Vall d’Hebron Hospital

1 © Vall d’Hebron University Hospital

Coordination Management and Communication Unit

Design Communication Unit

Photography Hospital’s field, Josep Maria Ardèvol and Quim Roser

Printing Pereda Print Solutions, SL

Legal deposit : B. 2921-2013

2 Index

A public institution referral ...... 4

From proximity to internationality...... 5

Vall d’Hebron in figures...... 6

Mission, vision values...... 8

Our assistance...... 9

Areas of excellence ...... 11

Aims and objectives...... 13

Training ...... 14

Research Institute of Vall Hebron University Hospital(VHIR)...... 16

Professionals...... 18

Quality and innovation ...... 19

Social commitment...... 20

Corporate Social Responsibility ...... 22

Contact us ...... 23

3 A public institution referral A health, teaching and research complex, with more than 22 buildings and 7.000 professionals, working for healthcare and well-being of patients

The Vall d’Hebron University Hospital is the largest hospital complex in 7 .000 professionals and one of the largest in Spain. It has a team of around 7,000 professionals and a 22 buildings budget of 563 million euros. It is located at the base of the Collserola Mountains, in the north of , and its area of influence includes the neighbourhoods of 1,146 beds (182 tertiary beds) Horta-Guinardó, and and the city of Montcada i Reixac, with a population of more than 450.000 inhabitants. At the same time, the Hospital 45 operating theatres has become a reference point for Catalonia, the rest of Spain and internationally, due 381 consulting rooms to its highly complex in tertiary care procedures.

3 Accident and emergency areas It is structured into three main health areas: General Area, Mother and Child Area and Orthopaedics and Rehabilitation Area. Located in the Pere Virgili Health Park, 98 Out-patient departments (OPDs) near the hospital complex, there is a Non-Hospitalisation Surgery Unit. The hos- pital also extends its activities to the Horta Primary Care Centre with a specialized €563 M budget primary care unit. National reference for 19 groups of pathologies CSUR With 1,146 beds, the hospital is committed to a management model that places (Centers, Services and Units for the patients at the centre of its actions, including training and research, and promotes National Health System) participation in Catalan and Spanish research projects. Quality is a key aspect for the professionals at the hospital, who enjoy national and international prestige and are Centre of reference in Catalonia for involved in initiatives with the Ministry of Health and the public company, Catalan tertiary care Health Institute, to which it belongs. Ictus Adult Oncology The Vall d’Hebron University Hospital encompasses practically all medical and sur- Mother and Children Oncology gical specialities and has the necessary healthcare modalities to cover all these areas, Congenital Heart Disease including clinical services and clinical support units, university educational centers, Major Burns public health services companies, research centers, laboratories and other installa- Spinal Injuries tions to round out the hospital’s activities in healthcare. Multiple Injuries Marfan Unit Inflammatory Bowel Disease Unit Multiple Sclerosis Neonatology Foetal Surgery Pulmonary hipertension

4 From proximity to internationality National and international Hospital referral

A communitarian Hospital working and networking with the community

Barcelona Reference area >450.000 people

5 Vall d’Hebron in figures

Annual figures A day in Hospital >57.000 discharges 116 Discharges

>30.000 surgical interventions 910 Hospitable stays

>870.000 outpatient visits 120 Surgery

>74.000 outpatient visits in day hospitals 3.525 Outpatient visits

>200.000 emergencies 550 Emergencies

>10.000.000 Determinations in labo- ratories

>130.000 patients attended in medi- cal surgeries (diagnostic tests of high and low complexity)

6 Tertiary and highly complex care

We commit to a new Medicine directed to the limits of knowledge. A Medicine that, from the understanding of the operation of the biomolecule and the biological processes is capable of incorporating innovative treatments, in order to boost the development of a healthier and supportive society

1.500 Radiotherapy treatment

588 Cardiac surgeries with extracorporeal circulation

200 Robotic surgeries

60 teleICTUS

30 Pediatric Cardiology Telemedicine Programs

Adult Transplants 82 Cornea 46 Liver 54 Bone marrow 46 Lung 95 Kidney

Pediatric Transplants 7 Heart 9 Liver 25 Bone marrow 3 Lung 10 Kidney 7 Mission, vision and values

Values We care about our patients’ health, our staff and the essential values of the public health system.

