DOCSLIB.ORG

COVID-19 - ESSKA Guidelines and Recommendations for Resuming Elective Surgery Caroline Mouton, Michael Hirschmann, Matthieu Ollivier, Romain Seil, Jacques Menetrey

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
COVID-19 - ESSKA Guidelines and Recommendations for Resuming Elective Surgery Caroline Mouton, Michael Hirschmann, Matthieu Ollivier, Romain Seil, Jacques Menetrey COVID-19 - ESSKA guidelines and recommendations for resuming elective surgery Caroline Mouton, Michael Hirschmann, Matthieu Ollivier, Romain Seil, Jacques Menetrey To cite this version: Caroline Mouton, Michael Hirschmann, Matthieu Ollivier, Romain Seil, Jacques Menetrey. COVID- 19 - ESSKA guidelines and recommendations for resuming elective surgery. Journal of Experimental Orthopaedics, Springer Verlag, 2020, 7 (1), pp.28. 10.1186/s40634-020-00248-4. hal-03175930 HAL Id: hal-03175930 https://hal.archives-ouvertes.fr/hal-03175930 Submitted on 22 Mar 2021 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Distributed under a Creative Commons Attribution| 4.0 International License Mouton et al. Journal of Experimental Orthopaedics (2020) 7:28 Journal of https://doi.org/10.1186/s40634-020-00248-4 Experimental Orthopaedics REVIEW Open Access COVID-19 - ESSKA guidelines and recommendations for resuming elective surgery Caroline Mouton1,2, Michael T. Hirschmann3, Matthieu Ollivier4, Romain Seil1,2 and Jacques Menetrey5,6* Abstract The roadmap to elective surgery resumption after this COVID-19 pandemic should be progressive and cautious. The aim of this paper was to give recommendations and guidelines for resuming elective orthopedic surgery in the safest environment possible. Elective surgery should be performed in COVID-free facilities and hospital stay should be as short as possible. For matters of safety, patients considered first for surgery should be carefully selected according to COVID infection status/exposure, age, ASA physical status classification system / risk factors, socio- professional situation and surgical indication. A strategy for resuming elective surgery in four phases is proposed. Preoperative testing for COVID-19 infection is highly recommended. In any cases, COVID symptoms including fever and increased temperature should be constantly monitored until the day of surgery. Elective surgery should be postponed at the slightest suspicion of a COVID-19 infection. In case of surgery, adapted personal protective equipment in terms of gowns, gloves, masks and eye protection is highly recommended and described. Introduction Premature and sudden lifting of interventions could lead Since March 2020, hospitals and surgeons have been ad- to a second wave of infections [3]. It is thus critical to vised to postpone or cancel elective scheduled operations maintain regulatory measures within healthcare infra- until the inflection point in the exposure graph has passed structures within the next months to assure patient and so that healthcare infrastructures can support the critical staff safety and limit the number of infections. This can patient care needs [1]. Hospital resources have therefore only be achieved by preparing the roadmap to elective mainly been dedicated to the care of COVID-19 patients surgery resumption. Unfortunately, there is, to date, no resulting in thousands of orthopedic surgeries being de- specific literature concerning the organization of an out- layed all over the world if they were not considered to patient clinic and surgical activities [4]. cause a significant harm to the patient or outcome. The aim of this paper was therefore to provide recom- It is commonly agreed that there should be a decrease mendations and guidelines for resuming elective ortho- in incidence of COVID-19 cases for at least 2 weeks be- pedic surgery in this period of pandemic in the safest fore elective surgery is resumed [2]. In Europe, several environment possible and according to the current state countries will soon reach this goal. Although the sanitary of knowledge on COVID-19. crisis can be considered to be under control, one should keep in mind that the pandemic is not finished yet. Surgeries covered by the present guideline The American Academy of Orthopaedic surgeons defined * Correspondence: [email protected] 5Centre de Médecine du Sport et de l’Exercice (CMSE), Swiss Olympic four type of orthopaedics procedures in times of pan- Medical Center, Hirslanden Clinique La Colline, Chemin Thury 7A, CH-1206 demic: A) emergency only, B) urgent types of surgeries, C) Geneva, Switzerland urgent/somewhat elective and D) elective (Table 1). The 6Division of Orthopaedic Surgery, University Hospital of Geneva, Geneva, Switzerland current guideline only covers categories A and B of this Full list of author information is available at the end of the article definition. These include all types of surgeries with © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Mouton et al. Journal of Experimental Orthopaedics (2020) 7:28 Page 2 of 7 Table 1 Adapted from AAOS guidelines for elective surgery [5] Category A B C D Degree of emergency Emergency Urgent Urgent/ Elective Somewhat elective Types of procedures Life- or limb- Joint/arthroplasty Acute intra- and periarticular Total joint arthroplasty (non-exhaustive