Thinking about the future of health and care

Thinking about the future of health and care 2009 Annual Report

careum

2 Careum, 2009 Annual Report

This year, Careum promotes artists Careum promotes education in the health sector. In this year’s annual report, this promotional idea is taken up again in a different context. With an invitation for contributions on the subject “Thinking about the future of health and care”, Careum has provided young artists with a platform for their work. The picture gallery by Julia Bruderer fully convinced the jury, as it illustrates Careum’s future orientation in a symbolic and abstract way.

Julia Bruderer lives in Zurich, working as a freelance illustrator. In 2009, she completed her master’s in Communication Design at the Central Saint Martins College of Art and Design in London. Soon after completion of her studies, she received the 1st Prize in the Swatch Young Illustrators Awards. She is currently working on various assignments from clients as well as personal projects including a work about the history of our forebears. Her greatest inspiration is nature, which provides an inexhaustible source of fascinating and often unexpected discoveries.

To find out more about Julia Bruderer’s work, visit www.juliabruderer.com.

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Table of Contents

5 Thinking about the future of health and care 7 Education and Training 8 Patient education: meeting the needs of competent patients 10 New study programmes thanks to the pioneering work of the WE’G Hochschule Gesundheit 12 Careum Training Centre for Health Professionals dedicated to supporting young talent 15 Research and Development 16 Careum Competence Centre changes to Careum Research and Development: ten dynamic years – and the development is far from complete 18 Careum Working Papers: future prospects 21 Promotion and Dissemination 22 Careum Publishing teaching materials stand the test of time 25 Support and Networking 26 Harkness/Careum Fellowship Program: research on the health policy of the USA and Switzerland 30 Careum Congress 2009: Moving boundaries: global healthcare – national challenges 32 Careum Forum 2010: No appreciation without a positive self-image 35 Careum – What’s behind it?

40 Board of Trustees and Committees 42 Organisational chart

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Thinking about the future of health and care

Having completed a long transformation process, Careum defined its strategy for the next five years in the course of the past business year.The founda­ tion’s activities are now divided into four business segments.

127 years after its foundation, Careum is in a unique situation: its environment – the health and education sector – is going through a phase of profound change.

At the same time, Careum itself has completed a long transformation process and is now able to benefit – in line with the foundation’s objectives – from the opportunities offered by this great phase of change and to use them to the advantage of the health and education sector. Careum sees this reorganisation as an opportunity and as part of its commitment to implementing the foundation’s objectives.

In April 2009, the Board of Trustees passed the “Strategy of the Careum Foundation”, thereby defining the general direction of Careum’s development for the next five years. The aim of this year’s annual report is to show where the journey is going and what measures have already been initiated, and not only to look ahead to the healthcare world of the future but also to make an active contribution to shaping it.

Over and above defining Careum’s future areas of activity, the adjustments in the composition of the Board of Trustees and the Management Committee also reflect the general strategic direction: the new members bring high-level expertise and a valuable network of professional contacts to the foundation.

As regards Careum’s core activities and overall mission, the basic principle remains unchanged: Careum will continue to promote education in the health sector by providing support and inspiration for the systematic development and establishment of education and training in this area in the future.

The four business segments Education and Training

Promotion and Dissemination

Research and Development

Support and Networking

This objective of the foundation has been broken down into four business segments which comprise both existing activities and new projects.

This year’s annual report follows this structure as well.

Careum’s activities are illustrated on the basis of project descriptions, field reports and conference summaries, as well as through statements by people who came into contact with Careum in one way or another during 2009. In addition, the last section of the report gives a concise overview of the structural entity which is “Careum” as well as its strategic orientation.

Hans Gut, Chairman Ilona Kickbusch René Kühne Beat Sottas Management Committee

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Education and Training Careum provides education, training and advice for teachers and students as well as partners in the education system

8 Careum, 2009 Annual Report

Patient education: meeting the needs of competent patients

Over the last few decades, patients have become more active and more competent. For this reason, patient education is becoming increasingly impor­ tant in the health sector. With its project “Patient Education” Careum is promoting this subject.

The role of the patient as citizen and consumer is becoming increasingly important in relation to health issues. A health-oriented society demands that individuals make an active and competent contribution to maintaining their own health and to overcoming chronic physical and mental illnesses. Patient involvement is now recognised and demanded all over the world as one of the central innovations required in the health sector. In response to these developments, Careum’s Board of Trustees approved the project “Patient Education 2010–2015” in November 2009.

