Tradition, Knowledge and Science in the Fight for Health

PUBLIC HEALTH INSTITUTION UNIVERSITY CLINICAL CENTER TUZLA

 

Public Health Institution University Clinical Center Tuzla is a modern medical facility with a clear vision and mission of its development so as continuing education to improve and raise the quality of services for its clients. In the University Clinical Center Tuzla a modern and highly sophisticated diagnostic procedures have been applied, new operational methods have been introduced and developments in medicine followed. Professional development and training for healthcare professionals and scientific research is an ongoing process. It is recognized for its good organization, efficiency and economy, developing and mastering the knowledge and skills in the field of highly differentiated medical methods.

With modern technology and high standards in the application of procedures in the diagnosis and treatment, Cliniacl Center Tuzla became a regional leader in health care for its citizens and beyond, based on treatment, education and innovation.

With modern technology and high standards in the application of procedures in the diagnosis and treatment, Clinical Center Tuzla became a regional leader in health care for its citizens and beyond, based on treatment, education and innovation.

Organization of Clinical Center Tuzla

The institution has a total area of 60,000 square meters placed and four locations: Gradina complex, comprising several buildings accommodating clinics, polyclinics, institutes, management, administration and technical support, and facilities in Kreka, Slavinovići and Solina.

Public health institution University Clinical Center Tuzla has a total of 42 organizational units: 23 Clinics, 2 Polyclinics, 2 Institutes, the Center of palliative care and Emergency center, Hospital pharmacy, 7 sectors and 5 services.

Statistics

In total, there are 2. 508 employees, of which 1.836 of them are medical staff, 537 medical doctors and 1.229 nurses/technicians (320 with university degree and 909 with nursing school). 58 health workers, 12 pharmacists and biochemists, and 672 different non- medical professionals are also employed.

Each year, Public Health Institution University Clinical Center Tuzla, with a capacity of 1.333 hospital beds, treating 46.000 patients, performing about 9.000 surgeries for inpatients and outpatients and providing more than 3.000.00 different services. In addition it achieves 300,000 hospital days and an average lenght of staying of 6.54 days.

Education as a commitment

Education has been responsibility of health professionals. The University Clinical Center Tuzla made professional connections with hospitals around the world and much have been invested in professional health education.

Teaching- scientific potential is 1 academician , 63 professors, 78 medical doctors with Ph.D., and 100 medical doctors with masters of science.

Clinical Center Tuzla is an educational base for Medical, Pharmaceutical, Faculty of Education – Rehabilitation Sciences, and High health and Nursing school. Since the year 2015, our center has been a teaching base for European University Brčko District and European University “Kallos” Tuzla. In addition, within the concluded agreements on cooperation with other health centers, Clinical Center Tuzla offers possibilities for various levels of education for doctors and nurses/technicians from other centers in Bosnia and Herzegovina. Our doctors are very active in the scientific research work and their results are published in indexed and peer reviewed journals cited in the Current Contents(CC) database.

The University Clinical Center Tuzla is an annual organizer of numerous professional events and being a host to more than 10.000 domestic and international participants. Professional meetings of employees from different clinics are held once a month to present the results of work.

Continuous education of staff through collaborative projects
By establishing cooperation with a number of medical centers around the world, University Clinical Center Tuzla based its development on permanent professional and scientific education of health professionals at home and abroad. There are many destinations in which doctors, nurses, administrators and other staff perform updating of skills. Education is conducted within the partnership projects that except residence of our experts in modern medical centers around the world but a world-renowned experts often reside in Clinical Center Tuzla.

Bilateral cooperation is ensured with successful centers from Slovenia (Ljubljana, Maribor, Golnik), Croatia (Zagreb, Split, Rijeka and Osijek), Serbia (Belgrade, Novi Sad, Sremska Kamenica, Ćuprija), USA (Buffalo, Cincinnati, Chicago, Maryland), France (Strasbourg, Paris, Anges, Nantes), Austria (Wienna), Germany (Günzburg, Ulm, Luebeck, Frankfurt, Regensburg), Sweden (Örebro), Norway (Oslo, Trondhaim), England (Leeds) , Italy (Udine), Switzerland (Berne) and Turkiye.

