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Hospital Healthcare Europe
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Latest issue Hospital Healthcare Europe 2017


HOPE

Hospitals in Europe: Healthcare data

The figures given here provide the most updated picture of the situation of healthcare and hospitals, compared with the situation at the beginning of the 2000s

For several years, hospitals have been required to act more efficiently and to increase productivity. Increased performance is indeed visible. Yet, healthcare systems are facing conflicting trends: short and long term impacts of an economic and financial crisis; increasing demand of an ever-expanding and ageing population; increasing request and availability of technological innovations; new roles, new skills and new responsibilities for the health workforce.

EU hospitals and healthcare services

The figures given here provide the most updated picture of the situation of healthcare and hospitals, compared with the situation at the beginning of the 2000s

For several years, hospitals have been required to act more efficiently and to increase productivity. Increased performance is indeed visible. Yet, healthcare systems are facing conflicting trends: short and long term impacts of an economic and financial crisis; increasing demand of an ever-expanding and ageing population; increasing request and availability of technological innovations; new roles, new skills and new responsibilities for the health workforce.

Representing public and private hospitals

HOPE is actively involved in exchanging good practices and sharing information, as well as in contributing to the work of 
the European Union

EU mechanisms: How health policy gets made

The European Member States delegate some of their decision-making powers to shared institutions they have created, with a real impact on hospitals and healthcare services


Cardiovascular

Making a difference in arrhythmia

By raising awareness and campaigning for the improved detection and care of heart rhythm disorders, Arrhythmia Alliance aims to extend and improve the lives of patients around the world

Cardiac manifestations of Fabry disease

Cardiac involvement is one of the three major causes of morbidity and mortality in Fabry disease, together with end-stage renal disease and cerebrovascular events

Proximal endovascular occlusion for CAS

Carotid artery stenting is an alternative to carotid endarterectomy, and embolic protection devices are recommended to reduce periprocedural stroke in patients at increased surgical risk

Vessel preparation for DCB with atherectomy

Vessel preparation prior to drug-coated balloon angioplasty using atherectomy for the treatment of femoropopliteal artery disease may improve efficacy of drug release and reduces provisional stent rate

Neprilysin/angiotensin inhibition in heart failure

Sacubitril/valsartan is recommended in major guidelines for treatment of heart failure with a reduced ejection fraction and its use should be considered to improve morbidity, mortality and quality of life

Cardiovascular disease in patients living with HIV

Patients living with HIV are exposed to a higher risk of adverse cardiovascular events, due to complex interactions between traditional risk factors and HIV infection itself


Emergency and Critical Care

Foreword

Emergency medicine (EM) stands in the centre of interest of healthcare systems all over Europe. The society, politicians and healthcare workers recognise this field of medicine as of utmost importance for the community, for obvious reasons.

Situation awareness during crisis in the OR

The operating room is a complex environment and knowledge and improvement of situation awareness can increase the performance in this domain and, therefore, provide better patient outcomes

Adequate staffing in the emergency department

A staff calculation model for emergency departments that can be adjusted to accommodate multiple factors, and therefore be applied to any organisation’s facility, is presented

Sepsis screening in the emergency department

In future, the identification of different sepsis patterns based on biomarkers, pathophysiology, or the responsible infection will allow the exploration of personalised treatments in this field


Oncology and Haematology

Targeted therapies in CD30+ malignancies

The CD30 cell receptor has pleiotropic biologic functions and represents an ideal target for monoclonal antibody therapy in haematological and non-lymphoid malignancies

Update on good risk acute myeloid leukaemia

Good risk AML is defined by the presence of good risk cytogenetics and is characterised by a significantly better outcome following standard induction chemotherapy and high-dose cytarabine

Preventing exposure to cytotoxic drugs

New policy recommendations on preventing occupational exposure to cytotoxic drugs have been launched in the European Parliament

Foreword

The European Society for Radiotherapy and Oncology (ESTRO) seeks to improve cancer patients’ outcomes by promoting innovation, research, and dissemination of science and by developing initiatives to increase awareness and understanding of radiotherapy treatment, and therefore facilitate its access.

Foreword

Thanks to new scientific and technological developments and accelerated review by regulators, innovative medicines become available at a faster pace.

Introducing biosimilar LMWH anticoagulants

Heparins are being used increasingly in new indications, but in introducing its biosimilars to Europe, differences in safety have resulted from differing definitions of biosimilarity throughout the world

Management of childhood ITP

Management of paediatric primary immune thrombocytopenia (ITP) based around recent guidelines and experiences at a large UK tertiary hospital that runs an expert regional ITP clinic are discussed


Pathology and Diagnostics

Component resolved diagnostics in allergology

Allergen component-resolved diagnostic testing is a new methodology in clinical allergy diagnosis, improving the ability to identify specific clinical phenotypes

Adding value to the healthcare system

More than 70% of critical clinical decisions are based on a diagnostic test; however, biomedical scientists who provide this essential service remain invisible.

