HUS DELIVERS HEALTH ACROSS LIFESPAN LIFE BEGINS AT HUS ure, t a m e r p n r o “Ella was b 12. 0 2 y a D ’s e n ti on St Valen f o s d n o c e s t rs From the fi r e t h g u a d r her life, ou re, a c t s i l a i c e received sp r.” e h t o m e h t as did I, as d 32 – E i ja , a g e LIFE BEGINS AT HUS EVERY THIRD FINN IS BORN IN A HUS HOSPITAL 6 maternity hospitals Around 18,000 babies are born in HUS hospitals every year Over 25% of Finnish women of childbearing age live in the HUS area LIFE BEGINS AT HUS EFFICIENT NEONATAL INTENSIVE CARE 400g 1500g 3500g Intensive care is typically required when a baby is born premature, experiences difficulties in breathing or has an infection, or there have been labour complications or problems caused by a disease affecting the mother. In university hospitals, mortality rates among small premature infants are 50% lower than those observed in central hospitals. At HUS, the rate of stillbirths and deaths in the first week of life is lower than 0.4%. LIFE BEGINS AT HUS CARE OF PREMATURE BABIES SCORES HIGHLY BY GLOBAL STANDARDS In a Vermont Oxford Network study, HUS Children’s Hospital Ward K7 ranked in the top 48 out of over 800 neonatal intensive care units. LIFE BEGINS AT HUS GOING HOME SOON! HUS DISCHARGES MOTHERS AND BABIES IN UNDER 3 DAYS DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS s a w e r u l i a f iac d r a c ’s o r e E “ ely t a i d e m m i discovered He . n r o b s a w after he ger y r u s t r a e h received . y a d h t r i b t s r before his fi da a e l n a c n o Now my s ” normal life. ged 37 – Pekka, a DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS HUS DELIVERS SPECIALIST PEDIATRIC CARE CARING FOR YOUR HEART OVER 60 YEARS HUS’s national responsibilities • Examination and treatment of severe cardiac problems in children • Demanding paediatric cardiac surgery and infant open heart surgery • Paediatric organ transplants and stem cell transplants • Severe epilepsy DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS ALMOST ONE PAEDIATRIC CARDIAC OPERATION PER DAY approx. 330 cardiac surgeries per year 240 open heart operations per year 15–25 organ transplants per year 40–50 new cancer patients per year 150 premature babies weighing under 1,500 grams DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS THE NATIONAL CENTRE FOR PAEDIATRIC ORGAN TRANSPLANTS Organ transplants by 2011 241 kidney First 1986 118 liver 1987 68 heart 5 lung 3 small intestine 1991 2007 2009 DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS 80–95% OF CHILDREN IN RECEIPT OF ORGAN TRANSPLANTS SURVIVE After the transplant, their growth and development is normal and they enjoy high quality of life. By international comparisons, the results of paediatric organ transplants are excellent. DEMANDING CARE, FROM PREMATURE BABIES TO TEENAGERS 80% OF CHILDREN WITH CANCER RECOVER The largest cancer groups are leukemia and brain tumours. 90% of pediatric stem cell transplants are performed at HUS. By international comparisons, Finland’s results are among the top three. EFFECTIVE HIV CARE AND RESEARCH he t t a h t w o n “We k r a e p p a s i d t ’ virus won t I’m u B . y l e t e l p com her t o r b y m t a glad th lead o t e l b a e b w ill d n a d e l l fi l u a long, f .” e f i l y h t l a e h ed 2 5 – Ville, ag EFFECTIVE HIV CARE AND RESEARCH OVER 60% OF FINLAND’S HIV-POSITIVE PATIENTS RECEIVE TREATMENT AT HUS 70–115 cases per year in the HUS catchment area Over 1,300 HIV patients monitored by HUS Infection Clinic Over 85% receive HIV medication EFFECTIVE HIV CARE AND RESEARCH ACHIEVING THE TARGET-LEVEL CONCENTRATION OF HI VIRUS IN BLOOD % of treated patients 100 90 < 400 80 