Niguarda Ca’ Granda General Hospital and Care Centers 1 // 3 ABOUT US HIGHLIGHTS

//6 GOVERNANCE AND PERFORMANCE

//7 NIGUARDA’S NUMBERS

//8 NEW NIGUARDA: THE MODEL FOR INTENSITY OF CARE

//9 A MODERN HOSPITAL: TECHNOLOGY AND SERVICES

//11 ROOMS AND FACILITIES

//12 RESEARCH

//13 INTERNATIONAL TEACHING HOSPITAL and health cooperation

//14 EXPO 2015

2

Highlights ABOUT US

// Highlights Niguarda is a general hospital and offers all clinical and surgical specialties ABOUT US for adults and children, but its very identity that brings it to the highest A LEADING levels of excellence is its ability to integrate the 360° care competences and ITALIAN GENERAL HOSPITAL technology, from diagnosis As a General Hospital, Niguarda to rehabilitation. hosts all the disciplines for adult and children. Situated in the North of Italy, in the heart All medical disciplines and of Europe, Lombardy represents a bridge to the Mediterranean. With its technologies, from diagnosis surface area of about 24,000 square km to rehabilitation, are integrated and almost 10 million inhabitants, it can on serving the best care even in be compared to a nation. situations of emergency or high The Lombard territory, symbol of complexity. modernity and development, present a great number of natural, artistic and Physicians, scientists, and nurse staff cultural beauties. have skills to work together The health system in Lombardy protects the health of patients with a mixed system, based on synergies between the public and private sectors, focused on quality and efficiency, in order to increase the accessibility of its strong network of hospitals, clinics and pharmacies.

Niguarda is located in the north of Milan, the main city, but it’s a referral hospital for all Lombardy and Italy too.

3 Highlights ABOUT US YES NIGUARDA ! Highlights

nal and international structures. Niguarda is national referral Center for Clinical areas Also the robotic surgery is applied to the heart transplantation and assist transplantation area with device for advanced heart failure, ONCOLOGIC SURGERY AREA considerable advantages to the donor.. complex arrhythmias, acute and chronic The diagnostic clinical activity is over the coronary artery disease. DIAGNOSTIC AREA highest standard and in a continuous The hospital is equipped with NEUROSCIENCE AREA development in the treatment of all laboratories that guarantee a wide range The aim of thi area is to coordinate spe- the tumours. The patient can rely on a of diagnostic-therapeutic services, as an cialist competence and the most multidisciplinary team with the effective support to the clinical activity. up-to-date technologies to guarantee guarantee of a certain diagnosis, surgical The laboratories, national centres for the a diagnostic and therapeutic excellence operations high technologically diagnosis and treatment of specific path for therapy of nervous system supported and personalized pathologies, are developed by highly pathologies. chemiotherapy targeted on individual specialized and authomatic technologies. The strengths are the treatment of the molecular basis. The goal for the medullar lesions, the surgery of pharma- oncologic patients is to improve the CARDIOTHORACIC & VASCULAR AREA coresistant epilepsy and of Parkinson’s survival rate and the quality of life sup- Built on the heritage of one of the first disease, the use of gamma-knife for ported by innovative technologies Cardiothoracic surgery centers this area tumor pathologies, the presence of the (mininvasive approach, magnetic provides all medical interventional and stroke unit for emergency treatment. resonance guided focused ultrasound surgical options for patients with any surgery, robotic surgery). kind of disease at any age (e.g. from GENERAL SURGERY AREA newborn and pediatric cardiac surgery, TRANSPLANT AREA Thanks to its high professionals and including pediatric transplantation, to technological competences, the Niguarda is the only centre in Lombardy transcatheter aortic valve implants for hospital is a national and international that has performed transplants of the very old). Multidisciplinary team reference point for the general surgery, every organ (heart, lung, pancreas, case discussion, highly specialized car- treated with a minimal invasive kidney, liver, cornea), and tissues and diac and anaesthesiology intensive care approach and with the robotic surgery. cells transplants. In the hospital there is staff, intermediate facilities, active ou- The goal is to develop the excellence in a Skin Bank, a laboratory specialized in tpatient and telecardiology services, pro- the surgical activity both in emergency engineered skin and cartilage for recon- vide the full spectrum of care in both the and in elective areas, through a structive operations, able to sustain the emergency and long-term care settings. multiprofessional cooperation, internal need and to supply other natio-