Liquid biopsies in clinical practice

The All Wales Medical Genetic Service has been providing stratified medicine services for cancer patients since 2009 and the benefits and uses of liquid biopsies in their clinical practice are discussed

Personalising therapies in primary osteoporosis

Circulating mini RNA-based algorithms for targeting therapies and early detection of post-menopausal osteoporosis are discussed

HCV genotyping by next generation sequencing

Sequencing the hepatitis C genome is essential for a range of applications, such as genotyping a patient’s strains in order to choose the most effective therapy

Breakthrough in detection of cancers

Deep learning techniques offer greater diagnostic accuracy to enhance the role of pathologists


Pharmacy and Therapeutics

Management of acute bronchiolitis

Predominantly seen in the winter months, 2–3% of children with bronchiolitis will be admitted to secondary care, and this article addresses the diagnoses and management of the disease

Ambulatory oxygen: now and in the future

In many respiratory patients, the presence of even mild oxygen desaturation during exercise or activities of daily living can be corrected with the use of an ambulatory oxygen regimen

Comorbidities in IPF

The identification and prompt treatment of comorbidities may have a clinically significant impact on overall quality of life and functional status of patients with idiopathic pulmonary fibrosis

Management of ADPKD in the era of tolvaptan

Autosomal dominant polycystic kidney disease is the most common hereditary renal disease and the fourth leading cause of end-stage renal disease, affecting millions of people worldwide. Here we discuss the first targeted therapy available

Faecal microbiota transplantation

Faecal microbiota transplantation is a key therapeutic option for the management of recurrent C. difficile infection and is being evaluated in a number of other gastrointestinal and metabolic disorders

Pharmacy education in Europe

The European Association of Faculties of Pharmacy (EAFP) was founded in 1992 when a group of academics from different European countries met in Paris to establish the Association with the aim of supporting networking in pharmacy education within a European dimension

Safe hand drying

Recent studies suggest that single-use paper towels are the safest way to dry hands – jet air dryers are efficient but can disperse microbes widely and create aerosols that could be inhaled

Clinical management of hyperkalaemia

Current options available for chronic treatment of hyperkalaemia are limited, particularly in the longer term, but novel compounds including patiromer and ZS-9 are likely to improve management

Optimising the care of patients with MND

The management of motor neurone disease requires a timely multidisciplinary, palliative care and holistic approach

Balancing economic viability and safety

Patient safety is dependent on the interaction of many different factors, and German hospitals have implemented appropriate systems to reduce avoidable incidents. But even measures such as these cannot guarantee absolute safety


Radiology and Imaging

Portable ultrasound technology

Routine use of pocket-size ultrasound devices has the potential to improve diagnostics and treatment of patients at a low cost

Locoregional therapy of liver tumours

In this article, methods of patient selection, techniques and protocols for transarterial chemoembolisation are described

Vascular plugs in different clinical settings

Interventional radiological procedures have grown and embolisation is a key area. Vascular plugs are important devices that can be used in a wide variety of clinical scenarios

A standalone breast screening modality

Initial results of Malmö Breast Tomosynthesis Screening Trial have shown a substantially increased cancer detection rate compared with mammography, and an acceptable elevation of the recall rate

Ensuring safety in nuclear medicine

Hospital Healthcare Europe spoke with Jilly Croasdale of the UK Radiopharmacy Group about guidance on safe drawing up of radiopharmaceuticals in nuclear medicine departments

Radiological treatments for uterine fibroids

Options for treating uterine fibroids are increasing, including uterine artery embolisation and MRI-focused high intensity ultrasound, but patient preference and tailored treatment still remain key


Theatre and Surgery

Use of IONSYS in clinical practice

A novel transdermal fentanyl system provides optimal individual pain control to surgical patients and may effectively serve as an alternative therapy option in the management of postoperative pain

ADEPT and optimising patient protection

It is only by the medical device industry working in partnership with the specialist medical societies that the safety and efficacy of medical devices can be established and patient care optimised

Stress immunity in surgeons

Stress immunity is an important personality trait of doctors, with a high representation seen in surgery. With 1 in 5 surgeons dropping out of training and 80% reporting burnout symptoms, methods to increase job satisfaction and reduce burnout are required

Optimal analgesia for major open surgery

This article aims to explore the various modalities available for providing analgesia for major open abdominal surgery and the evidence surrounding their use, risks and benefits

Monitoring during anaesthesia and recovery

The 2015 Association of Anaesthetists and Great Britain and Ireland standards of monitoring during anaesthesia and recovery is a landmark guideline that builds upon previous recommendations

Haemodilution and avoidable blood transfusions

This review will attempt to describe the frequent occurrence of haemodilution due to fluid administration and its potential impact on decisions to administer blood transfusion

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