With this project, Careum aims, in cooperation with national and international partners, to strengthen patient education for the chronically ill and their relatives and to make it part of healthcare and training in the long term. Careum thereby positions itself at the cutting edge of a momentous international development in the health sector and makes a contribution to the health policy debate on the role of the patient in the health system and on future healthcare strategies.

With its professional and innovative project management, Careum will do its share to ensure that a new area is developed in the health sector of the future. A project advisory board will be responsible for involving important stakeholders.

The approved project was preceded by a preliminary study, in which the current situation in Europe, local needs, and the feasibility of the intended project were analysed. In addition, an expert meeting of international pioneers in this field took place in Zurich.

Structure of the CDSMP programme Based on previously conducted analyses, Careum will support the comprehensive implementation of the Chronic Disease Self-Management Program (CDSMP) in Switzerland and create the basis for an independent CDSMP competence centre. Several experts in Switzerland are currently in the process of setting up the first regional CDSMP products, and experience has been

gained through individual local projects and hospitals. The time is especially opportune for Careum to move ahead together with these partners, for there is generally a great need for cooperation, networking and mutual support. The basic principle of the project implementation is that Careum will primarily take care of coordinative activities and that its function is to facilitate promotion, provide support and optimise networking.

National and international network In addition, Careum is committed to setting up an independent platform, the “Careum Patient Campus”, for networking, innovation and knowledge management in patient education with a national and international reach. Apart from the Careum premises, virtual space will be used for this purpose. This platform will enable players in Switzerland and abroad to network and exchange ideas, at the same time helping to publicise innovative projects.

Chronic Disease Self Management Program, Stanford (USA) The CDSMP was developed at the Stanford University Patient Education Center in the mid-1980s. It is an effective group intervention tool for patients with a chronic illness who are taught various skills which will be useful in their daily lives.

The programme is standardised with its details laid down in a handbook. It is implemented by two trained lay course instructors (persons who are chronically ill themselves) or by tandem leadership (i.e. one lay course instructor and one health professional). The course instructors can become qualified training supervisors. Recruitment and training form an important part of the programme. The CDSMP has been evaluated by the founders as well as independent research groups on an ongoing basis for about 25 years and has shown impressive results with regard to effectiveness and acceptance. In Europe, the CDSMP is now offered countrywide in Great Britain and Denmark.

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Lastly, Careum will be involved in setting up a “European Network for Patient Education”. Participants in the expert meeting in Zurich in September 2009 expressed an interest in a European network in which institutions involved in patient education can exchange information on their existing and new projects as well as their project ideas and instruments. This issue is also seen as relevant in the European Union and in European Patient Organisations.

Ilona Kickbusch Head of the Patient Education Project Member of the Board of Trustees and of the Management Committee

With the above-mentioned projects, Careum is able, thanks to its independence, to promote trend-setting topics in patient education – for example with regard to healthcare and inter-professionalism – and to create awareness among decision-makers of the increasing significance of patients and their competencies. In the large number of training courses in which Careum is involved, patient education must – where this is not already the case – be included as a subject of study and discussion.

International network: Expert meeting “Patient Educa­ tion” held on 10 September 2009 in Zurich The expert meeting organised by Careum united – for the first time – representatives of different approaches to patient education in an intensive workshop. Representatives of a number of different projects attended, including MindfulnessBased Stress Reduction (MBSR); Mini Med School, Austria; Patient University, Hanover; Expert Patients Programme EPP, England; CDSMP, Denmark; Planetree, USA and the Netherlands. The meeting provided valuable inspiration for the patient education project and for the Careum Congress 2010, which is dedicated to the topic “The power of patients – patients’ role in shaping the healthcare system of the future”. The congress will feature systematic and in-depth presentations on innovative international experience with patient education. The outcomes arising from this conference will be discussed in the context of the reorientation that is needed in the area of health policies.

Upcoming event: Careum Congress “The power of patients” to be held on 11/12 November 2010 in Ruschlikon, Switzerland www.careum-congress.ch

10 Careum, 2009 Annual Report

New study programmes thanks to the pioneering work of the WE’G Hochschule Gesundheit

The WE’G Hochschule Gesundheit, in which Careum holds a stake, is developing fast. The qualification Bachelor of Science in Nursing has been recognised by the federal government since since 2009. The master’s programme has already been launched and gained government recognition in spring 2010.