With quality to success

For a step forward in the organization and pursuit of contemporary trends, as well as creating a strong image of health center that offers numerous standard and high quality services an important role plays establishing a quality improvement system in cooperation with the Agency for Healthcare Quality and Accreditation in Federation of Bosnia and Herzegovina (AKAZ). Standardization process includes the establishment of an internal quality improvement system, defining the mission, vision and values of the health center, strategic planing in the field of quality management and providing certain resources for these purposes, drafting certain acts within the health center such as clinical guidelines, documented procedures, programs, protocols, records and the establishment of relevant indicators through which quality is measured.

In December 2014, the University Clinical Center Tuzla received recognition in the category of good practice as the institution that contributed the most to the project of quality improvement and patient safety expansion, and helping others to establish the same system. In the year 2016, according to a survey conducted by the Association for the Development of Society “Kap”, with the support of the US Embassy, the University Clinical Center Tuzla was pronounced the best health care center in Bosnia and Herzegovina.

The University Clinical Center Tuzla is the first accredited health center in the Federation BiH

Following the principle of quality improvement in healthcare, the University Clinical Center Tuzla, in 2003, had entered the process of standardization, primarily standardization of work processes. All these activities were carried out by a specially formed organizational unit, whose task was to standardize, establish, maintain as well as to improve the system of quality and safety in cooperation with all other hospital’s organizational units. These activities led to fulfillment of regulatory accreditation requirements set by Accreditation Standards for Hospitals and the Transplantation Medicine Certification Standards, that is, an external review process and an unconditional accreditation and certification.

The process of external evaluation and accreditation process has performed the Agency for Healthcare Quality and Accreditation in the Federation BiH (AKAZ). On 5 December 2018, the University Clinical Center Tuzla received accreditation for successful implementation of the quality system in a healthcare facility.

Our recognition

Transplantation Medicine

Clinical Center Tuzla is officially verified by the Ministry of Health as an institution for typing, explantation and transplantation of tissues and organs. This is achieved thanks to a well educated team, good organization of material and technical facilities of the centre, which are conditions without it would be impossible to realize the transplant program.

Today Clinical Center Tuzla offers cadaveric kidney transplantation, liver and cornea, allogeneic and autologous stem cell transplantation – bone marrow and liver and kidney transplantation with living donors.
Until the year 2021, we performed 263 transplantations of the kidney of which 38 is cadaver, 22 cadaver transplantations of the liver, and 40 cadaver transplantation of the cornea.

Allogeneic and autologous transplantation of bone marrow stem cell in the University Clinical Center Tuzla have been performed since 2004. The bone marrow transplantation team consists of specialists in hematology, transfusion, pathology, immunology, microbiology, molecular biology, radiotherapy, clinical pharmacologists and nurses/technicians, who are all together equally important for the success of the transplantation program. HSCT is a is a highly sophisticated modality treatment od numerous hematological and non- hematological, malignant and non- malignant diseases where conventional therapy is not sufficient. By the year 2021, a total number of performed HSCT is 146, of which 125 are autologous and 21 allogeneic.

Bariatric Surgery

The extreme obesity in patients is treated only by doctors in Tuzla in Bosnia and Herzegovina.

Another step in expanding the range of Clinical Center Tuzla health services is made by performing very complex and demanding surgeries called laparoscopic gastric banding, laparoscopic sleeve gastric resection, mini gastric bay pass and biliopancreatic diversion. This operation in the field of bariatric surgery that has been applied in patients who are extremely obese and in whom treatment is not possible to perform by conservative approach.

Surgical treatment of the chest wall tumors- Clinic of Surgery

Surgical resection of the chest wall tumor and following reconstruction of the chest wall is being performed using dual synthetic and titanium MESH techniques. The goal of this technique is complete protection of the heart and large blood vessels with preserving the respiratory function of the chest.

Endovascular Surgical Neuroradiology

In recent years, the Clinic for Neurosurgery in conjunction with the Clinic for Radiology specialized expertise in the field of Endovascular Surgical Neuroradiology. This discipline involves procedures of coil embolization of brain aneurysms, embolization of arteriovenous brain malformations and arterial stenting of the brain and neck. It also includes trombectomy for treatment of acute stroke.