70 60 50 50 40 30 20 10 0 1998 2000 HIV-NH < 50, medication commenced > 4 months earlier OVER 90% 2002 2004 2006 2008 2010 2012 of patients treated at the HUS Infection Clinic achieve the target level TREATMENT SCORES HIGHLY BY GLOBAL STANDARDS Successful treatment requires continuity – patient commitment to receiving treatment has been effective. EFFECTIVE HIV CARE AND RESEARCH mortality/ 100 patients 10 MORTALITY OF HIV PATIENTS, AURORA INFECTION CLINIC 8 BREAKTHROUGH 6 4 2 0 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 in HIV medication at the end of 1990s HIV DEATHS HAVE DECLINED Only 1–2 % of HIV patients at HUS die each year. Deaths resulting from AIDS are extremely rare. With modern treatment, the risk of dying does not significantly differ from the average of the population. EFFECTIVE HIV CARE AND RESEARCH DECISIVE FACTOR IN THE HIV TREATMENT OF SUBSTANCE ABUSERS Munkkisaari Service Centre was established at the end of 1990s by HUS’s initiative • A model for close cooperation between the voluntary sector and public health care • Excellent results in the treatment of socially excluded substance abusers: approximately 90% uses HIV medication Satisfactory or better results for over 89% of patients on HIV medication • Significantly decreased the transmission of HIV among drug users EFFECTIVE HIV CARE AND RESEARCH An estimated 34 million people in the world are HIV positive COMPREHENSIVE HIV RESEARCH HUS Infection Clinic •Through the international INSIGHT network, researchers are involved in the START study, determining the correct timing of the initiation of HIV medication • An EuroSIDA research centre THOUSANDS OF JOINT REPLACEMENTS EACH YEAR uch m p u n e v i g “I had to e u d g n i l c y of my c in n i a p t n e t s i pers tor c o d e h T . e my kne an o t e m d e r refer d, n a t s i d e a p ortho t u o n r o w y m eventually, ith w d e c a l p e r joint was ow, N . t n i o j l a i an artific er b m e m e r n I don’t eve my n i s t n a l p the im knee.” aged 57 , i r a k a S – THOUSANDS OF JOINT REPLACEMENTS EACH YEAR IN FINLAND ORTHOPAEDIC AND TRAUMA ACCOUNT FOR OVER 40% OF ALL OPERATIONS Typical operations include arthroscopies, reconstructive surgery and cast applications, treatment of herniated disks, and artificial joint replacement surgery for the hip and knee. THOUSANDS OF JOINT REPLACEMENTS EACH YEAR THOUSANDS OF JOINT REPLACEMENTS EACH YEAR For joint replacements, the number of patients aged 30–59 is rising dramatically. Prognosis: Joint replacements will increase, but at a moderate pace in Finland. ? Number of joint replacements in Finland 2011 9,482 HIPS 11,147 KNEES Source: THL, Terveys 2013 THOUSANDS OF JOINT REPLACEMENTS EACH YEAR A NEW LEASE OF LIFE FOR MANY Basic joint replacements are performed in all HUS hospitals. Demanding joint replacement surgery is performed at HUS Surgical Hospital and Peijas Hospital. 90% of surgery is performed without difficulty. At HUS the risk of re-operation is under 3%. THOUSANDS OF JOINT REPLACEMENTS EACH YEAR hospital day 12 OVER 11 DAYS LENGTH OF TREATMENT DUE TO SURGERY 10 8 6 KNEE 4 APPROX. 5 DAYS 2 0 1997 1999 2001 2003 2005 2007 2009 LENGTH OF TREATMENT DUE TO JOINT REPLACEMENT HAS HALVED Length of treatment is one of the key factors affecting cost. THOUSANDS OF JOINT REPLACEMENTS EACH YEAR COST CUTTING THROUGH SMART PROCUREMENT € 4 000 3 000 PRICE DEVELOPMENT 2004 2009 2 000 1 000 Price of artificial joints has dropped significantly due to centralised competitive bidding. 