4 Highlights ABOUT US

integrated application of the most rare pathologies too. It hosts one of the QUALITY AND CLINICAL advanced technologies and the operators main psychiatric department of the town. SAFETY WELFARE training. MOTHER AND CHILD AREA Since 1991, the hospital has invested on EMERGENCY-URGENCY AREA The mother and the child are quality and has established a specific body Niguarda is able to host patients from protagonists of a health project that with members belonging to the whole metropolitan area of Milan, in goes beyond the prevention, the different professions. this choice allowed very severe conditions, thanks also to the treatment and the rehabilitation, that the organization to work since almost helicopter service. places them at the centre of the research twenty years on methodologies and Its emergency- urgency dedicated and care activity, from the conception to topics which are key for a “good” services, including: Coronary Unit and the adul age. In fact, the service for the medical science. ICU, Stroke Unit, Trauma Team, Centre family includes a full phases assistance, Since 1999 the hospital has launched a of Poison Control, Emergency Medicine from the wish of the procreation to the Quality Certification System for transversal clinical processes, following and Surgery and Burn Unit. delivery. The child treatment is international Joint Commission Moreover the hospital has a national role assured for every type of pathology, Standards required for the accreditations. for the maxi-emergencies in case of even the rare, through personalized natural disaster and nuclear catastrophe. technologies and routes in the respect of the religious, social and SPECIALIST MEDICINE AREA cultural diffrences. Niguarda offers the widest set of high complexity services of general and ADVANCED TECHNOLOGIES specialist medicine. The hospital is the Advanced MRI, PET, interventional headquarter for many Regional and radiology, linear accelerators, robotic NIGUARDA ALSO HOSTS: National reference Centres in allergolo- surgery, hybrid OR, gamma knife, gy, diabetes, nutritional, endocrinolo- focused ultrasound: the constant • Burned Care Unit, gy, rheumatology, infectious diseases, updating of the technological park is • Tissue Bank, pneumology, as well as in pre and post driven by the development of • Anti-Poisoning Center transplantation treatments for heart, professional skills of high profile. • Stroke Unit lung, liver, kidney-pancreas and pancrea- Diagnostic tests are shared in real time • Rare Disease Center in safe and responsible way through our tic islet. It has an important role for dia- • Mobile Unit for maxi emergency gnosis and treatment for more than 120 ICT system.

5 GOVERNACE AND PERFORMANCE

Clinical activity data 2014

Economic and financial performance prediction budget 2014 Niguarda recognizes the importance of the human touch in providing health services within structures with a high level of technology, designed not only for health activities but also on patients’ needs.

We want to create places for the promotion of the culture of life and healthwhere doctors are motivated to improve themselves.

Every day at Niguarda we are committed to meet the health needs of our people.

As providers of the Regional Health care services, our clinical activity and research must comply with quality standards according to the government criteria, which calls for the provision of appropriate health care without waste, within the economic and financial rules which guarantee the best use of public fund.

The hospital is also strongly oriented to the development of new organizational and administrative procedures aimed to improve the quality of its services in terms of efficiency and effectiveness according to the national guidelines planned by the Social Health Care Plan of the Lombardy Region.

6 NIGUARDA’S NUMBERS

1.213 BEDS 4.124 TOTAL EMPLOYEES

1.138 ORDINARY

740 MEDICAL OFFICERS 75 DAY HOSPITAL & DAY SURGERY

30 BABY CRIBS 63 HEALTH MANAGERS

20 NEONATAL PATHOLOGY BABY CRIBS

8 INTENSIVE CARE 1.593 BABY CRIBS NURSING STAFF

33 MIDWIVES

42 OPERATING ROOMS 14 DIETICIANS

340 AMBULATORY ROOMS 128 REHABILITATION STAFF

7 New Niguarda THE MODEL FOR INTENSITY OF CARE

// New Niguarda The New Niguarda project, started in 2007 and completed by 2014, is based on a NEW MODERN HOSPITAL THE MODEL health organization specialized for the New Niguarda has changed the intensity of care and on the optimization organization developing FOR INTENSITY of the efficiency putting the patient at the multidisciplinary team focus on OF CARE center of the healthcare service 4 core business: organization. • CANCER CENTER The new hospital has been planned Modern medicine requires a new • DE GASPERIS CARDIO CENTER on three blocks: model of hospital organization • TRANSPLANT CENTER designed around the patient > The Emergency-Urgency (DEA block) • TRAUMA CENTER