C

Commitment . We are responsible and accurate with the resources we are allocated accountable to society showing our results with transparency. We are committed to Mission the sustainable progress of the health system and society. Trust . We aim to build trust among patients, professionals, society and the health We take care of people’s health, in authority. We believe our professionals, our strengths and work with conviction and order to meet their needs and expec- dedication to improve our weaknesses. tations through a comprehensive, effective, efficient and quality health care system. We aim to promote the training of professionals that society A needs and developing a research that Accessibility . We are an institution accessible to patients, trying to respond quickly contributes to improving the health and easily to your health problems. We guarantee the support of our specialists to and quality of life of people. primary care professionals and other health care institutions in the region. Welcome . We offer a humane, warm, friendly and personalized service to our Vision patients and their families. We aim to be a friendly and comfortable hospital for patients and professionals. Our aim is being an excellence health institution, a referral in Catalonia, nationally and interna- R tionally in health care, teaching and research. We aspire to be recognized Respect . We respect the dignity, autonomy and decision-making capacity of by the citizens, professionals and the patients and their families. We guide the relationships with other professionals and environment as an innovative or- institutions towards respect for the work and responsibility that each one has as- ganization in all lines of activity noted signed. for the quality of its performances, Resolution . We solve the healthcare problems of the patients in an effective, effi- and adds that generates knowledge. cient and safe way, our basis is the best scientist evidence and the available technol- Contributing to the advancement of ogy, promoting the healthcare continuity and sharing our knowledge. sustainable health system is essential to achieve the continuous professional and personal development of those E who work in our Hospital.

Expertise . We have highly skilled professionals and leaders who apply the latest scientific evidence and the latest technology to solve the health problems of the population, driving innovation and progression of knowledge, with the will for learning, teaching and continuous improvement. Equity . We are an institution of the public system committed to its essential values. We provide health care under principles of justice and equity, according to the healthcare needs of the population we serve.

8 Principles

Towards the patient oriented We focus our efforts on providing a comprehensive response to the needs and ex- pectations of the patient, from a technical point, such personalized information and ensuring continuity of care. We respect the dignity, autonomy and decision-making capacity of patients and their families.

Committed to Society and Health Care System We are committed to society and the healthcare system, because we are aware that the activities and progress in knowledge of the hospital have an important impact. We view it as a system, networking and promotes strategic partnerships with key actors and institutions around.

Recruitment and career development based on merit Actively promote the professional and personal growth of people working in our hospital. We promote the acquisition of knowledge and skills that add value to pa- tients in the hospital and society. We encourage teamwork, participation and sense of belonging.

Knowledge and innovation at the service of people We apply the latest knowledge, technology and scientific-technical practices based on the best available evidence. We have a proactive approach to innovation in health sciences and organizational changes, the ability to generate and incorporate new ideas and flexibility to adapt to new circumstances.

Quality and continuous improvement as the basis of all our actions We seek excellence and continuous improvement of processes and outcomes in any and all of our lines of action.

Accountability, transparency and ethics in decision making We seek to align responsibly and transparent, sustainable and effective and efficient use of resources we have been allocated at all times with fairness and ethics and ethical criteria in each one of our actions.

9 Our health care delivery The patient and their needs are the centre of all our Plan Action

A multidisciplinary team work, individualized vision and a global treatment of the healthcare problems enable us to attend to the healthcare needs of the people through their lives

10 Our health care delivery

We act as a reference centre for the National Health System (Spanish territory) for high complex procedures in adults and children involving in the areas of cardiology, oncology, ophthalmology, orthopedic, pediatric transplants of all the solid organs and of hematopoietic progenitors, severely-burned patients and other reconstructive procedures in plastic surgery, multiple sclerosis and neurosurgery

We are a reference in tertiary care We are a reference in tertiary care for the biggest part of medical and surgical high complex processes and procedures, in Catalonia, Spain and in the world over. This is possible thanks to the knowledge of our professionals that involves all the disci- plines related to healthcare and the use of pioneer technologies.

Territorial attention and ambulatory procedures We work further beyond the doors of the Hospital with a narrow collaboration with the rest of health suppliers of our territory: primary health attention, long term care and mental health.

11 Areas of excellence

Highly specialized medical and surgical attention We have all medical and surgical specialties, highly qualified professionals and leaders who apply their expertise and advanced diagnostic and therapeutic technol- ogy to meet the needs and care expectations of patients in acute, chronic, prevalent minority illnesses (pathologies affecting a maximum of five people per 10,000).