With this Careum plays a pioneering role in the Swiss education landscape.

The only private health college in Switzerland, (WE’G FH) was founded in 2005. In addition to Careum, it is owned by two other partners, Kalaidos Bildungsgruppe and “Stiftung Bildung – Gesundheit”. This means that it is financed solely via private contributions in the form of tuition fees and investments by the owners and no public funding is received.

Bachelor’s and master’s degrees For the WE’G FH, gaining recognition for its Bachelor of Science in Nursing (BScN) programme from the Federal Office for Professional Education and Technology (OPET) in 2009 was a key event. So far, 53 students have successfully completed their BScN. Further-

more, the WE’G FH launched the Master of Science in Nursing by Applied Research (MScN by Applied Research) and various Master of Advanced Studies (MAS) programmes at the beginning of 2009 and government recognition was granted in spring 2010. As the first health college in Switzerland to offer a master’s programme in nursing in the German-speaking part of Switzerland, Careum plays a pioneering role in the Swiss education landscape.

European Network Nursing Academies Cooperation across national borders is especially important to Careum. In line with this outlook, the WE’G FH has become part of an international network, the “European Network – Nursing Academies” (http://en-na.eu). So far, this network comprises eight colleges based in German-speaking Europe, i.e. schools based in Germany, Austria and Switzerland.

It is expected that similar institutions from the Netherlands and Sweden will join the network in the near future. The objective of the network is to promote international cooperation in care-related research and teaching.

MAS in Oncology Care: student testimonial “Having read and analysed a number of studies, I am now capable of conducting a database search to systematically identify relevant literature, recognise research designs and assign relevant research questions. I can understand research reports and compare results and make inferences for practical patient care. My experiences were very positive, and my inter-professional work with doctors was marked by mutual respect throughout.”

Astrid Biedermann, oncology nurse

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The comprehensive services offered by the WE’G Hochschule Gesundheit – Bachelor of Science in Nursing – Master of Science in Nursing by Applied Research – Master of Advanced Studies – Management issues in healthcare institutions – Geriatric care – Oncology care – Palliative Care – Care Management – Wound Care – ICT in healthcare institutions More information: www.weg-fh.ch.

Careum awards scholarships

Programmes offered by the Careum Institute

Careum wants to support students who have achieved above-average results in their bachelor’s degree and who intend to complete the “Master of Science in Nursing by Applied Research” offered by the WE’G FH in Aarau.

Careum awards a limited number of scholarships every year.

More information: www.careum.ch.

Under the name “Careum Institute”, the WE’G FH offers study programmes in palliative care and oncology nursing at the Careum Campus in Zurich.

More information: www.careum.ch and www.weg-fh.ch.

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Careum Training Centre for Health Professionals dedicated to supporting young talent Due to the growing number of students, the Careum Training Centre has been steadily growing. In re­ sponse to its new size, the Training Centre has adjusted its organisational structure. 2009 also saw the introduction of the EFQM quality standard.

Careum’s strategic plan states that: “ ‘Providing education and training’ has been a central issue in the activities of the foundation since its inception. Accordingly, this has become one of Careum’s most important fields of activity.” With 1300 trainees and students enrolled in 2009, the Careum Training Centre now represents a central business field for Careum.

Together with its three partners (Stiftung Diakoniewerk Neumünster – Swiss School of Nursing, Eleonorenstiftung – Children’s Hospital Zurich, Kalaidos Bildungsgruppe Schweiz), Careum, acting as the majority shareholder, called into life Careum AG, Training Centre for Health Professionals (Careum AG, Bildungszentrum für Gesundheitsberufe) on 9 March 2005. Following the cantonal mandate to the Careum Training Centre on 15 February 2005, its development took an unprecedented and rapid turn when 25 healthcare colleges were closed down in the Canton of Zurich.

In its 5th year of operation, the Careum Training Centre now offers two courses of study at the upper secondary school level (patient care assistant, healthcare specialist). In the area of higher-level vocational colleges, five courses of study are offered (nursing, medical laboratory, medical radiology, surgical techniques and dental hygiene). With this range of study courses, the Careum Training Centre, which is constituted under civil law, is the largest health training centre in Switzerland.

In order to cope with this growth, those responsible for the Careum Training Centre made preparations as early as 2008 by creating the new management organisation based on the corporate strategy and the future service portfolio. At present the Careum Training Centre has four divisions (Vocational Colleges, Higher-Level Vocational Colleges, Marketing, Finance and Administration) which are integrated in its

management. Due to its rapid growth, 2009 was further more marked by the establishment of a new management level in all areas and by the integration of an additional study programme offered by the higherlevel vocational college for dental hygiene.