> The South Block for high intensity of care patients (surgery, onco-hematholo- gy, cardiology and transplantation) HOSPITAL BETWEEN > The North Block for medium intensity HISTORY AND ART of care patients and medical services. Niguarda is a relevant structure even The hospital structure is designed from the architectural and artistic point according to the patient’s need. of view. The process of care is completely realized The hospital boasts a series of relevant within one single unit, in order to avoid works of art. Niguarda is protected by the Ministry of Fine Arts and it has been moving the patient. always sensitive to “ the beauty” and to the artistic culture. In 1940 it has been defined as “The City of Art” by historian Constantini, it expresses a strong connection with the city of Milano and its history by its monumental and rational structure.

8 TECHNOLOGY AND SERVICES

The integration between diagnosis and treatment in 25 the different specialties is at the base of rational clinical, an appropriate use of the resources and a better efficiency of the intervention, even with high complexity situations or emergencies.

Imaging advanced technologies RMN, PET, interventional radiology, linear accelerators, robotic surgery, gamma knife, focalized ultrasound: the constant update of the technological park is driven by a development of high profile professional competences. Diagnostic tests are shared in real time in liability and safety through our ICT system. The integration between diagnosis and treatment in 25 the different specialties is at the base of rational clinical, an appropriate use of the resources and a better efficiency of the intervention, even withhigh complexity situations or emergencies.

DA VINCI SURGICAL SYSTEM With the da Vinci Surgical System, surgeons operate through just a few small incisions. The da Vinci System features a magnified3 D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexteri- ty and control. We use da Vinci in urolgy, cancer and general s urgey treatments. The robotic surgery is also applied to the transplantation area.

HYBRID OR A hybrid OR is huge room, with radiological equipments, permits to carry out both the traditional and the radiological guided operational activity. The hybrid OR allows interventions invasively reduced for the valves surgery, the by-pass, the installation of aortic endoprothesis and the “hybrid” installation of devices for the cardiac resynchronization. It is the “integrated” room, it means that the machines are linked together and consent the use of videoconference technologies, intervention fied records in hd with the possibility for the operators to utilize wide screens and touch screen use. In the angiography hybrid OR are performable simultaneous operations of different specialists: cardiosurgeon and vascular surgeon, hemodyna- mist, electrophysiologist, radiologist, torax surgery spcecialist and interventional radiologist.

9 GAMMA KNIFE SURGERY Gamma Knife surgery sometimes referred to as stereotactic radiosurgery (SRS), is a non-invasive method for treating brain disorders. It is the delivery of a single, high dose of irradiation to a small and critically located intra-cranial volume through the intact skull. It is preferred for its extreme accuracy, efficiency and outstanding therapeutic response. System benefits include faster set-up andtreatment delivery to one or more tumors in a single session. Perfexion allows treatment of a wider range of targets faster and more efficiently than ever before.

10 ROOMS AND FACILITIES

Niguarda has custom-made furnishings with a design concept that reaches beyond the basic requirements of quality, duration and ergonomics.

The hospital is equipped with more than 40 front offices for booking and check in: the modern “centralized” system for managing the customers flow, drives the patient from the access to the hospital and it conducts him, through the front office activities, to the call in the outpatient where the doctor is waiting. Throughout the integration of digital signage systems, algorithms and complex technologies it is possible to design and customize systems of information facilities and welcome and booking processes managing both with the Natio- nal Health System and in private area.

