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VU University Medical Center

Summary Annual Report 2013

This is a summary and translation of the 2013 Annual

Report ‘VU University Medical Center makes a new

start’ (hereafter: 2013 Annual Report). In case of any

discrepancy between this text and the full and original

2013 Annual Report, the latter takes precedence. No

rights may be derived from the text of this summary.

Summary Annual Report | 2013 3

| Mission | Vision

VU University Medical Center (VUmc) stands for

distinctive patient care, top-level scientific education

and breakthrough research. VUmc is based on a

Christian tradition, and combines a belief in personal

treatment, integrity and respect with a healthy

ambition and fundamental curiosity. VUmc aims to

make people better and at the same time to improve

itself and to contribute to tomorrow’s medical

knowledge.

VU University Medical Center aims to make a significant

contribution to the quality of health care, and with it

the welfare of people. As university medical center,

VUmc focuses on a leadership position in education

and training, scientific research and patient care.

VUmc is dedicated to caring for patients, those who

are near and dear to them, referrers, students,

professionals in training and research clients. VUmc

aims to be regarded and recognized as an innovative,

high-quality organization with an excellent reputation,

a strong network and pleasure in what we do; an

excellent center for education and research, with

distinctive patient centers and a leadership position in

patient logistics.

VU University Medical Center is based on a Christian

tradition, of which human values and treatment with

respect are essential aspects. VUmc stands for

sustainability, and has an eye for people and their

environment. VUmc offers a challenging and ambitious

intellectual and working climate, in which pleasure,

respect, integrity and service are at the forefront.

4 Summary Annual Report | 2013


IntroductionThis summary of the 2013 Annual Report gives an

overview of the efforts, the performance and results in

2013, the strategy of VUmc and its management and

governance.

Patient care A total of 27,457 patients were admitted to VUmc in

2013, there were 326,172 outpatient visits and 31,102

patients received Accident & Emergency treatment.

The table below shows the output of VUmc in 2013.

VUmc considers it of great importance to know

patients’ views on the health care provided. These

have been measured at teaching hospitals on a

nationwide basis since 2003. Patients were asked to

give their opinions in 2013 using the Consumer Quality

Index (CQ index). This research shows that patients

rate the quality of care at VUmc highly, with scores of

7.95 for hospital admissions and 8.22 for out-patient

visits.

In 2013 VUmc set itself the goal of improving

transparency in the quality of care. Among the

initiatives taken, in addition to nationwide investigations,

was to adopt the Net Promotor Score (NPS).

The Hospital Standardized Mortality Ratio (HSMR) is

one of the tools used to measure the quality and

safety of care. This is an indicator that shows the

standardized mortality rate for hospital, and takes

into account the patient mix of the hospital. The

HSMR for VUmc was 96, which means that VUmc had

a lower mortality rate than would be expected on the

basis of the national average. The average HSMR for

all hospitals is 100.

Output data

Outpatientvisits

Admissions Total daynursing

Nursingdays Firstoutpatient

visits

Accident &Emergency

patients

350000

300000

250000

200000

150000

100000

50000

0

Pieter ten Brink is chairman of the Patient Participation

Council

‘The relationship between patient and professional is key’

“The Patient Participation Council represents the

viewpoint of patients and visitors at VU University

Medical Center. We have short lines of communication

with the Board of Directors, and are guided by

developments in the care process of which they are

advised by the departments.

We work together on practical matters such as signing

and the provision of information, or the accessibility

for people using rollators or wheelchairs. Other

questions relate to patient service and care, or on

organizational or policy matters; accreditation is

submitted to us, we take part in the safety

inspections, give our views on the CQ index and are

involved at an early stage in the overall planning of

the new electronic patient records system.

The fact that we are somewhat further removed

from operational details sometimes gives us different

insights. That can be very instructive, and helps to

prevent tunnel vision. The key message? We want to

create awareness of the relationship between patient

and professional, in which both have their own

responsibilities.

Good communication is tremendously important.

This is why we have drawn up ten tips as part of the

Patient Safety Week to help patients be well prepared

for visits to the doctor. We intend to present these in

the form of a card in 2014.”


ResearchAs a knowledge center VUmc stands for distinctive

translational scientific research. The research at VUmc

is concentrated within five focal areas. The research

in these five focal areas is assigned to five research

institutes (see table below).

Focal area Research institute

Cancer and Immunology VUmc Cancer Center

Amsterdam (CCA)

Brain Neuroscience Campus

Amsterdam (NCA)

Heart and blood vessels Institute for Cardiovascular

Research (IcaR)-VU

Extra- and transmural EMGO+ Institute for Health &

Care Research

Movement MOVE research institute

Amsterdam

The VUmc strategy of concentrating its research on

five focal areas organized in research institutes

appears to have contributed to the good performance

of VUmc in scientific research, which has shown a

clear further improvement in recent years.