Women’s and children’s care Our vast experience and the availability in obstetrics, gynaecology and paediatrics equips us with the requisite tools for an integral treatment, from the fetal age to adolescence, as well as a following to adult age through multidisciplinary teams.

12 Areas of excellence

Highly specialized medical and surgical attention We are the second to none national reference in the treatment of multiple-wound including severe burns and medullar injured patients, in both, adults and children, always providing the best care and specialized surgical rehabilitation..

Referral centre for major burn patients We are the only center for major burns in Catalonia. We have a unit leader equipped with the most modern infrastructure, and emergency surgeries from their own beds in critically ill patients, and all the resources necessary to deal with such patients.

Transplants in adults and children The availability of highly qualified medical and surgical teams and highly special- ized nursing, allow us to have a wide range of transplant programs, solids (lung, liver, kidney, heart pediatric transplantation) and all kinds of hemopoietic progeni- tors. Also, we pioneer in multi-tissue transplants (complete face transplant).

Multidisciplinary and comprehensive oncological care We account for the largest hospital of oncological care in Catalonia, both in adult- hood and childhood. We offer medical, surgical and central services highly spe- cialized in oncological care to ensure a comprehensive process, incorporating all aspects of preventive, diagnostic, therapeutic and monitoring these patients needs, including personalized therapies and the use of genomic platforms.

Critical patients care Our hospital provides health care to critically ill adult neurotraumatological pa- tients, pediatrics and neonatal critical cares, offering more than 180 beds to meet these highly complex patients. Our units include support to critical patients and also in neonatal and pediatrics: extracorporeal membrane oxygenation (ECMO) and ventricular mechanics assistance. In these units, the care of mental and physical development (NIDCAP) are the pillars we are focused on. We are a training center.

13 Areas of excellence

Interventionism and minimally invasive therapeutic procedures We are committed to the performance of a wide range of minimally invasive thera- pies, that range from endovascular interventionism to highly complex procedures in upper, respiratory, urologic obstetric and gynecologic endoscopy, and as well as, video surgery in all of its aspects, including robotics.

Outpatient major surgery and devices alternative to conventional hospitalization We are leaders in outpatient surgery and we have an Outpatient Surgery Unit pioneered in the Spanish state. Technological advances enabled us to move to- wards alternative devices in conventional hospitalization, that makes it possible to organize healthcare, diagnostic and treatment for patients with acute and chronic diseases. Therefore, we have a long-term functional unit interdisciplinary geriatric, a interdisciplinary palliative long-term functional unit, a home care Unit, hospitals and multi-day consultation monographs for immediate attention and diagnostic approach to patients in whom the diagnosis cannot be delayed.

Skilled nursing facility A comprehensive and individualized skilled nursing care is offered in order to give the best health care practices, ensuring a safe and quality care. The nurses make sure the quality of the treatment they provide is based on scientific evidence, resulting from the research in this field. They plan and perform the appropriate interventions to take care of the patients and their relatives, continuously in order to achieve the best health level, autonomy and satisfaction. We boast of experts and specialized nurses, who work in accordance with standards of care. Because of the commitment and professionalism, which is evident in the effort and dedication to patient care, the HUVH has been chosen as one of the eight hospitals for the international Cent- ers of Excellence Committed to Care.

14 Areas of excellence

In vitro diagnosis The In Vitro Diagnostics Area is built on two pillars: a latest generation of techno- logical park and the excellence our professionals’ knowledge. This synergy allows us to offer a unique wide service portfolio in the Health System. At a first level, there is a set of diagnostic tests on the frontier of knowledge, including genetic and molecular techniques for the diagnosis, prevention and treatment of the diseases most prevalent in our society. On a second level, in vitro diagnostics for many rare diseases for which we are national reference center. This model defines our mission and our commitment to a tertiary care and a border of medicine targeted to the individual.

Pharmacy Nowadays, it is the service with the highest level of automation of the supply chain across Europe, including the automatization of the preparation of injectable and parenteral nutrition. There is a system to support the oncohaematological process controlling the production and maintenance of traceability in the preparation of chemotherapy. The Clinical Trials Unit specific for oncohematology performs more than 300 clinical trials in surgery and provides pharmaceutical care to patients in clinical trials, phase I-IIa.