In addition, in response to the decision of the Office for Secondary Education and Vocational Training of the Canton of Zurich (Mittelschul- und Berufsbildungsamtes des Kantons Zürich) to abolish the existing student admission procedure, hitherto organised by the canton, and instead to delegate this responsibility to the Careum Training Centre, the Marketing Division was built up in a very short time and completed one and a half years earlier than planned.

In total, 89 salaried employees and about 300 assistant lecturers ensure that the educational standards of the Careum Training Centre translate into high-quality courses for the benefit of trainees and students. For the upper secondary level, this means the consistent implementation of the CORE method (Competency and Resources) and for the Tertiary Level B with its higher-level vocational colleges it requires consistent implementation of problem-based learning (see textbox). In addition, it is a distinguishing feature of the Careum Training Centre that it develops inter-profes

The Competency Resource Model (CORE) The curriculum of the vocational college for healthcare specialists is based on the competency resource model which defines educational goals in accordance with descriptions of typical situations in everyday professional life. The aim is to enable students to deal competently with a range of professional situations. For this reason, it is not sufficient to limit educational activities to imparting knowledge. Rather, students must be able to put this knowledge to good use in order to competently handle concrete situations that they are faced with in their daily work. It follows that the aim of the training provided is to develop relevant professional competencies.

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sional training modules and offers such courses for students of healthcare and medicine as well as for the various levels of training and study programmes within the centre. The introduction of the quality standard in accordance with EFQM (European Foundation for Quality Management) in the year 2009 testifies to the Careum Training Centre’s commitment to constantly improving the quality of its services.

The Careum Training Centre is aware that it will face great challenges in the near future. Ensuring the recruitment of young people in the healthcare sector will become extremely important. The staff of the Careum Training Centre are therefore highly committed to the comprehensive promotion of young talent within the organisation, in their immediate work environment and, of course, at cantonal and even national level – a commitment which manifests itself in their active participation in the relevant committees.

Christian Schär Director of the Careum Training Centre

Problem­Based Learning (PBL) Problem-based learning, a pedagogical and didactic concept and at the same time a learning method, was developed at McMaster University in Canada in the late 1960s and subsequently quickly conquered the world. Knowledge often results from the process of wanting to understand and solve problems.

The starting point of PBL is therefore work-relevant situations which are formulated as “problems” in the sense of “difficulty” or “challenge”. This triggers a cognitive conflict in students which motivates them for further thought processing: they now want to understand and solve the problem. Teaching inspired

by PBL revolves around the student with the teachers acting as supporters of the learning process who do not present knowledge but instead systematically ask questions.

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Research and Development

Careum conducts research and develops teaching and learning materials as well as pedagogical concepts for healthcare education

16 Careum, 2009 Annual Report

Careum Competence Centre changes to Careum Research and Development: ten dynamic years – and the development is far from complete Goal­ and job­oriented, and useful in everyday work situations: in the ten years of its existence, the Careum Competence Centre has, among other things, developed teaching and learning aids for eight different study programmes. And the next step is already being planned: develop­ ment of Careum R+D.

Ten years of research, development and implementation. Ten years with the aim of making available the best standards in the various disciplines of the health sector for trainees, students and teachers. Many people have worked hard to realise this goal showing a great deal of commitment and dogged perseverance, and continuously search for improvements.

The chief objective of Careum has always been to “promote education in the health sector through innovation and development”, and in the future this will continue to serve as a guiding principle for visions, strategies, projects, products and services of the Careum Competence Centre – which will become Careum R+D (Careum F+E) in 2010. The new name Research and Development also denotes a programme.

The activities of the Careum Competence Centre have been highly dynamic over the last ten years, all the while bearing in mind its motto “Thinking about the future of health and care”. In the process, a sound foundation for the consolidation of the “Research and Development” division has been created.

Pia Riedo Head of the Careum Competence Centre

Many members of our society, especially patients and members of the health profession, deal with life and death, health and sickness and the experiences associated with them. They look for practicable and useful approaches and solutions which are suitable for their goals and intentions. People in our society – in this context primarily trainees and students – can only really relate to those (knowledge) contents that are significant for their life, fit into their world and are goal- and practice-oriented, as well as interdisciplinary.