This is shown primarily by the high average impact of

the scientific publications.

In 2013 VUmc took first place for the third year running

among the Dutch University Medical Centers in the

citation analysis of the Center for Science & Technology

Studies (CWTS). The VUmc Mean Normalized Citation

Score (MNCS) of 1.75 means that VUmc publications are

cited 75% more frequently than the world average in

the corresponding fields in which publications appear.

Publications

MNCS

Prof.dr. Yvette van Kooyk, professor of molecular cell

biology and immunology, received the prestigious

Advanced Grant from the European Research Council

(ERC) in August 2013.

‘This grant will allow me to develop a cancer vaccine’

“The Advanced Grant is awarded personally to

established scientists with an excellent track record

working on relevant, unconventional and innovative

research and dealing with breakthrough questions.

This is the most prestigious European grant for

individual researchers, which makes it a tremendous

honor. The grant was awarded in August, and

it was a real celebration with gifts, flowers and

congratulations. I really feel I’m recognized.

I work on innovative fundamental research to find

a vaccine to strengthen the immune response

of cancer patients. Thanks to this grant I have a

budget of 2.5 million euros for a period of five years,

which will allow me to fund three PhD candidates,

two postdocs and an analyst, as well as lab reagents.

Best of all, we can now take the step to clinical work,

and so we can really develop a cancer vaccine. We

can also use the knowledge and experience that we

gain through this work for research into a number of

infectious diseases. That’s what’s so fascinating about

immunology: once you know how it works, you can use

if on a number of different fronts.”


The graph below shows the numbers of VUmc

publications in recent years. In 2013 VUmc published

2,788 scientific publications; 195 more than in 2012.

Education and trainingVU University Medical Center offers educational

programs in the medical, biomedical, medical support

and nursing areas. There were 2,381 students

registered in 2013, of whom 347 were first-year

Bachelor’s students and 322 were first-year Master’s

students.

Detailed measured are made of the rating by students

of all courses and educational programs. In 2013 the

results were as follows:

• Students rate their satisfaction with the overall

medical Bachelor’s programs at an average of 7.2

• Students rate their satisfaction with the overall

medical Master’s programs at an average of 7.8

• Participants in the VUmc Amstel Academy rate their

satisfaction at an average of 7.6

• Participants in the VUmc Academy rate their

satisfaction at an average of 8

• Clients of the VUmc Academy rated the quality of

the VUmc Academy in an (external) CEDEO quality

assessment at 9.2

Scientific publications

3000

2500

2000

1500

1000

500

02008 2009 2010 2011 2012 2013

278825932424230018502007Scientific publications

Prof.dr. Sonja Zweegman was named in 2013 as best

Bachelor’s lecturer. The Hematology and Oncology

block was named as the best of the year.

‘Education needs to be a celebration’

“Our block has been among the prizewinners for

years. I think that’s mainly because we show that

it’s great to be a hematologist. As well as that we

aim to make education a ‘celebration’, so students

don’t just listen, they also feel what it’s like to be a

doctor. Congratulations are due to all colleagues who

structurally devote a lot of time to education, through

which they ensure continuity. After the theory in the

first year, we are one of the first to offer a complete

clinical block in the second year. That has a strong

emotional content, because it’s about people with

cancer who are fighting for their lives. We not only

involve the students in the technical and financial

aspects of oncological treatment, but we also deal

with the emotions and the ethical dilemmas that

you’re faced with as a doctor. As well as that we take

the students into

the laboratory. That’s how we create an incubator for

talent, because we hope that some of the students

will become so enthusiastic about scientific research

that they decide they want to be the doctors who build

link between the pure clinicians and the molecular

biologists or chemists in the lab. And that translation

is an essential part of what we do.”


StaffVU University Medical Center invests in innovative

HRM policy, particularly in relation to career

development, mobility, competence management, job

evaluation and support in reorganizations. A career

center was established in 2013. It helps departments

in possible reorganizations and supporting staff

in finding other positions in case of (threatened)

reorganizations. VUmc had a staff of 6,848 in 2013.

Number of employees

8000

7600

7200

6800

6400

6000

5600

5200

4800

4400

40002009 2010 2011 2012 2013

6278 6557 6796 6810 6846

5392 5620 5828 5844 5891

Number of employees

Number of FTEs

Monique Velder is management assistant in the

Economics, Purchasing and Care Administration (BIZA)

department.