Diagnostic imaging, nuclear medicine and radiology We offer the professionals a wide range of image-based diagnostics and nuclear medicine techniques and therapies, and interventional radiology procedures, guar- anteeing the highest quality technology and professional qualifications.

15 Professionals

As experts and committed professionals, we offer quality service; we are integrated into the society with a strong sense of belonging

The professionals of the Vall d’Hebron Hospital are the bedrock of a model of care focused on patients and based on knowledge and multidisciplinary action. The professionals from different disci- plines can contribute their knowledge and expertise to providing high quality healthcare.

Participation and commitment are essen- tial in this model, in which promoting the talent, professional leadership and profes- sional development are set out. To achieve this, one of the key aspects is to improve our competences through continuous training.

With more than 1,000 different lines of action, ranging from hosting and strategic training, continuous in-service training, annually updating and deepening knowl- edge, our professionals are the greatest potential of our organization.

Due to their prestige, it is common to find professionals of Vall d’Hebron University Hospital as a part of groups of experts, in national and international committees, boards of scientific societies, advisory groups of the Health Services and discus- sion forums.

16 Quality and innovation of our services We promote innovation and continuous improvement of the quality of our processes and results. We provide the most advanced technology to serve people

We seek excellence, guiding the organization to meet the needs and expectations of customers and interests groups to continuously improve processes and outcomes through leaders. These leaders drive the organization’s strategies, promote partner- ships, foster innovation and encourage involvement and professional development. To achieve this, in 2004 we adopted the European Excellence Model (EFQM) which is the basis of our Quality Management Model.

The quality of our services, units and procedures have been recognized by obtain- ing several certifications and external accreditations, awarded, among others, by the Ministry of Health, the International Organization for Standardization (ISO) and various national and international organizations.

We have the most advanced technology applied to the diagnosis and therapy and the improvement of information and communication between professionals and the public. The implementation of shared medical field with primary care and other institutions, electronic prescribing and telemedicine and telecare tools have allowed us to improve the coordination, continuity of care, quality and safety of attention.

17 Training Generate, transform and transmit knowledge in all the fields of health sciences areas

Degrees of UAB University education More than 750 students practice in the Hospital every year Medicine Nursing We have been one of the teaching hospitals in the Autonomous University of Bar- Biomedicine celona since 1971 and we have a Teaching Unit of the Faculty of Medicine on our Masters and postgraduate certificates premises. In addition, we have agreements with other universities or schools for

external work experience or specific activities. Training for students of external faculties and colleges

Medicine Dietetics and Nutrition Nursing Physiotherapy Pharmacy Occupational Therapy Biosciences Social Work Masters and postgraduates

18 Training

We see teaching as a strategic bed-rock of health system, which should be aimed at improving health care and its quality. We want to contribute to the training of professionals, who are committed to society, welcoming, guided by ethical and deontological principles, active in research, experts and innovators

Specialized health care training We are the Hospital with most More than 600 permanent residents and more than 300 residents in accredited vacancies for teaching external rotation in Spain

We were among the first hospitals in Spain to launch the MIR system in 1968. To- Autonomous community of origin day we have the most specialized accredited training places and one of the greatest appeals to potential residents. Catalunya 54% Rest of the country 46% We offer specialized training to graduates in 7 professions (Medicine, Nursing, Pharmacy, Psychology, Physics, Chemistry and Biology) 47 in major specialties and 4 external specialties. This covers more than the 90% of all recognized specialties. Andalucía 19% València 16% We support the accreditation of educational centers and receive a large number of Galicia 11% residents every year from more than 100 hospitals in all the autonomous regions Madrid 10% who come to do clinical rotations in specific areas. Aragón 7% Castilla León 6% Rest of autonomous 31% communities

Courses and training periods Country of origin We receive professionals from more than 28 nationalities who undergo additional training periods of up to 6 months, in integrated in care South America 63% services in 40 specialties Mexico and Central 23% America Europe 11% We offer a wide range of courses and training periods for Spanish and foreign spe- Rest of the countries 3% cialized professionals.

We organize clinical sessions, courses, workshops and conferences, designed by our Services for both internal and external professionals. Our quality is endorsed by Health Professionals for Continuous Education/ Committee of Continuous Educa- tion of the National Health System (CCFCPS / CFC SNS) that each year approves of more than 120 activities.