Our hospital- based imaging facility provide full service imaging and treatment for most emergencies 24 hours a day, seven days a week.

The most complex neurosurgical procedures

The Clinic for Neurosurgery offers a wide range of services- comprehensive evaluations, treatment planning, surgery and rehabilitation for patients of all ages. The neurosurgery team of specialists provides the latest medical and surgical treatment options for all neurosurgical conditions which includes neurovascular, neurooncological, neuropediatric, spinal and functional neurosurgery, microsurgery, endoscopic and stereotaxic techniques in the treatment of the most complex cases. Minimally invasive neurosurgery is a major force in contemporary neurosurgery, on account of which this Clinic has become known beyond the borders of BiH.

Diagnostics and therapy of blood vessels

The Department of Interventional Radiology has managed to connect all links in the chain of vascular diagnostics and introduce new endovascular techniques for the treatment of vascular diseases such as angioplasty and stent placement in peripheral arteries of the lower extremities, endovascular coil as the first- line treatment for intracranial aneurysms, 3D CT angiography of blood vessels, the liver MRI with Primovist, endovascular treatment of subclavian artery stenosis, and endovascular treatment of spinal arteriovenous malformations.

Breast reconstruction with implants

Following trends in surgical procedures clinicians specialists from the Clinic for Plastic and Reconstructive Surgery perform the breast reconstruction procedure using implants in patients with diagnosis of malignant disease and mastectomy, whereby making impact on the patient’s quality of life and psychosocial adjustment.

From the year 2011 they have successfully performed 22 replacements of the hand and fingers. As an experienced specialists in plastic, cosmetic and reconstructive surgery our doctors regularly perform state- of- the- art surgeries of congenital anomalies, skin and soft tissue tumors, burns, but also cosmetic surgery, the face lift- ritidioplasty, blepharoplasty, rhinoplasty and rhinoseptoplasty, the ear correction- otapostasis, corrective surgeries on the breast, abdomen, extremities, as well as lipectomy, liposuction and lipofilling surgeries.

Biologic therapy in inflammatory eye conditions

The organization and strategies at the Clinic for Eye Diseases are based on principles and standards of contemporary ophtalmology practice. The Clinic offers for our patients following ophtalmology services: a modern cataract surgery method- Phacoemulsification, the cornea transplantation, modern approaches to glaucoma treatment, and surgery of the posterior segment of the eye in children and adults.

Modern concept of Pediatric Intensive Care Unit

The project reconstruction and adaptation of Clinic for Children’s Diseases took place on December, 2018. Within the project the Clinic got a multidisciplinary intensive care unit.

Significant fund investments were made in purchase of a new medical devices such as mechanical ventilators, incubators, infusion and enteral nutrition feeding pumps, monitors, and warm tables. The whole reconstructed space covers twenty units for patients, and the ultimate goal was to prevent and minimize severe neonatal conditions and neonatal mortality. Education and training of healthcare staff was done in Cincinnati, the USA.

New Department for Hematology and Oncology

The latest available data indicates that the Tuzla Canton is the leading in the number of children and youth suffering from malignant diseases, mostly leukemias, tumors of the central nervous system and other severe conditions. To meet increased workload demands, the University Clinical Center Tuzla recently opened a new facility created to improve spatial capacities and healthcare delivery processes for patients that may remain in the hospital for several months during all phases of diagnosis and treatment.

Pediatric and neonatal surgery

For children requiring surgery, our certified and skilled surgeons perform a wide range of services from the field of pediatric and neonatal surgery. Pediatric surgeons diagnose, treat and manage the surgical needs of children, including congenital anomalies of the gastrointestinal tract, anterior abdominal wall, anorectal anomalies, and sacrococcygeal tumors. Surgical procedures in pediatric urology are performed in little patients with congenital or acquired diseases of the kidneys, urinary tract and genitals, as well as endoscopic treatment of vesicoureteral reflux. A safe and effective surgical treatments are also performed to solve the chest and abdominal tumors and other acute conditions in pediatric patients. The knowledge and skills in neonatal surgery obtained during trainings abroad our surgeons are using to solve congenital chest deformities.