‘It’s very enjoyable working here’

“I started working here 22 years ago as a member of

the medical administration staff. VUmc is a very good

employer. I’ve had plenty of freedom to develop myself,

and I’ve always been able to develop my skills.

There are always new challenges, I have a good

knowledge of the organization and great colleagues.

That combination makes it a really good place to

work. Since June 2013 I’ve been managing the diary of

Paul Meijs, head of Sales and Marketing. That’s a new

department within BIZA, and its tasks include handling

the negotiations with the insurance companies. It’s

new, intensive and sometimes a bit hectic, but that’s

all part of the job. As well as that, VUmc is preparing

for the merger with the AMC. I’m not too concerned

about that. I enjoy my work, and I try to keep

everybody as happy as possible. If no-one complains

it means I’m doing my job well!”


Finance and managementThe graph below shows that the operating income

increased from € 666 million in 2012 to € 720 million

in 2013. The operating expenses increased from

€ 641 million in 2012 to € 707 million in 2013.

The budget and the multi-year outlook show that the

financing of VU University Medical Center for the years

2014 and 2015 is under pressure. The introduction

of performance-related financing and the associated

tightening of the risk profile of the care sector, for

example by finance providers, means it is important

to maintain a sufficient solvency level at least meeting

the standards applicable in the sector. The financial

position that has been built up in recent yeans means

the expected solvency ratios will remain well above

the minimum level required by finance providers.

Appendix 1 shows the institutional income statement

of VU University Medical Center.

Strategy and policyThe strategy of VU University Medical Center is

described in the document ‘Strategie VU medisch

centrum 2010-2014: kennis maakt ons beter, keuzes

maken ons onderscheidend’ (Strategy of VU medical

center 2010-2014: knowledge makes us better, choices

make us more distinctive). The strategy spearheads of

VU University Medical Center for the period 2010-2014

are:

- strengthening focus and making choices

- delivering and experiencing quality

- investing in our staff

An important element of the strategy of VU University

Medical Center is the partnership with the AMC.

VU University Medical Center took significant steps in

2013 in this partnership. VU University Medical Center

and AMC both provide highly specialized care for

patients for whom no further referral is possible. In

many cases the numbers are small, or the treatment

is very complex. The planned partnership creates a

concentration of expertise, innovative infrastructure

and technology for specific and often highly complex

conditions.

VU University Medical Center and AMC have already

work closely together on the purchase, installation

and implementation of a new electronic patient records

system. The implementation of such a system has

the aim of modernizing and optimizing the access to

information.

A new and modern electronic patient records system

increases the quality of care and patient focus. An

effective information system is of great importance

in a university medical center for patient care, but also

for other tasks such as research, education and the

administrative functions related to care.

As well as the partnership with the AMC and the

introduction of the electronic patient records system,

the focus in 2014 will be on a number of strategic

areas including: the introduction of (internal)

performance-related financing, the economies in

programs, the Imaging Center and the NIAZ

reaccreditation.

Management and governanceThe Board of Directors of VU Medical Center consists

of three members, who together form a collegial

executive (see Appendix 2). Wouter Bos is the

chairman, Wim Stalman is deputy chairman and dean,

and Chris Polman is member with the Patient Care

portfolio. Together with VU University Amsterdam,

VU University Medical Center is part of Stichting

VU-VUmc (VU-VUmc Foundation). Governance of both

institutes is exercised by the Supervisory Board of

Stichting VU-VUmc (see Appendix 3).

Operating income/operating expensesin millions of €

750

700

650

600

550

500

4502009

598

582

2010

610

598

2011

656

632

2012

666

641

2013

720

707

Operating income €

Operating expenses €


Appendix 1: Institutional income statement 2013

2013 2012

€ 1,000 € 1,000

OPERATING INCOME:

Income from budgeted care provision 78,632 73,848

Non-budgeted care provision (excluding DBC) 5,778 5,857

Revenues DBC (diagnosis treatment combination) products B segment (cure) 44,727 36,332

Revenues DBC (diagnosis treatment combination) products A segment 270,566 260,746

Revenues from transition scheme and honorarium ceilings 35,831 19,206

Subsidies 173,081 165,598

Other operating income 111,537 104,850

Total operating income 720,153 666,437

OPERATING EXPENSES:

Personnel costs 457,286 434,578

Honorarium costs of independent medical specialists who invoice 0 0

the institute for specialized medical care

Depreciation of intangible and tangible fixed assets 33,052 30,225

Impairments of fixed assets 0 0

Other operating expenses 217,115 176,696

Total operating expenses 707,453 641,499

OPERATING RESULT 12,699 24,938

Financial income and expenses -9,439 -9,991

RESULT FROM ORDINARY OPERATION 3,260 14,947

Exceptional income 0 0

Exceptional expenses 0 0

Exceptional result 0 0

RESULT FOR THE FINANCIAL YEAR 3,260 14,947

ALLOCATION OF RESULT

The result is allocated as follows: 2013 2012

€ €

Addition/(withdrawal):

