newborns, for and by nurses and midwives

• 19 February 2016 – Study Day on incontinence and peeing problems in children

• 3 March 2016 – Kick-off Symposium Immuno-Oncological Network Ghent on cancer immunology and immune therapy.

• 14 March 2016 – Symposium on organisational and surgical aspects of aid in terror attacks

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08 Awards and recognitions

‘I have always had

excellent collaboration

experiences with

UZ Gent’

In 2016 Prof. Dr. Jan De Maeseneer was granted a lifetime achievement award by Domus Medica, the Flemish GP associa-tion, because of his ‘persistent commit-ment for a better general medical care.’

‘I was very pleased with that recognition. With the Department of General Medicine and Primary Care of the UGent, we have indeed tried to renew

the first line – for example, by making payments on a flat-rate basis, in addition to payment per performance, or by encouraging cooperation between GPs and other healthcare providers in regional health centres that do not only focus on the individual but also on the population in a neighbourhood.’

Across the lines

‘I have never been connected to UZ Gent, but I got to know the hospital very well in a variety of roles. For more than twenty years I was chairman of the Medicine Education Committee. We have always worked together with UZ Gent in excellent understanding to implement the innovations that have made UGent’s medical education the best of the country. The role of UZ Gent – as a place where future doctors gain practical experience – is essential in the process.

In addition, I have been a general practitioner for forty years now. During that time, my attention has grown towards the transition from the first line to the hospital and back again. When, around 1985, UZ Gent started with continuous outpatient peritoneal dialysis, one of the first candidates was a patient from our district health centre. I still remember the excellent collaboration with the Nephrology department and the nurses of UZ Gent – a wonderful example of cooperation across the lines, when no one even talked about policy notes.’

Cost-effective models

‘If we want to strengthen the first line, it must be able to cooperate with a strong second and third line. Acute, non-health-threatening medical problems should be addressed first by the general practitioner – only a small percentage requires referral to specialised care. In addition to this linear model, I see a spiral

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model for chronic conditions: those patients are referred hori-zontally, for example from the GP to the physiotherapist, but also vertically, for specialist examination. These collaboration models are cost-effective and guarantee that every health-care provider can act according to his or her competence. Unfortunately, many caregivers spend a large part of their time on task they are overqualified to do – a major cause of burnout and demotivation.

For optimal cooperation across the lines, good information and communication are of course necessary, which is not always so self-evident in a large hospital. I strongly believe in the new opportunities offered by ICT: video conferencing, for example, so that GPs can consult with physicians in the hos-pital or telemedicine, so that you can forward images from a less mobile patient for specialist advice. ICT can take the information where it is needed, without having to transfer/relocate the patient right away.’

Social responsibility

Finally, as chairman of the City Health Council (Stedelijke Gezondheidsraad), I learned to appreciate UZ Gent because it accepts its social responsibility to advance the health of the population of Ghent. Certainly now that inequality and socio-economic health differences are increasing, we have the duty to ensure that we can offer everyone accessible care, without thresholds, regardless of income, education level, religion or ethnicity. For example, I greatly appreciated the fact that UZ Gent took measures to provide direct access to medical assistance to people without papers. As a caregiver we should never forget that we have a universal mission – we are here for everyone.’

In 2016 many physicians, researchers, employees and projects of UZ Gent received awards. Consult the overview of awards and recognitions on

jaaroverzicht.uzgent.be

“WE HAVE THE DUTY TO ENSURE THAT

WE CAN OFFER EVERYONE ACCESSIBLE CARE.