0 Hip Cement-free Cement-free resurfacing I hip II hip III TOP SPECIALIST IN CANCER TREATMENT elt f I g n i n e e r c “After the s ld o t s a w I – really low er. c n a c t s a e r b that I have r u o f n e e b It has now g n i n e e r c s e th years since one g s a h r e c n and the ca completely.” ed 4 4 g a , i v i ä P – TOP SPECIALIST IN CANCER TREATMENT HUS IS A TOP INTERNATIONAL SPECIALIST IN CANCER TREATMENT Finland’s largest cancer treatment centre admits patients not only from the HUS area, but also elsewhere from Finland. An expert in its field, it is also an internationally respected facility. Rated one of the best Comprehensive Cancer Centers (CCC) in Europe. Cancer Treatment is centralised at the HUCH Cancer Center. Operations are performed in all HUS hospitals. TOP SPECIALIST IN CANCER TREATMENT ONE IN THREE FINNS WILL BE DIAGNOSED WITH CANCER The HUS Cancer Center treats approximately 15,500 patients per year, with nearly 70,000 radiotherapy sessions in total. TOP SPECIALIST IN CANCER TREATMENT THE ONLY CERTIFIED COMPREHENSIVE CANCER CENTER IN THE NORDIC COUNTRIES One of the first and most innovative new-generation magnetic resonance simulators in Europe. 10 radiotherapy devices in use. The only Finnish hospital in the Nordic NECT cooperation network to perform early clinical trials in oncology. TOP SPECIALIST IN CANCER TREATMENT TOP RESULTS THROUGH COOPERATION BETWEEN SPECIALIST FIELDS Finland’s treatment results rank among the best in Europe. The Cancer Center specializes in more than 20 tumor groups, which • have 3–5 specialists per team • closely monitor the development of treatment methods for specific tumours • are responsible for preparing treatment instructions on specific tumours at HUS. TOP SPECIALIST IN CANCER TREATMENT Over 90% of breast cancer patients are cancer-free within five years of diagnosis. 60% OF WORKING-AGE PATIENTS WILL RETURN TO WORK ORGAN TRANSPLANTS GIVE MANY A NEW LEASE OF LIFE n a r o f t s i l g n aiti w a d e r e t n er “I e t f a t h g i a r t nt s a l p s n a r t n d n a orga n u g e b had t n e m t a e r t a rs dialysis e y o w t y e n kid w e n a d e v is h t t recei u o b a d hte g i l e d l e e f l l e f i l y l i ago. I sti m a f l ma r o n a d a e l chance to nt.” e m t a e r t l a t ospi h t u o h t i w – ed 3 8 – S a i ja , a g ORGAN TRANSPLANTS GIVE MANY A NEW LEASE OF LIFE ALL ORGAN TRANSPLANTS IN FINLAND ARE PERFORMED AT HUS First organ transplant: kidney in 1964 Organ transplants 2013 189 kidney 49 liver 15 lung 21 heart 10 pancreas 1 intestine 1 heart-lung ORGAN TRANSPLANTS GIVE MANY A NEW LEASE OF LIFE EXPENSIVE OPERATION = SAVING + = For example, kidney transplants are an extremely cost-effective treatment, since they save over 800,000 euros of public money in comparison to dialysis. ORGAN TRANSPLANTS GIVE MANY A NEW LEASE OF LIFE 1 DONOR SAVES MANY, HIGH DEMAND FOR TRANSPLANTS Approx. 350 patients are waiting for an organ transplant at HUS. Finland has fewer than 100 brain-dead organ donors per year. New Organ Donor Act 2010: Organ donation can be performed if the deceased person did not prohibit it while they were still alive. ORGAN TRANSPLANTS GIVE MANY A NEW LEASE OF LIFE TREATMENT RESULTS ARE AMONG THE BEST IN THE WORLD Organ transplants provide the recipient with many years of high quality of life. Over 80% of organ transplant recipients are alive five years after surgery. OUTPATIENT CARE A KEY TO MENTAL HEALTH ill e m a c e b I ago s r a e y r u o F “ n. o i s s e r p e d with severe wn o y m g n i d d en e r e d i s n o c I t n e m o m t s e la h t t a t u b , e lif eel f I w o N . t n tme a e r t t h g u o Is d to a e h a k o o l to h g u o n e e v bra k.” e e w t x e n p tr i my fishing ged 53 – Seppo, a OUTPATIENT CARE A KEY TO MENTAL HEALTH child psychiatry adolescent psychiatry adult psychiatry