Reserve for acceptable costs 421 14,207

Fire and damage -613 -613

Reserve assigned to Imaging Center 0 1,726

General reserve 1,040 -2,159

Special reserves for education and research 2,412 1,786

3,260 14,947


Appendix 2: Board of Directors of VU University Medical Center

Name and postition Background

W.J. (Wouter) Bos Wouter Bos has been chairman of the Board of Directors of VU University Medical(1963) Center since August 2013. He studied political science and economics at VU University, where he graduated cum laude in 1988. Mr. Bos started his career at Shell, where he held positions in the Netherlands,

Romania, Hong Kong and London. He subsequently started his political career inChairman 1998 as member of the House of Representatives for the PvdA (Labour Party), of which he became political leader from 2002 to 2010, and from 2007 to 2010

he was deputy Prime Minister and Minister of Finance. He left politics in 2010 and became a partner in KPMG Healthcare in the

Netherlands. He left KPMG in 2013 to take up the position of chairman of the Board of Directors of VU University Medical Center.

Primary attention areas - Overall coordination of strategic policy-making and planning & control - Finance - Personnel and organization - Building and accommodation - Coordination VU-VUmc - Private care

Prof.dr. W.A.B. (Wim) Stalman Prof.dr. Wim Stalman has been deputy chairman of the Board of Directors of (1951) VU University Medical Center and Dean of Medicine. Prof. Stalman studied medicine

at the University of Nijmegen and gained his registration as general practitioner at Utrecht University in 1981. For a large part of his 20 years as general practitioner

in a multidisciplinary partnership he was affiliated to the UMC Utrecht as professor Deputy chairman/Dean of general practice and senior researcher. From 1997 to 2001 he was chairman of the Dutch College of General Practitioner (NHG), where he won the international

Bertelsmann prize in 2001. Prof. Stalman has been with VU University Medical Center since 2001; until 2007 as professor of general practice, and was founder of the first Dutch university general practice at VU University Medical Center in 2004.

Primary attention areas - Education - Specialized medical education and further nursing education - Scientific research - ICT - Knowledge valorization

Prof.dr. C.H. (Chris) Polman Prof.dr. Chris Polman (1958) has been member of the Board of Directors of (1958) VU University Medical Center since July 2013, with the Patient Care portfolio. Prof.

Polman has been with VU University Medical Center since 1986. He was appointed in 1994 as professor of neurology, and became head of this department in 2011. He is an eminent scientist in the field of multiple sclerosis (MS), he was named

Member as the world’s leading MS expert in 2013 and is an inspired neurologist who has performed numerous management functions over the years. In his different

functions prof. Polman has gained experience with policy and management responsibilities, and has also been closely involved in quality of patient care.

Primary attention areas - Patient care - Quality and safety of care - Introduction of the electronic patient record system


Appendix 3: Supervisory Board of Stichting VU-VUmc

Name and position

Drs. W.J. (Wim) Kuijken (1952) Chairman

H.H.J. (Herman) Dijkhuizen RA (1960) - Deputy chairmen - Chairman Remuneration Committee - Chairman Audit and Accommodation Committee

Prof.dr. E.C. (Eduard) Klasen (1949)

- Chairman - Chairman Quality Committee

mr.drs. J.L. (Jan Louis) Burggraaf (1964)

- Member Audit and Accommodation Committee - Attention area VU

Drs. W. (Willem) Geerlings (1950)

- Member Quality Committee- Attention area VUmc

Prof.dr. A.T. (Annetje) Ottow (1965)

- Member Quality Committee - Attention area VU

Drs. J.P. (Jacqueline) Rijsdijk (1956)

- Member Remuneration Committee- Member Audit and Accommodation Committee - Attention area VUmc

Ancillary positions

Delta Commissioner and ABDTOP consultant

Chief Financial Officer NIBC Bank N.V.

Former member of the Board of Directors and dean Leiden University Medical Center

Partner at Allen & Overy LLP

Chairman of the Board of Directors of Medisch Centrum Haaglanden. Mr. Geerlings will step down from his board membership position in 2014

Professor of Public Economic Law at the Europa Institute of Utrecht University

Former divisional director of Nederlandsche Bank and former member of the Board of Directors of ASR Nederland

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VUmc

PO Box 7057

1007 MB Amsterdam

020 444 4444

www.vumc.nl

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