19 Research . Vall Hebron Research Institute (VHIR) Basic, clinical and translational research at the service of the people

The VHIR, created in 1994 as a research foundation is the Research Institute of Vall d’Hebron University Hospital belongs to the Catalan Institute of Health, the Department of Health and is a member of CERCA, an organism of the Ministry of Awareness and Economy of the Govern- ment of Catalonia.

The VHIR shares its activity with UAB and is an institute accredited by The Carlos III Institute of Health and is also a member of the Network of Hospitals and Centers of Research: Itemas.

Since 2011 the VHIR has been the Spanish scientific coordinator of the European Ad- vanced Translational Research Infrastruc- ture in Medicine, EATRIS, which includes the governments, research centers and hospitals from many European countries.

VHIR in figures

>10 research areas > 60 research Groups > 1,200 researchers > 650 publications per year > 3,000 IF Total, annual average > 35% publications in international partnership > 250 competitive research projects > 600 active clinic trials > 20 active patents > 60 thesis per year

20 Research . Vall Hebron Research Institute (VHIR)

We would like our research and innova- tion to expand beyond the borders of knowledge and to become an active and important reference for our society, our health system and our citizens, attract- ing talent and ensuring that our busi- ness in terms of excellence, quality and translation, corresponds with the leading position that the Vall d’Hebron Hospital should have.

21 Our history

1955 inaugurated General Hospital Vall d’Hebron (formerly known as the Residen- tial Care Franco). A single thirteen-floor building that functioned as an open center, with no fixed medical staff and especially for surgical patients because it had not yet 1955 decided to accommodate complex medical patients.

1960 The first surgical teams were incorporated to attend emergency surgery and the first medical interns.

1966 The residence became the Sanitary City. Three new monographical buildings were built: orthopedics and rehabilitation, pediatrics and obstetrics and gynecology as an extension of the General Hospital.

1966 The Nursing School was set up The nursing of Vall d’Hebron prompted its own definition of nursing.

1967 The Traumatology and Rehabilitation Hospital was inaugurated. The increase of traffic accidents and work was the origin of this specialized center which acquired great prestige, currently in force in the care of spinal injured and cerebral palsy.

1967 Maternal Hospital and Child Clinic were set up, in which they used to attend to an average of 80 deliveries per day in the early seventies.

1968 First promotion of medical interns and residents (MIR) as the second author- ized center in Spain, after the Puerta del Hierro Clinic in Madrid.

1968 The first national Pediatric Intensive Care Unit was created.

1968 The hierarchy of the Internal Medicine Department was undertaken by Dr Au- gustin Pedro i Pons. They developed the Internal Medicine and medical specialties.

1970 Dr. Angel Díez-Gascón undertook the hierarchy of surgical services. This included services in Cardiac Surgery, Ophthalmology, Urology, ENT, Angiology and Vascular Surgery, Anesthesiology and Surgery Maxillofacial.

1970 first pediatric hemodialysis in Spain.

1971 The Vall d’Hebron University Hospital joined Autonomous University of Barce- lona UAB as a teaching unit.

1975 The building of the General Hospital was expanded, extending one of its ends.

1975-1979 With the transition for democracy, Vall d’Hebron name was consolidated.

1981 Catalonia was the first community to accept health transfers as a result of the new territorial organization of the Spanish State established by the Constitution, which recognized the right to autonomy of the regions of the state.

1981 The first pediatric kidney transplant in Spain was performed.

1983 The Catalan Health Institute (ICS) was set up as an operator of centers and health services in Catalonia Social Security, but did not begin to run until 1st January 1984. Until then, the Hospital was managed by ICS.

1985 The first pediatric liver transplant in Spain was performed in Vall d’Hebron University Hospital.

1988 The Adriano Surgical Clinic joined the Hospital, which has now been replaced by the Outpatient Surgery Unit Pere Virgili Health Park, under the management of the Hospital Vall d’Hebron as a satellite center. 22 Our history

1988 the Maternity and Children Hospital started running as a result of the fusion of Maternal Hospital and Child Clinic. In the new stage, Outpatient Hospital became really important so that patients could receive treatment without an overnight stay in the Hospital.