geriatric psychiatry forensic psychiatry addiction psychiatry HUS PSYCHIATRY – THE FULL LIFESPAN Mental health problems are often dependent on the life stage and age. OUTPATIENT CARE A KEY TO MENTAL HEALTH ONE IN FIVE ADOLESCENTS SUFFER FROM MENTAL HEALTH PROBLEMS The social and economic significance of mental health problems has radically increased. €523 million in expenses for disability pensions claimed on the basis of depression in 2010. €116 million in daily allowances claimed on the basis of depression in 2010. OUTPATIENT CARE A KEY TO MENTAL HEALTH MODERN TREATMENTS WORK EFFECTIVELY IN OUTPATIENT CARE Waiting lists for treatment have reduced dramatically. Care quality has improved with specialised clinics and wards. Significant IT developments in mental health: online therapy sessions, video consultations etc. OUTPATIENT CARE A KEY TO MENTAL HEALTH ACCESS TO TREATMENT 2012 DIRECT METHOD 3 • Focused on outpatient care months • Often at the patient’s home AVERAGE LENGTH OF TREATMENT ON THE WARD 2008 WAITING LIST 1–3 years METHOD • Focused on institutional care • Outpatient care at the clinic 6 months IMMEDIATE HELP FOR EATING DISORDERS NEARBY OUTPATIENT CARE A KEY TO MENTAL HEALTH COST OF SPECIALISED PSYCHIATRIC MEDICAL CARE € million (deflation adjusted) JORVI HOSPITAL 30 PEIJAS HOSPITAL 20 10 0 2008 2009 2010 2011 COSTS HAVE DECREASED SAVING 8% For example, the cost of specialist psychiatric medical care for municipalities within the Jorvi and Peijas catchment areas has fallen by more than 8%. OUTPATIENT CARE A KEY TO MENTAL HEALTH 2008 2011 NEW ORGANISATION DELIVERS EFFECTIVE CARE Under the new organisational model, the same directors and specialists are jointly responsible, with municipal organisations, for the overall care each patient group receives. THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD reak b h c n u l y “I was on m . My g n a r e n o h when the p en k a t n e e b d husband ha a f o e s u a c e b to hospital ly n o e W . n o i t brain infarc y tic l o b m o r h t – got a scare ’t n d i d e w t a t th n a e m y p a r the ng o l e h t h g u o hr have to go t on, o S . d o i r e p n rehabilitatio e h t h s u p o t ur n it’ll be his t !” r e w o m n w a l g ed 5 8 a , a n e e L – THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD In the Helsinki Metropolitan Area, acute care for CEREBROVASCULAR DISORDERS IS DELIVERED at Meilahti Hospital, Neurology Emergency Clinic THE BEST TREATMENT CHAIN FOR CEREBROVASCULAR DISORDERS IN THE WORLD HUS’S treatment chain for cerebrovascular disorders was ranked the best in the world in the Dr. Foster quality assessment published in 2013. THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD SITS-MOST 2003–2006 Austria Belgium Denmark Finland France Germany Greece Italy Netherlands Norway Portugal Spain Sweden United Kingdom Meilahti delivers more THROMBOLYTIC THERAPY treatments than any other hospital in the world. 0 20 40 60 80 100 treatments / million citizens FAST TREATMENT IS THE KEY TO ACUTE CARE THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD SPEED SAVES. HUS IS THE FASTEST IN THE WORLD. 357 patients received thrombolytic therapy in 2011 At HUS, the median time from patient arrival to the start of the thrombolytic therapy is approximately 20 minutes – the shortest time in the world. Nearly one in three brain infarction patients receive thrombolytic therapy. THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD GOOD CARE REDUCES COST AND IMPROVES QUALITY OF LIFE Effective acute care improves patient prognosis and reduces the need for long-term and expensive institutional care. The savings achieved in the acute care for cerebrovascular