Patients have access to: • single-double beds rooms with private bathroom • foreign patients’ office • free service of language assistance • vegetarian menu on demand • relatives: hotels at special price • children’s or over 65 ‘ relatives can stay all the day long with the patient • coffee shops, self-service restaurants • cash point • shopping centers • internal paying parking

11 RESEARCH

// In recent years a positive trend in clinical The main strength point is the high trial has been observed, in neuroscience, volume of diagnostic/ therapeutic RESEARCH diabetology, pain therapy, gene therapy, activities that allows an optimal cardiovascular diseases, haematology, integration between research and patient oncology, resulting in an improved care, defining Niguarda as one of the best scientific impact factor. possible clinical sites for translational Niguarda is at the forefront of research. research for trials testing new Niguarda is a public hospital dedicated It offers concrete opportunities to pharma therapies supported by international to care; clinical research and knowledge- and biotech company. sharing are fully integrated in the cooperation activities. hospital strategy.

The presence of professional skills, technological competences, certified laboratories and high complexity patient cohorts make Niguarda a unique and interesting partner for future cooperation.

It offers concrete opportunities to Pharma and Biotech Companies that are looking for a reliable and expert clinical/ scientific partner.

The attitude to a real multidisciplinary approach offered to researcher makes Niguarda as a unique “one stop shop” for research and development.

12 INTERNATIONAL TEACHING HOSPITAL

High professional competences, high tech AORTIC PROSTHESES IMPLANTATION // and teaching accreditation, make Niguarda is an European training INTERNATIONAL Niguarda Hospital a strong centre of school adopting the advanced system of attraction for professional figures which the hybrid room that performs TEACHING want to bring themselves up to date on delicate surgeries in an accurate and new technologies, diagnostic and the- minimally invasive way. HOSPITAL rapeutic procedures to gain an excellent operative methodology and new skills. and health cooperation International training activity is based on ADVANCED INTERNATIONAL different standards: MINI-INVASIVE SURGERY Affiliated to: AIMS Academy (the first multidisciplina- • TWINNING among international ry structure in Italy dedicated to research Università degli Studi Statale -Milan hospitals scheduled by international and training in minimally invasive Università Bicocca- Milan cooperation programs advanced surgery, third pole of an European network with Strasbourg and • TRAINING STAGES included in interna- Guildford. The program includes demon- tional institutions agreements. strations of laparoscopic surgery, theo- ry sessions and practice sessions made of HEALTH COOPERATION simulations in the wet lab.

Every year Niguarda hosts patients from other nations affected by ECOCARDIOGRAFY CENTER CONTACT US pathologies that are incurable in their Niguarda and its ecocardiografy center own countries. Niguarda also plays an is accredited by European Association of For training stage or information active role in international cases of Cardiovascular Imaging . An Ecolab is about educational cooperation health emergencies. fully equipped for training. program: Then, the Hospital has initiated several international project around [email protected] the world in research and training NIGUARDA FACULTY OF NURSING skilled professionals. Niguarda is a University Teaching Center for Nursing ( Università degli Studi Milan).

13 EXPO

Milan is the Made in Italy brand for // fashion, art , music and culture. EXPO BUSINESS MEETINGS EXPO 2015 AND TOURS The 2015 year will be the centre of the world thanks to the EXPO – Universal Ex- Tailored meeting can be position- “Feeding the Planet, Energy for arranged to visit the Hospital, to Expo Milano 2015 is a Life”. get in touch with the Board, the non-commercial Universal doctors and our service providers. Exposition with some very unique Milan Expo 2015 runs from May to October and innovative features. and deals with themes of nutrition, food security, sustainable practices, and Not only is it an exhibition but also celebrating global culinary cultures. a process, one of active participation Health is a leader theme. INTERNATIONAL INFO POINT among a large number of players Milan will host more than 30 million pe- around the theme of Feeding the [email protected] ople. Planet, Energy for Life tel: +39 02 6444.2302

The Expo is the chance to visit Milan and its efficiency health system.

During Expo we provide health for people coming from other countries.

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INTERNATIONAL INFO POINT mail: [email protected] phone: +39 02 6444.2302 ospedaleniguarda.it/eng

A.O. OSPEDALENIGUARDA CA’ GRANDA Piazza Ospedale Maggiore, 3 20162 Milano