selection) threatening infections ligament & tendon conditions Osteotomies conditions Chronic intra- and periarticular Most trauma (e.g. ACL tears, meniscus ligament & tendon conditions cases bucket handle tears) Chronic peripheral nerve Selected trauma cases compression syndromes predominantly chronic conditions or acute cases where pandemic, they should be monitored on a regular (e.g. surgery generally can be delayed without causing serious weekly) basis and their protection be guaranteed (sup- harm to patients. More precisely, the following procedures plies, PPE). Testing of patients should also be organized are considered: tendinous or ligamentous intra- or peri- before any surgery to avoid importing asymptomatic articular injuries of chronic and acute in nature; cases within the COVID-negative clinical pathway as deformity-correcting osteotomies; joint arthroplasty pro- well as to prevent secondary surge. Prescreening of ex- cedures; elective shoulder, elbow, hand, hip, knee and foot posed patients is of importance to avoid the planning of and ankle surgery. surgeries during the incubation period of COVID-19 The present guideline is essentially based upon a re- and adequate policy should be implemented to avoid view of sparse literature, interviews of specialist and peri-operative COVID infection. Finally, care should be mostly expert opinion. The content has been reviewed taken to operate patients when a standardized and suffi- by a scientific committee. It can be useful in conducting cient postoperative follow-up is assured. Nurses, the negotiations or for practical implementation at the level team of anesthesiology, physiotherapists should be con- of a hospital or a national specialty society but cannot be sulted and aware that elective surgeries will start again imposed as official guidelines. The purpose of this guide- to guarantee proper patient care. line is only to provide the community with possible an- swers as well as to raise awareness of the complexity of Preselection of patients eligible for surgery the problem. When resuming surgical activities, a careful selection of patients should be implemented in order to limit the risk Before resuming surgical activities of infections and complications. The selection of priori- The main objective before resuming any surgical activity tized patients should take into account several parame- is to assure that all necessary regulatory measures are in ters such as COVID exposure, age, American Society of place within the healthcare infrastructure to allow for Anesthesiologists (ASA) physical status classification sys- the safety of patients, physicians, staff and institution tem / risk factors and socio-professional situation. until the end of the pandemic. All decision in the According to Fineberg [6], patients should be treated organizational aspect should naturally be locally based according to their COVID-19 exposure. The author de- decisions, follow legal restrictions and guidelines from fined five types of patient categories: A patient (1) who the relevant health authorities. is not known to have been exposed or infected, (2) who First, state and hospital regulations should allow for a has been exposed but is asymptomatic, (3) who has re- return to outpatient clinic and elective surgeries. These covered from infection and maybe adequately immune, regulations/rules
Load more

Recommended publications
  • Press Release
    PRESS RELEASE Geneva, 9 September 2019 HIRSLANDEN CLINIQUE LA COLLINE JOINS LAVER CUP AS OFFICIAL MEDICAL PARTNER Hirslanden Clinique La Colline has been selected by the Laver Cup to become its official medical partner in Geneva, September 20-22, 2019. The Laver Cup today announced its official medical partnership with Hirslanden Clinique La Colline, who’s recently inaugurated Sports Medicine Center has been recognized by Swiss Olympic as Sport Medical Center and professional osteopathy services in the tennis field. Hirslanden Clinique La Colline will be working with Laver Cup and ATP Physiotherapists to provide dedicated treatment and massage therapy services during the tournament. “We are delighted to become the official medical partner of the Laver Cup in Geneva. With our combined expertise in sports medicine, orthopedics and osteopathy, our goal is to enable Team Europe and Team World to showcase the best of their abilities in Geneva. Performance is a matter of preparation and discipline”, says Gilles Rufenacht, Director of Hirslanden Clinique La Colline in Geneva. “We look forward to working with the professional team at Hirslanden at the Laver Cup in Geneva. Their experienced practitioners will be a key asset for all the players, and will ensure both teams have access to the services they need to prepare for what promises to be an incredible weekend of tennis action,” Laver Cup CEO Steve Zacks said. “ Information: Hirslanden Clinique La Colline Laver Cup Magali Dauwalder Prue Ryan Head of Communications Head of Public Relations T +41 79 107 56 76 +61 419 308 369 [email protected] [email protected] www.hirslanden.ch Hirslanden Private Hospital Group As of 31 March 2019, the Hirslanden Private Hospital Group consists of 18 hospitals in 11 cantons, many of which have an integrated outpatient surgery centre and emergency department.
