NATIONAL SPECIAL RESPONSIBILITIES

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Austen Robinson
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1 NEUROCENTER

2 NATIONAL SPECIAL RESPONSIBILITIES Neurocenter treats neurosurgical and neurological patients. Responsible for the diagnostics, treatment and rehabilitation of central nervous system diseases in the Helsinki University Hospital area. The center also holds national responsibilities and responsibilities related to its specific catchment area (cerebral bypass surgery, diagnostics and surgical treatment of complex epilepsy, DBS treatment of Parkinson s disease, telestroke consultation network, demanding neurological emergency patients). 2

3 HIGH-QUALITY EXPERTISE Treats patients continuously from the initial emergency evaluation of an acute symptom through procedures, inpatient treatment, and rehabilitation to discharge. Surgery, emergency, and intensive care activities are mainly centralized to Meilahti and Töölö Hospitals. Approximately 15,600 referrals, 9,300 emergency patients, and 3,600 surgeries every year. 3

MEDICAL RESEARCH Lively international networking and co-operation. International high-quality neuroscientific research. A total of 222 scientific publications in 2018.

4 MEDICAL RESEARCH Lively international networking and co-operation. International high-quality neuroscientific research. A total of 222 scientific publications in In addition to government funded research projects, the Neurocenter has significant competitive funding from external financiers (Academy of Finland, Michael J. Fox Foundation, European Research Council, Business Finland etc.). 4

EXAMPLES OF OUR SERVICES Brain tumour surgery Thrombolytic therapy for cerebral infarction and mechanical removal of blood clots in the brain Brain aneurysms Cerebral arteriovenous malformations

5 EXAMPLES OF OUR SERVICES Brain tumour surgery Thrombolytic therapy for cerebral infarction and mechanical removal of blood clots in the brain Brain aneurysms Cerebral arteriovenous malformations Surgery for epilepsy Complex diagnostics and treatment of neuroimmunological diseases Complex diagnostics and treatment of neuromuscular diseases Infusion and stimulator therapies for progressed Parkinson s disease Tumours and compressions in the spinal cord 5

Aivotalo is open around the clock, every day of the week.

6 AIVOTALO.FI Aivotalo website offers reliable information on brain health and brain disorders in adults. Aivotalo provides support when faced with an illness and digital services to support treatment. Aivotalo is open around the clock, every day of the week. Aivotalo website was created by Finnish professionals in neurology, neurosurgery, and neuropsychology together with patient organisations. HUS coordinates the implementation and updates of the national Aivotalo website. 6

7 HOSPITALS Peijas Hospital Laakso Hospital Meilahti Tower Hospital Meilahti Triangle Hospital Orton Paciuksenkatu Jorvi Hospital Töölö Hospital 7

8 BRIDGE HOSPITAL 2023 Neurosurgery will transfer from Töölö to Meilahti campus.

ORGANIZATION Director Atte Meretoja Director of Nursing Maarit Virta-Helenius Financial Manager Markus Pelttari Communications Specialist Anna-Mari Hursti Administrative Chief Physician Riku

9 ORGANIZATION Director Atte Meretoja Director of Nursing Maarit Virta-Helenius Financial Manager Markus Pelttari Communications Specialist Anna-Mari Hursti Administrative Chief Physician Riku Kivisaari Nurse Administrator Maarit Virta-Helenius Nurse Administrator Ritva Salmenperä Head of Neurology Nina Forss Head of Neurosurgery Mika Niemelä Head of Research and Development Aki Laakso Chief Psychologist Neuropsychology Marja Hietanen Coordinating physicians in charge Brain tumours Laakso/Ollila Brain injuries and neurological rehabilitation Siironen/Melkas Strokes Curtze/Lehecka Epilepsy Roivainen/Laakso Pain neurology Harno/Kivisaari Motion disturbances Pekkonen/Kivisaari Neuroimmunology Tienari Memory disorders Verkkoniemi/Karppinen Emergencies and neurological intensive care Strbian/Siironen Spine and peripheral nervous system Antinheimo/Auranen 9

OPERATING REVENUE AND EXPENSES Year 2018 Administration, teaching and research Operating revenue Operating expenses 2 554 000 10 322 000 Neurosurgery 44

10 OPERATING REVENUE AND EXPENSES Year 2018 Administration, teaching and research Operating revenue Operating expenses Neurosurgery Neurology Neuropsychology Neurocenter * * Expenses with depreciation 10

11 SERVICES PRODUCED IN treatment days in neurosurgery outpatient clinic appointments in neurosurgery 3612 neurosurgical procedures appointments in neurosurgery Neurocenter treated specialized health care patients treatment days in neurology outpatient clinic appointments in neurology 6969 outpatient clinic appointments in neuropsychology 5702 inpatient treatment periods in neurology appointments in neurology 4501 appointments in neuropsychology treatment days in Neurocenter outpatient clinic appointments in Neurocenter DRG treatment periods in Neurocenter appointments in Neurocenter

12 PERSONNEL 680 Employees in total 121 Physicians 443 Nurses 68 Specialist staff members 48 Other staff members Personnel by personnel group sizes 7, ,8 65,1 Hoitohenkilökunta Nursing staff Lääkärit Physicians Muu Other henkilökunta staff Erityistyöntekijät Other specialist staff 12

13 NEUROSURGERY 13

14 LEADING CENTER FOR SURGERY OF THE CEREBRAL BLOOD VESSELS IN EUROPE Patients with difficult cases of skull base tumors, brain aneurysms, and venous malformations are referred to us from elsewhere in Finland and even from abroad.