Newer trends in interventional cardiology

The Clinic for Invasive Cardiology staff work is organized to provide the treatment of ST- segment Elevation Myocardial Infarction (STEMI) 24 hours a day /seven days a week. (24/7). The Clinic offers a wide scope of cardiac services, endovascular treatments, non- surgical treatments of peripheral artery occlusive disease (PAD) primarily legs, renal arteries and neck.

Also, cardiac resynchronization therapy (CRT) and balloon dilatation of the aortic valve are an accepted and available treatments for patients with heart failure. The management of heart valve diseases in patients, as a trend in cardiology, was quite challenging for the interventional team from the Clinic.Transcatheter aortic valve replacement (TAVR) has been introduced as a therapeutic option for patients with severe symptomatic aortic valve stenosis as an alternative to open-heart valve surgery.

Cardovascular surgery

The surgeons at the Clinic for cardiovascular surgery possess highly specialized skills, experience and education, allowing them to perform the most complex surgeries on the heart and the major blood vessels around it. Equipped according to modern standards, the Clinic for cardiovascular surgery is committed to providing comfortable conditions and high-quality diagnostics, surgery and patient care by skilled and experienced medical staff. The cardiac surgery program offers coronary artery bypass grafting (CABG), heart valve surgery, aortic aneurysm and aortic dissection surgery, as well as daily routine upper and lower extremity bypass surgery. The strategic plan identifies and prioritizes key initiatives that will help us achieve our vision to establish a lifesaving heart transplantation program in our center.

Gastroenterology- diagnostics and treatments

The endoscopic hemoclip method in interventional gastrointenstinal endoscopy is routinely used for managing bleeding, mostly from the proximal part of gastrointestinal tract.

The future of endoclipping method in gastrointenstinal interventional endoscopy is not only the treatment of bleeding, but also its application in non-operative gastrointenstinal perforation treatment and management. The application of new and improvement of interventional endoscopy services will reduce the number of conventional surgical procedures and the overall cost of treatment.

Ethanol ablation for liver tumor

The team of doctors at the Department for Gastroenterology and Hepatology are skilled in performing a nonsurgical method for the treatment of liver tumors. In the ultrasound- guided procedure called ethanol ablation of liver tumor, a certain amount of concentrated alcohol is injected directly into the tumor under local anesthesia. The ablation destroys tumor cells and a small portion of the surrounding healthy tissue, whereby the tumor is being destroyed in a percentage of 90-100% , and replaced by scar tissue. The procedure lasts about 20 minutes and does not require a hospital stay.

Minimally invasive procedures in orthopedy

Modern surgical techniques and equipment allow orthopedic surgeons at the Clinic for Orthopedy and Trauma to perform complex surgeries. The shoulder arthroscopy is a minimally invasive endoscopic surgery that is being performed through two to three small incisions of about few millimeters, which results in less pain for patients, shortens the time of recovery, and reduces the cost of hospital staying. Orthopedic surgery program at the Clinic covers a broad range of endoscopic procedures such as: shoulder rotator cuff syndrome, calcific tenditis, frozen shoulder, posterior shoulder instability and dislocation.

Installation of the first PACS / RIS Solutions in BiH

In the University Clinical Center Tuzla in 2007 began the implementation of the biggest CR/ PACS / RIS. The introduction of a PACS system (a system for processing, archiving and distribution of radiological images), RIS (radiology information system) and CR (apparatus for digitizing), complete processing, distribution and archiving of radiological images and the written findings of the University Clinical Center Tuzla is taking place in electronic form.
The system is based on modern Web technology and equipped with software tools for application in various fields of diagnostics (standard radiography, mammography, 3D views (voxar) for CT-MRI diagnosis, diagnostic ultrasound, angiography, virtual colonoscopy, orthopedics). This mode allows the improvement of work processes, the creation of electronic database of demographic data, raising the quality of diagnostic discipline in total, increase productivity and efficiency of modalities with reduce of operating costs.

Electronic Health Record (EHR), the systematized collection of patient and population electronically stored health information from primary care centers, ie. family health teams and other health centers is introduced in 2011. With centralized electronic health records for every patient, information is quick and simple to access when required – helping to enhance care quality, clinical safety and patient experience.