    [Show full text]
  • Prospectus Relating to Mediclinic Combination
    NOTICE IMPORTANT: You must read the following before continuing. The following applies to the document following this notice, whether received by email or otherwise received as a result of electronic communication. You are advised to read this disclaimer carefully before reading, accessing or making any other use of the document. In accessing the document, you agree to be bound by the following terms and conditions, including any modifications to them, each time you receive any information as a result of such access. NOTHING IN THIS ELECTRONIC TRANSMISSION CONSTITUTES AN OFFER OF SECURITIES FOR SALE IN ANY JURISDICTION WHERE IT IS UNLAWFUL TO DO SO. THE FOLLOWING DOCUMENT MAY NOT BE FORWARDED OR DISTRIBUTED TO ANY OTHER PERSON AND MAY NOT BE REPRODUCED IN ANY MANNER WHATSOEVER. ANY FORWARDING, DISTRIBUTION OR REPRODUCTION OF THIS DOCUMENT IN WHOLE OR IN PART IS UNAUTHORISED. FAILURE TO COMPLY WITH THIS DIRECTIVE MAY RESULT IN A VIOLATION OF THE U.S. SECURITIES ACT OF 1933 (THE ‘‘SECURITIES ACT’’) OR THE APPLICABLE LAWS OF OTHER JURISDICTIONS. This document does not constitute or form a part of any offer or solicitation to purchase or subscribe for securities in the United States or any other jurisdiction where such offer or sale would be unlawful. The shares that may be received in the business combination described in the following document (the ‘‘Combination’’) have not been, and will not be, registered under the Securities Act, or with any securities regulatory authority of any state or other jurisdiction in the United States, and may only be offered or sold in reliance on the exemption from the registration requirements of the Securities Act provided by Rule 802 under the Securities Act.
    [Show full text]
  • Right Colon Cancer : Left Behind ?
    Article Right colon cancer : left behind ? GERVAZ, Pascal, BOUCHARDY MAGNIN, Christine, USEL, Massimo Reference GERVAZ, Pascal, BOUCHARDY MAGNIN, Christine, USEL, Massimo. Right colon cancer : left behind ? British Journal of Surgery, 2013, vol. 100, no. s5, p. 8 DOI : 10.1002/bjs.9154 Available at: http://archive-ouverte.unige.ch/unige:90372 Disclaimer: layout of this document may differ from the published version. 1 / 1 SSS abstracts Swiss Society of Surgery The following abstracts will be presented at the 100th Annual Congress of the Swiss Society of Surgery, held in Berne 12–14 June 2013. Visceral of the operation according to a standardised protocol. The patient, the surgeon and the outcome assessors were blinded. Clinical follow-up investigations were Effect of intra-operative infiltration with local anesthesia on the performed after one day, 2 weeks, 1, 3, and 12 months postoperatively. Three development of chronic pain after inguinal hernia repair. A randomized interim analyses with data monitoring committee meetings were performed to controlled triple-blinded trial check whether stopping criteria were met or the sample size had to be adapted. A. Kurmann1,2,H.Fischer3, N. Wippich3, S. Dell-Kuster4,5, The study was stopped after the third interim analysis for futility reasons R. Rosenthal5,J.Metzger3, P. Honigmann3,6 because it was unlikely that significance could be reached within an adequate sample size and time. Chronic postoperative pain was estimated by means of 1 Department of Visceral Surgery, Cantonal Hospital Luzern, Luzern, Switzerland, a Visual Analogue Scale (VAS) and defined as any pain (VAS > 0) 3 months 2 Department of Visceral Surgery and Medicine, University Hospital Bern, Bern, postoperatively.