disorders cover the costs of emergency clinic visits by nearly all other neurological patients. THE MOST EFFECTIVE BRAIN INFARCTION CARE IN THE WORLD SHARED EXPERTISE IS THE BEST EXPERTISE Direct video consultation link enables the delivery of thrombolytic therapy also in smaller hospitals. Rovaniemi Kemi Kajaani Kokkola HUS Mikkeli Hämeenlinna Lappeenranta Kuusankoski Kotka Ahvenanmaa THE SURVIVAL RATE OF HEART ATTACK IMPROVES d e b o t o g o t out b a t s u j s a “I w e r u s s e r p d n in a a p t l e f I n e wh o t e m i t d a h .I in my chest ance l u b m a e h t think that ti h a l i e M o t me e k a t d l u o w r. e t f a e r e h e and onto th w e n e h t t e g l l But soon, I’ en e b s a h a m l socks Se ” ! e m r o f g n knitti ed 74 – Elias, ag THE SURVIVAL RATE OF HEART ATTACK IMPROVES 463 630 2010 2011 Number of STEMI patients per year OVER 700 TREATED INFARCTIONS 54% of patients receive coronary angioplasty 43% of patients receive thrombolytic therapy THE SURVIVAL RATE OF HEART ATTACK IMPROVES NUMBERS INCREASING, MORTALITY DECREASING PATIENT MORTALITY RATE WITHIN 30 DAYS OF INFARCTION mortality % 9 2007-08 8 7 2010 6 2011 5 2013 4 3 2 1 0 Thrombolytic Coronary therapy angioplasty Total THE SURVIVAL RATE OF HEART ATTACK IMPROVES GOOD SURVIVAL RATE OF INFARCTION PATIENTS AT HUS INFARCTION MORTALITY BY HOSPITAL DISTRICT PER YEAR East Savo Kanta-Häme Central Finland Kainuu South Savo North Savo North Karelia Kymenlaakso Päijät-Häme Vaasa North Ostrobothnia Pirkanmaa Southwest Finland South Ostrobothnia Lapland West Ostrobothnia Satakunta HUS South Karelia Central Ostrobothnia person 0 5 10 15 Average in Finland 20 25 QUALITY OF LIFE UNTIL THE END far o s s a w s s e “Anja’s illn had e w t a h t d e advanc was e h s t a h t d accepte ife w y M . e i d going to t il n u e r a c d o received go nally fi e h s d n a the end fully e c a e p y a w passed a n.” i a p t u o h t i and w ged 86 – Aarni, a QUALITY OF LIFE UNTIL THE END VALUABLE LIFE AND DIGNIFIED DEATH FOR EVERYONE Pain management plays an important role • Pain management can improve quality of life for years after the actual treatment period has ended Modern methods and their continued development are the key • Top expertise in pain management and medication • Psychosocial support • Physiotherapy • spinal cord stimulators • research into new pain management methods, including in conjunction with basic health care LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE ies n a p m o c c a ”HUS le d a r c m o r f , through life ur o e u n i t n o c e to grave. W joy n e e l p o e p lp efforts to he ” . e f i l f o y t i l a good qua rse – Eeva, Nu LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE GLOBAL LEADER 5 TH Top European Institutions in clinical medicine HUS + Helsinki University Faculty of Medicine = Helsinki Academic Medical Center Scientific research is a prerequisite for high-quality patient care: improvements resulting from our own research are adopted more than once a week. LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE 462 368 PATIENTS 86 982 surgical procedures 18 061 deliveries 1 657 421 outpatient visits 462 386 individual patients in specialised medical care Source: HUS, Annual Report 2013 LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE 21 750 HUS EMPLOYEES 12 189 nursing staff 2 860 physicians 1 012 other specialists 5 690 other employees 56% nursing staff 26% other employees 13% physicians 5% other specialists LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE HUS DELIVERS CARE FOR ALL OF FINLAND HUS’s national specialist responsibilities 1 Treatment of severe burns 2 Organ transplant surgery 