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Management Committee

PresidentProf. Dr. Eric Mortier, CEO

MembersProf. Dr. Renaat Peleman, Chief Physician Prof. Dr. Rik Verhaeghe, Director of NursingProf. Dr. Koenraad Vandewoude, Director of External Relations and ServicesMrs Chantal Haeck, Director of Business Support Sector

Supervisory bodiesMr Yannick De Clercq, Government Commissioner at Ghent University and UZ GentMr Daniël Ketels, Inspector-General of Finance

SecretaryMrs Sabine De Smyter, secretary Board of Directors and Management Committee

The Management Committee is charged by the Board of Directors with the general management of the day-to-day operations of Ghent University Hospital, including the management of the expenses and income. It performs the powers

of the director as provided in the hospital act. Decisions are made as a board.

9 Management

Board of Directors

Management Committee

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Board of Directors

PresidentProf. Dr. Anne De Paepe, Vice-Chancellor of UGent

Members

The dean of the Faculty of Medicine and Health Sciences of Ghent UniversityProf. Dr. Piet Hoebeke (since 1.10.2016)

The CEO of UZ GentProf. Dr. Eric Mortier

Three members chosen by the Board of Governors of Ghent University Prof. Dr. Petra De SutterMrs Mieke DolphensMr Alexander Vercamer

Two members chosen by the Chief Physician and by the medical heads of departmentProf. Dr. Wim Van Biesen  Prof. Dr. Bruno Verhasselt

Two members chosen by the physicians who are not department heads, with at least a part-time mandateProf. Dr. Luc Vanden Bossche Dr. Nadia Den Blauwen

Two members co-opted by the above members and the president on the basis of their managerial competency Mr William Van Malderen Mr Ivo Van Vaerenbergh

Supervisory bodiesMr Yannick De Clercq, Government Commissioner at Ghent University and UZ Gent Mr Daniël Ketels, Inspector-General of Finance 

SecretaryMrs Sabine De Smyter, secretary Board of Directors and Management Committee

Attending the meeting upon invitationProf. Dr. Freddy Mortier, Deputy Vice-Chancellor of Ghent University (with voting right if the president is absent) Prof. Dr. Renaat Peleman, Chief Physician

According to the Hospital Act the Board of Directors has the general and ulti-mate responsibility for the hospital activity in terms of organisation and the operations and in financial terms. The composition of the Board of Directors and its powers are laid down in Royal Decree No. 542 dated 31.3.1987 on the organisation, operations and management of the state university hospitals of Ghent and Liège.

The Board of Directors meets in principle every last Monday of each month, except in July. In 2016 the Board of Directors met 13 times.

The decision process is laid down in the household rules and the charter of good management. The mandates of the chairman and the directors are unsalaried, except for two co-opted external directors. They receive a fixed remuneration of EUR 2,871 on an annual basis and EUR 278 attendance fee per meeting, as well as a compensation for travel expenses related to the performance of their mandate. The amounts are in accordance with the regulation in force for cat-egory 1 provisions in the Decision of the Flemish Government of 9 March 2007 on the settlement of compensations of Directors of external autonomous agencies of the Flemish government in a public-law form. The aforementioned amounts are adjusted to the index on the basis of the health index of January 2012 (basis 2004). Both external directors received a fixed compensation of EUR 2,992.34 in 2016. In addition, they received a variable compensation, for one director for an amount of EUR 3,590.76, for the other for an amount of EUR 3,291.53.

Within the Board of Directors the Audit Committee and the HR and Remuneration Committee function as fixed committees. Both committees have a merely advi-sory function with regard to the Board of Directors, which in any case keeps his full power of decision. In accordance with the good governance charter the operations of the Board of Directors are evaluated at least every two years on initiative of the president.

Colophon

Responsible publisher | Prof. Dr. Eric Mortier, CEO

Editing and coordination | Jansen & Janssen Creative Content and the Communication & Events department of UZ Gent

Photography | Christophe Vander Eecken, Thomas Verfaille (p. 24, p. 62), BPC/Luc Dequick (p.28)

Design | Karakters

May 2017

Universitair Ziekenhuis Gent

De Pintelaan 185 | 9000 GENT

+32 (0)9 332 21 11 | info@uzgent.be

www.uzgent.be

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