    [Show full text]
  • Medical Specialty Title Firstname Name Street Zip Town Region
    Languages English Updat Medical Specialty Title Firstname Name Street Zip Town Region Hospital/Organization Phone Website E-mail spoken Language ed English, Alternative Medicine - Shiatsu Mrs. Susan Vogt Freie Strasse 97 4051 Basel BASEL 061 272 58 78 [email protected] Extensive 2019 German English, German, Chiropractic Dr. Peter Rufener St. Alban-Anlage 27 4052 Basel BASEL 061 271 76 62 [email protected] Extensive 2019 French, Spanish English, Dental Medicine Dr. Daniel Hänggi Birsigstrasse 105 4054 Basel BASEL Private practice 061 281 33 66 www.praxishaenggi.ch [email protected] German, Extensive 2019 French English, Extensive German, (Dentist), Swedish, Limited Dental Medicine Dr. Ines Miolin Oberwilerstrasse 133 4054 Basel BASEL Private practice 061 281 15 16 www.miolin.ch [email protected] 2019 Italian, (Assistance French, + Spanish Telephone) English, German (dental assistants Dental Medicine Dr. Donna Hänggi Birsigstrasse 105 4054 Basel BASEL Praxis D. Hänggi 061 281 33 66 www.praxishaenggi.ch [email protected] Extensive 2019 fluent in Spanish, Italian and English,French) German, Dental French, Dr. Nenad Antic Holbeinstrasse 52 4051 Basel BASEL 061 283 80 20 www.drantic.ch [email protected] Extensive 2019 Medicine/Implantology/Periodontology Italian, Spanish, Romanian English, German, Ear, Nose & Throat Dr. med. Annemarie Haag Jordan Schifflaende 2 4051 Basel BASEL 061 262 02 66 www.basel-hno.ch [email protected] French, Extensive 2019 Spanish, Italian English, General Practice / Internal Medicine / Dr. med. Gideon Nagel Burgfelderstrasse 200 4055 Basel BASEL 061 322 10 22 www.baslerdoctor.com [email protected] Hebrew, Extensive 2019 Geriatrics German English, www.bethesda.ch German, Gynecology and Obstetrics Dr.
    [Show full text]
  • 2021 Clinical Services Report Contents
    TOGETHER WE CARE 2021 CLINICAL SERVICES REPORT CONTENTS MEDICLINIC’S CORE PURPOSE IS TO ENHANCE THE QUALITY OF LIFE 25 2 COVID-19 overview Introduction 8 About Mediclinic 8 At a glance 9 Committed to clients 10 Highlights Better ways to connect Mediclinic’s healthcare Employees keep clients at the heart of all landscape Mediclinic does. That is the commitment 11 Unique but united behind putting Patients First. 20 Value equation index 34 Better ways to connect 25 Patient experience 34 Better ways to unlock value Better ways to care 36 Clinical performance Klinik Hirslanden, Switzerland 44 Clinical outcomes Better ways to unlock value The Group is dedicated to partnering with 58 Facility focus all its stakeholders and forging long-term relationships. 59 Partnerships 36 61 Assurance 63 Clinical ethics summary 65 Glossary of terms 67 Contact details Better ways to care Superior clinical performance is essential to achieve Mediclinic’s purpose of enhancing the quality of life. ABOUT THIS REPORT Mediclinic International plc (‘Mediclinic’ or the ‘Company’) is proud to publish a Clinical Services Report annually as part of a suite of reports in respect of both the 2020 calendar year and 2021 financial year. The reporting suite listed below is available on the Group’s website. 2021 Annual Report and Financial Statements 2021 Clinical Services Report 2021 Sustainable Development Report 2021 Modern Slavery Statement 2021 Notice of Annual General Meeting SCOPE The goal of this Report is to provide Mediclinic stakeholders with an overview of the most important clinical performance characteristics across its divisions in Switzerland, Southern Africa (South Africa and Namibia) and the United Arab Emirates (‘UAE’) (collectively, the ‘Group’) for the 2020 calendar year, unless stated otherwise.