15 Neurosurgical patients from the HUS area, Southern Karelia, Kymenlaakso, and Päijät-Häme hospital districts. Procedures (incl. endovascular treatment) in a year: 3,600. All cerebral bypass surgeries in Finland. The only round-the-clock, stand-by unit for pediatric vascular surgery in Finland operates in Helsinki. 15

16 One of the best units in the world in microneurosurgical treatment of cerebral blood vessels. Annually, over 100 foreign visitors come to us to learn the newest methods in microneurosurgery. 16

17 NEUROLOGY 17

THE MOST EFFECTIVE TREATMENT OF CEREBRAL INFARCATIONS IN THE WORLD, ALSO AS TELE- STROKE CONSULTATIONS The median time it takes from the patient s arrival to

18 THE MOST EFFECTIVE TREATMENT OF CEREBRAL INFARCATIONS IN THE WORLD, ALSO AS TELE- STROKE CONSULTATIONS The median time it takes from the patient s arrival to the start of thrombolytic therapy is 17 minutes the shortest time in the world. Nearly one in four cerebral infarction patients receives thrombolytic therapy.

NEUROLOGY EMERGENCY UNIT Meilahti has a 24/7 neurology emergency unit: Circa 8,300 emergency visits annually Responsible for a population of over 2.

19 NEUROLOGY EMERGENCY UNIT Meilahti has a 24/7 neurology emergency unit: Circa 8,300 emergency visits annually Responsible for a population of over 2.1 million (in addition to the HUS area, provides demanding neurological emergency care for Carea, Eksote, and Päijät-Häme) Mechanical removal of cerebral blood clots A neurologist provides telestroke consultation services remotely for 12 hospitals 19

20 Meilahti Hospital administers the highest number of thrombolytic therapies per hospital in the world. Dr. Foster s quality comparison (incl. 40 leading hospitals in the world): lowest mortality rate for cerebral infarction patients in the world. Levodopa and apomorphine infusion therapies and directional deep brain stimulation for Parkinson s disease. Complex epilepsy diagnostics and evaluation of epilepsy surgery. The Brain Injury Clinic, Outpatient Clinic for Muscular Diseases as well as the Rehabilitation Evaluation Unit operate as specialised outpatient clinics, among others. 20

21 RESEARCH Co-operation with several health technology and pharmaceutical companies. Active participant in dozens of international multicenter trials. Research-oriented clinic with 15 independent research teams. 21

22 NEURO- PSYCHOLOGY 22

23 LARGEST UNIT IN NEUROPSYCHOLOGICAL RESEARCH AND REHABILITATION IN FINLAND Around 60% of workingage patients with a transient ischemic attack will return to work after receiving outpatient neuropsychological rehabilitation.

NEUROPSYCHOLOGICAL EXPERT UNIT Nearly 7,000 patient visits every year Provides neuropsychological examination and neuropsychological rehabilitation for neurological patients Scientific research

24 NEUROPSYCHOLOGICAL EXPERT UNIT Nearly 7,000 patient visits every year Provides neuropsychological examination and neuropsychological rehabilitation for neurological patients Scientific research and development Examination of children's speech and language disorders Consultations to other Helsinki University Hospital clinics Offers clinical supervision and work counselling also outside HUS 24

After a cerebral infarction, problems with information processing are the most impactful factor when it comes to returning to work and the cost of the infarction to society.

25 After a cerebral infarction, problems with information processing are the most impactful factor when it comes to returning to work and the cost of the infarction to society. Correctly timed neuropsychological assessment and rehabilitation is an integral part of the clinical pathway for neurological patients. The length of neuropsychological rehabilitation can vary from a short period of counselling to longer periods of rehabilitation. 25

26 NEUROSCIENCE NURSING 26

27 THE MODEL OF PROFESSIONAL NURSING PRACTICE FOLLOWS THE FRAMEWORK OF MAGNET HOSPITAL DESIGNATION

28 Neuroscience nurse s handbook, career model, and mentor programs help to standardize the training process. The training program for neuroscience nursing consists of 6 training days, and a job rotation program operates between divisions. Skilled Nurses work to promote evidence-based nursing (+5 nurses with Skilled Nurse training in 2018). Neuroscience nurses co-operate nationally (Finnish Association of Neuroscience Nurses) and internationally (EANN and WFNN). 28

Expert groups work in the units to promote evidencebased practices for example systematic use of sensitive instruments in nursing (falls, pain, nutrition, and pressure sores), analysis of the

29 Expert groups work in the units to promote evidencebased practices for example systematic use of sensitive instruments in nursing (falls, pain, nutrition, and pressure sores), analysis of the results, and utilizing them in daily work. For example, Neurological Ward K4A in Triangle Hospital Evaluating risk of pressure sores 91 % at the beginning of treatment Recognising the risk of malnutrition 91 % Risk of falls 91 % in the preliminary information 29

30 THANK YOU 30

We will look at the definition of Neuro-Rehabilitation as opposed to Palliative Care, What impairments patients have at diagnosis How good we are at

We will look at the definition of Neuro-Rehabilitation as opposed to Palliative Care, What impairments patients have at diagnosis How good we are at picking these up; What we need to do to change the system