3 Treatment of cleft lip and palate 4 Treatment of craniofacial abnormalities 5 Primary care of osteosarcoma, bone dysplasia, and soft-tissue sarcomas 6 Sex reassignment surgery 7 Surgical treatment of antibody positive (F-VIII) haemophiliacs 8 Surgical treatment of severe obesity 9 Epilepsy surgery 10 Treatment of eye cancers LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE FINLAND’S SECOND LARGEST EMPLOYER 21 750 employees 21 hospitals 2 831 patient beds Annual turnover over €1 800 million 14% 86% LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE Mäntsälä Lapinjärvi Hyvinkää Karkkila Järvenpää Pomainen Tuusula Askola Nurmijärvi Vihti Lohja Vantaa Loviisa Porvoo Sipoo Espoo Siuntio SHARED HUS Finland’s largest hospital district and joint authority, owned by 24 municipalities. Raasepori Inkoo Kauniainen Helsinki Kirkkonummi COUNCIL Hanko Audit Committee EXECUTIVE BOARD Minority Language Board HOSPITAL AREA BOARDS Psychiatric Board BUSINESS ENTERPRISE BOARDS LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE Hyvinkää: Hyvinkää Hospital Tuusula: Kellokoski Hospital Lohja: Lohja Hospital Paloniemi Hospital Vantaa: Peijas Hospital Espoo: Jorvi Hospital Tammisaari: Tammiharju Hospital Länsi-Uusimaa Hospital 22 HOSPITALS Porvoo: Porvoo Hospital Helsinki: Herttoniemi Hospital Skin and Allergy Hospital Surgical Hospital Kätilöopisto Maternity Hospital Children’s Hospital Children’s Castle (Hospital) Meilahti Triangle Hospital Meilahti Tower Hospital Women’s Hospital Psychiatry Centre Eye and Ear Hospital Department of Oncology Töölö Hospital LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE COMPREHENSIVE PATIENT CARE THROUGH SUPPORT FUNCTIONS Medical support services • Medical Appliance Center • HUS Pharmacy • HUS Medical Imaging • HUSLAB Other support services •HUS-Desiko • HUS Logistics • HUS Servis • Property Management Services • Ravioli • Information management Subsidiaries • HUS Real Estate Ltd. • Uudenmaan Sairaalapesula Oy (laundry service) • HYKSin kliiniset palvelut Oy (clinical services) LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE COSTS OF SPECIAL CARE PROVIDED BY THE HOSPITAL DISTRICT OTHER HOSPITAL DISTRICT 1000 950 900 HUS 850 The division of work between HUS and the City of Helsinki has been taken into account in the calculations. 800 750 700 2000 2005 2010 2013 Deflated to the 2013 level YEAR 2013 899,3 € / RESIDENT LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE AVERAGE CLAIMS PAID FOR PATIENT INJURIES / 100,000 RESIDENTS Hospital district Number of residents, approx. HUS 1 550 000 Pirkanmaa 490 000 Southwest Finland 470 000 North Ostrobothnia 400 000 CLINICAL TREATMENT AND CARE North Savo 250 000 OTHER PROCEDURES 0 5 10 15 20 25 30 35 40 SURGERY AND ANESTHESIA 45 THE HIGHEST NUMBER OF RESIDENTS, THE LOWEST NUMBER OF PATIENT INJURIES LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE COMPETITIVE LEADER IN TOP-LEVEL CARE HUS objectives for 2012–2016: • Being a world-class hospital which produces new knowledge • Providing timely, safe and customer-oriented care • Being a competitive service provider and preferred employer • Forging closer partnerships with primary health care LEADER IN TOP-LEVEL CARE NOW AND IN THE FUTURE EMPLOYEES FINANCES +EFFECTIVENESS =DEVELOPMENT Cornerstones of success now and in the future • Competent, motivated and sufficient staff = human resources policy • Financial stability, predictability and efficiency = systematic financing • Functional facilities, technology and environmental responsibility = investments, renovations, ICT ”WE MUST CONTINUE TO INVEST ON QUALITY AND EFFECTIVENESS.” Aki Lindén Chief Executive and President HUS