    [Show full text]
  • US Embassy Bern
    Hospital/ Languages English Medical Specialty Title Firstname Name Street Zip Town Region Phone Website E-mail Updated Organization spoken Language Alternative Medicine - English, Mrs. Susan Vogt Freie Strasse 97 4051 Basel BASEL 061 272 58 78 [email protected] Extensive 2020 Shiatsu German English, German, Chiropractic Dr. Peter Rufener St. Alban-Anlage 27 4052 Basel BASEL 061 271 76 62 [email protected] Extensive 2020 French, Spanish English, Dental Medicine Dr. Daniel Hänggi Birsigstrasse 105 4054 Basel BASEL Private practice 061 281 33 66 www.praxishaenggi.ch [email protected] German, Extensive 2020 French English, Extensive German, (Dentist), Swedish, Dental Medicine Dr. Ines Miolin Oberwilerstrasse 133 4054 Basel BASEL Private practice 061 281 15 16 www.miolin.ch [email protected] Limited 2020 Italian, (Assistance + French, Telephone) Spanish English, German (dental assistants Dental Medicine Dr. Donna Hänggi Birsigstrasse 105 4054 Basel BASEL Praxis D. Hänggi 061 281 33 66 www.praxishaenggi.ch [email protected] Extensive 2020 fluent in Spanish, Italian and French) English, German, Dental Medicine/ French, Implantology/ Dr. Nenad Antic Holbeinstrasse 52 4051 Basel BASEL 061 283 80 20 www.drantic.ch [email protected] Extensive 2020 Italian, Periodontology Spanish, Romanian English, German, Ear, Nose & Throat Dr. med. Annemarie Haag Jordan Schifflaende 2 4051 Basel BASEL 061 262 02 66 www.basel-hno.ch [email protected] French, Extensive 2020 Spanish, Italian General Practice / English, Internal Medicine / Dr. med. Gideon Nagel Burgfelderstrasse 200 4055 Basel BASEL 061 322 10 22 www.baslerdoctor.com [email protected] Hebrew, Extensive 2020 Geriatrics German English, Gynecology and 4102 Binningen www.bethesda.ch Dr.
    [Show full text]
  • CLINICS and HEALTH in GENEVA Geneva Offers a Large Selection of Clinics, Each Characterised by Its State-Of-The-Art Facilities
    CLINICS AND HEALTH IN GENEVA Geneva offers a large selection of clinics, each characterised by its state-of-the-art facilities. They offer care and personalised attention as well as a hotel and culinary service of five-star quality. Groupe La Tour Avenue J.D. Maillard 3 - 1217 Meyrin Web: http://www.la-tour.ch/fr/ Telephone: +41 22 719 61 11 Let's build tomorrow's healthcare together. La Tour is the largest private hospital group in the Canton of Geneva and comprises the Hôpital de La Tour, the Clinique de Carouge and the Centre Médical de Meyrin. The Hôpital de La Tour is the only private acute care facility in French-speaking Switzerland to offer a 24/7 emergency service, a ten-bed intensive care unit, a renal dialysis centre and a level IIA neonatal unit. A pioneer in embracing numerous innovations, and a hub for over 60 medical specialisations, each year the Groupe La Tour welcomes 7,000 inpatients and 300,000 outpatients including 40,000 emergencies, as well as performing 5,800 operations and training 40 doctors across seven medical disciplines. It employs 950staff and has 350 registered doctors. To guarantee integrated and personalised care to its patients and their families, its activities are organised into six healthcare pathways: - Orthopaedics and sports medicine - Oncology - Metabolism and obesity - Internal medicine - Cardiology - Woman and child The La Tour group's facilities are recognised on the Canton of Geneva’s hospital list and are also mandated to accept patients without additional private health insurance in certain specific cases. Outpatient services are available to all those with basic national health insurance (LAMal and LAA).