1990 The first lung transplant in Spain was performed in Vall d’Hebron Hospital.

1991 The Catalan Healthcare Service was created.

1991 the Interdisciplinary Healthcare Functional Unit (UFISS) of Geriatrics was set up, backing by alternative devices to hospitalization.

1992 Vall d’Hebron signed the first contract with the Catalan Health Service. A step towards a more corporate management.

1994 Research Foundation of Vall d’Hebron University Hospital was created, being a precursor of Vall d’Hebron Research Institute (VHIR).

1994 Vall d’Hebron performed the first multiorganic transplant, of liver and kidney in Spain.

1997 The UFISS of Palliative Health Care was set up.

1998 Catalan Institute of Pharmacology Foundation was created, an entity associated to Vall d’Hebron and the Autonomous University of Barcelona.

2001 Fusion of the 3 hospitals into one under the name of Vall d’Hebron University Hospital.

2002 Ictus Unit was set up.

2002 Home Hospitalization Service was set up.

2002 Neonatal Program started.

2003 The Mediterrània building of Vall d’Hebron Research Institute was inaugurated.

2006 Vall d’Hebron Institute of Oncology was created.

2006 Immediate Care Consultation (CAI) was set up.

2009 The Ministry of Science and Innovation, through the Instituto Carlos III cred- ited VHIR as a health research institute.

2009 Integration of specialized care that took place in the field of Primary Reference Area.

2009 Implementation of SAP® Healthcare System.

2010 Foundation of Research in Molecular Therapy Unit, committed to a personal- ized medicine.

2011 Creation of the new Paediatric Intensive Care Unit, the best in Europe because of its technology and organization.

2012 Inauguration of PET-CT (IDI-HUVH).

2012 Inauguration of Multiple Sclerosis Center of Catalonia (Cemcat).

23 Commitment to the environment We are a supportive and committed Hospital to the environment and society

We are an integrated part in the society We are part of the 3 Health Councils of the Neighborhoods.

We work for public health prevention, our professionals reach out to the neighbor- hoods, through clubs and associations, and as well as the media.

We listen to the citizen’s opinion We organize surveys and focus groups to assess public opinion on the Hospital and make improvements. Each year, we receive an average of 738 suggestions in the Citi- zen Service Unit of the Hospital, 315 of them are surveys in hospitalization.

24 Commitment to the environment

Volunteering A thousand volunteers from different organizations collaborate with us to patients and their families stays feel at home.

We have the first Ciberclass that was created in 2002 in Spain, where hospitalized children and their families to form relationships and share leisure and entertain- ment activities. In our classrooms teachers help children on admission to catch up with their classes

A solidarity Hospital We treat patients from other countries through international cooperation with NGOs.

Social Work We work in integrated social care teams, focused on patients and their families, act- ing on the psychosocial aspects that hinder health recovery

25 Corporate Social Responsibility Conscious of the impact that welfare activities have on the environment and on health, The Hospital promotes environmental sustainability

Policy of saving and waste recycling The Hospital promotes the responsible and efficient use of available resources in our organization, in compliance with regulations on the reduction of impact on the environment. With this, each year we reduce waste such as cardboard, paper, pack- aging, clothing, plastic bags, gardening waste, office equipment, and health waste health such as needles, syringes, surplus drugs, or material that has been in contact with blood. The training courses that have been organized recently have created awareness of the need to recycle correctly.

Smoke-Free Hospital The HUVH is a member of the European Network of Smoke-Free Hospitals and is proactive in eradicating smoking among professionals and users, and in the promo- tion of public health.

26 Contact us

University Vall d’Hebron Hospital Passeig de la Vall d’Hebron, 119-129 08035 Barcelona

Tel. 93 489 30 00 / 93 274 00 00 www.vhebron.net Twitter @hvhebron Directions to the Hospital Underground Line 3, Vall d’Hebron and Montbau stations Line 5, Vall d’Hebron station

Buses V21, 17, 19, 27, 60, 73, 76, 112, 112, 119, 185, N4

Taxi You have a taxi stop within the HUVH grounds

By car Exit 5, Ronda de Dalt

General Area Mother and Child Area Orthopaedics and Rehabilitation Area Vall d’Hebron Research Institute (VHIR) Cemcat Blood and Tissue Bank Clinical Laboratory (blue module) Outpatient modules (A, B and C) Former Nursing School

27 www .vhebron .net 28