    [Show full text]
  • 2018 Capital Markets Day Presentation
    2018 CAPITAL MARKETS DAY 28 JUNE 2018 ZURICH, SWITZERLAND WELCOME DR RONNIE VAN DER MERWE CEO MEDICLINIC INTERNATIONAL MEDICLINIC DISCLAIMER This presentation contains certain forward-looking statements relating to the financial condition, the regulatory environment in which we operate, results of operations and businesses of Mediclinic and the Group, including certain plans and objectives of the Group. All statements other than statements of historical fact are, or may be deemed to be, forward-looking statements. Forward-looking statements are statements of future expectations that are based on management’s current expectations and assumptions and involve known and unknown risks and uncertainties that could cause actual results, performance or events to differ materially from those expressed or implied in these statements. Forward-looking statements include, among other things, statements concerning the potential exposure of Mediclinic to market risks and statements expressing management’s expectations, beliefs, estimates, forecasts, projections and assumptions, including as to future potential cost savings, synergies, earnings, cash flow, production and prospects. These forward-looking statements are identified by their use of terms and phrases such as “anticipate”, “believe”, “could”, “estimate”, “expect”, “goals”, “intend”, “may”, “objectives”, “outlook”, “plan”, “probably”, “project”, “risks”, “seek”, “should”, “target”, “will” and similar terms and phrases. Slide 3 2018 CAPITAL MARKETS DAY AGENDA 1 Introduction and Group Overview
    [Show full text]
  • Acquisition of Clinique La Colline
    MDC - MEDICLINIC INTERNATIONAL LIMITED - Acquisition of Clinique La Colline June 25, 2014 Acquisition of Clinique La Colline Mediclinic International Limited (Incorporated in the Republic of South Africa) (Registration number 1983/010725/06) JSE share code: MDC ISIN: ZAE000074142 ("Mediclinic" or "the Company") ACQUISITION OF CLINIQUE LA COLLINE Shareholders are referred to the announcement released on SENS on 11 June 2014 in which the Company set out its intentions to raise equity capital to fund various acquisitions and investment opportunities, one of which is an acute care multi-disciplinary hospital in Switzerland. Mediclinic is pleased to announce that all conditions precedent to the transaction have been fulfilled and subsequently its Swiss business, Hirslanden, has acquired a 100% interest in the operating business of Clinique La Colline ("La Colline") in Geneva, Switzerland (hereinafter referred to as "the Transaction"). Overview of La Colline and transaction rationale La Colline is a multi-disciplinary medical and surgical private hospital with 95 beds (including inpatient, outpatient and specialty beds) and six operating theatres equipped for general, endoscopic, and navigation-assisted surgery. La Colline has a significant market share in orthopaedic treatments performed in Geneva. Other treatments offered at La Colline include internal medicine, visceral surgery, neurology, ophthalmology, general surgery, urology, plastic surgery, and gynaecology. The Transaction significantly strengthens Hirslanden's position in Western Switzerland, through providing a footprint in Geneva, and is in line with the Company's strategy to increase capacity in attractive markets with strong fundamentals. Purchase consideration The total enterprise value paid for La Colline will be c.CHF130m representing a LTM EV/EBITDA multiple of 8.7x.
    [Show full text]
  • 2019 Annual Report Contents
    MEDICLINIC INTERNATIONAL PLC MEDICLINIC INTERNATIONAL | ANNUAL REPORT FOR THE YEAR ENDED 31 MARCH 2019 ANNUAL 2019 ANNUAL REPORT CONTENTS 4 At a glance GOVERNANCE AND REMUNERATION 103 Chairman’s Introduction STRATEGIC REPORT 104 Board of Directors Business overview 110 Group Executive Committee 10 Performance summary 114 Corporate Governance Statement 12 Chairman’s Statement 136 Audit and Risk Committee Report 16 Business model 150 Clinical Performance and Sustainability 18 Our strategy, goals and progress Committee Report 22 Investment case 154 Nomination Committee Report 23 Five-year summary 159 Directors’ Remuneration Report Performance and future outlook 179 Statement of Directors’ Responsibilities 24 Chief Executive Officer’s Review 29 Financial Review FINANCIAL STATEMENTS 40 Value added statement 182 Group Financial Statements 41 Clinical services overview 280 Company Financial Statements Risk management ADDITIONAL INFORMATION 55 Risk management, principal risks and uncertainties 296 Shareholder information 60 Viability statement 300 Company information Divisional reviews 302 Forward-looking statements 62 Divisional Review – Switzerland 303 Glossary 67 Divisional Review – Southern Africa 71 Divisional Review – UAE Non-financial performance 76 Sustainable development overview 100 Non-financial information statement OVERVIEW ADAPTING LOSS OF MEDICLINIC TO THE CHANGING GLOBAL £151M* HEALTHCARE impacted by non-cash ENVIRONMENT Hirslanden and Spire impairment charges and is a priority with focus other exceptional items throughout the
    [Show full text]
  • Mediclinic International Annual Report 2020
    ENHANCING THE QUALITY OF LIFE 2020 ANNUAL REPORT STRATEGIC REPORT Introduction 4 Section 172 statement 6 Non-financial information statement 7 Report profile 8 Performance summary 10 At a glance Business overview MEDICLINIC’S 12 Market overview 14 Business model CORE PURPOSE 16 Investment case 18 Value added statement IS TO ENHANCE 19 Five-year summary Performance and outlook THE QUALITY 20 Chair’s Review 28 Group Chief Executive Officer’s Report 36 Strategy, goals and progress OF LIFE 44 Continuum of care 46 Stakeholders summary 50 Clinical services overview 62 Sustainable development overview 78 Group Chief Financial Officer’s Report 92 Divisional Report – Hirslanden 100 Divisional Report – Mediclinic Southern Africa 106 Divisional Report – Mediclinic Middle East Risk management 114 Viability statement 116 Emergency preparedness summary 119 Risk management, principal risks and uncertainties GOVERNANCE AND REMUNERATION REPORT 128 Chair’s Introduction 130 Board of Directors 136 Group Executive Committee 138 Corporate Governance Statement 170 Audit and Risk Committee Report 184 Clinical Performance and Sustainability Committee Report 188 Nomination Committee Report 194 Remuneration Committee Report 221 Statement of Directors’ Responsibilities FINANCIAL STATEMENTS 224 Group financial statements 330 Company financial statements ADDITIONAL INFORMATION 348 Shareholder information 351 Company information 352 Forward-looking statements 353 Glossary of terms To find out more visit: www.mediclinic.com CONTINUUM OF CARE Expansion across the continuum of care will widen the Group’s service focus, improve accessibility and create the opportunity to form a lasting relationship with clients. 44 50 CLINICAL QUALITY More than 75 clinical indicators are measured monthly across the divisions to identify trends and opportunities for improvement.
    [Show full text]
  • Expertise You Can Trust Hirslanden Private Hospital Group
    EXPERTISE YOU CAN TRUST HIRSLANDEN PRIVATE HOSPITAL GROUP 08/01/2020 Hirslanden Private Hospital Group 2 AGENDA 1 The Hirslanden Private Hospital Group 4 2 The Swiss public healthcare system 14 3 Hirslanden's fields of competence 17 4 Hirslanden's community involvement 22 08/01/2020 Hirslanden Private Hospital Group 3 AGENDA 1 The Hirslanden Private Hospital Group 4 2 The Swiss public healthcare system 14 3 Hirslanden's fields of competence 17 4 Hirslanden's community involvement 22 08/01/2020 Hirslanden Private Hospital Group 4 THE HIRSLANDEN PRIVATE HOSPITAL GROUP AT A GLANCE Key Figures 2018/19 Hospitals 17 in 10 Cantons Patient days2,3 479 631 Affiliated doctors 2 303 Newborns 6 742 Employees (including employed doctors) 10 442 Length of stay3 4.5 days Patients1 106 851 Turnover CHF 1 778 m Key Figures as of: 31 March 2019: 1 Inpatient admissions, without newborns / 2 Adult and maternity patients, source H+ / 3 Average in days, source H+ At a glance At 08/01/2020 Hirslanden Private Hospital Group 5 THE HIRSLANDEN PRIVATE HOSPITAL GROUP AT A GLANCE 21.8% Basic 48.7% Semi-private Private 29.5% At a glance At 08/01/2020 Hirslanden Private Hospital Group 6 THE HIRSLANDEN PRIVATE HOSPITAL GROUP 17 HOSPITALS BETWEEN CONSTANCE AND LAKE GENEVA geneva and lake constance 17 hospitals between 08/01/2020 Hirslanden Private Hospital Group 7 THE HIRSLANDEN PRIVATE HOSPITAL GROUP MEDICAL NETWORK 17 3 2 17 5 Hospitals Outpatient clinics day case clinics Radiology institutes Radiotherapy institutes Aarau Lausanne (2) Bern Lucerne Aarau Lucerne (2) Aarau Bern (3) Lucerne Schaffhausen Zurich Bern (2) Basle Geneva Biel Meggen Düdingen Biel Münchenstein Lausanne Cham Zug Basle Münchenstein Cham Zug St.
    [Show full text]