From the basic principle into practice In our postmodern society, learning revolves around construction, reconstruction and deconstruction. We are the inventors of our reality (construction), we are the discoverers of our reality (reconstruction), and we are the debunkers of our reality (deconstruction). Careum made a commitment to these three principles of a systematic and constructivist pedagogic and didactic method in the year 2000 and delegated to the Careum Competence Centre the task of developing study programmes for future health professionals at upper secondary school level, as well as tertiary levels B and A, in accordance with this teaching theory. Today, ten years later, “problem-based” curri-

cula as well as teaching and learning materials are available for the study programmes of eight different health professions, and they are successfully used by trainees, students and teachers in various educational institutions. The path from the vision to the actual application of the “problem-based” educational method would not be exhaustively characterised without mention of the related offers which are decisive for success: postgraduate courses for teachers and consulting and support services for education providers to help them implement the “problem-based” curricula, quality management and public relations work.

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Integration of the Careum Competence Centre and vocational college research in “Careum R+D” as of 2010 The Careum Competence Centre has always been a pioneer in the development and introduction of “problem-based learning” (PBL) in Switzerland. Careum is determined to continue to play this pioneering role in the future and to extend it further. For this reason, Careum has decided, against the background of new challenges in advanced training and patient education which demand new methodological approaches and the critical analysis of pedagogic trends, to supplement the current Careum Competence Centre together with partners by adding a research division, and to strengthen it further by creating the business field “Research and Development”.

Starting 2010, the Careum Competence Centre and the R+D tasks of the WE’G Hochschule Gesundheit will be merged in order to enable optimal alignment of the resources and competencies in fulfilling the tasks and reaching the set goals.

On the one hand, this means that the development work of the Careum Competence Centre is raised, in line with the international trend, to university level. On the other hand, the federal government standards for universities of applied sciences are met, because, apart from the basic and advanced training offered by the WE’G Hochschule Gesundheit, an R+D centre of national importance is being created which will clearly surpass the prescribed job volume in the areas of research, development and services.

Careum R+D creates synergies and significant added value: • More effective training concepts and teaching media The changes in the health sector in the form of new healthcare models, new roles for health professionals and more autonomous patients will have a lasting impact on education in the health sector. By establishing a connection between the didactic know-how of Careum and the research expertise of the college, ideal conditions can be created for the development of effective training concepts and teaching media.

• Setting up a sound knowledge basis and optimal transfer Oncological healthcare and medical care research into the progression of acute and chronic diseases provide a solid knowledge basis. The combination of the two facilitates the transfer into teaching materials, teaching and advanced training.

• Addressing new and relevant research questions The interface between professional healthcare, nursing by relatives and the possibility of reconciling care-giving and work commitments is becoming increasingly important for those affected and for the economy as a whole and leads to new research questions, consulting services and advanced training courses.

• Dissemination of the generated knowledge through publi­ cations and conferences The range of activities of Careum R+D is completed with research projects on questions of patient education, inter-professionalism, paradigm shifts, demography and profitability as well as trail-blazing publications and conferences of national and international significance.

As of 2010, Careum R+D will be established on the Careum Campus in Zurich in order to make use of the proximity to the university hospital and other institutions for our forward-looking projects.

18 Careum, 2009 Annual Report

Careum Working Papers: future prospects

The aim of the Careum Working Papers is to create a sound basis for overcoming future challenges in the health sector. In cooperation with experts, Careum critically questions current concepts used in health education in order to make the right deci­ sions for the future.

The first five Careum Working Papers were launched in the “Research and Development” business segment in 2009. The Working Papers serve the purpose of putting into practice the central idea of Careum of “thinking about the future of health and care”. The question underlying the Working Papers is whether the concepts currently used in health education are suitable for training health professionals to deal with the challenges of the future. On the basis of a clearly defined problem, theses, which are supported by analyses, syntheses, position statements and recommendations, are formulated in cooperation with experts.

The Working Papers should have an impact on both the internal and the external environment. Their primary function is to illustrate points of view and to provide inspiration and arguments for workshops and congresses. Another function is that of providing “workshop reports” which document the latest research and development project results and make them available to interested groups and to the public at large.

This means that, thanks to its analyses, Careum can identify trends at an early stage and thus perform a pioneering function. At the same time, the Working Papers aim at demonstrating approaches and solutions for actual implementation. Overall, they help to sensitise decision-makers in the health and education sector to challenges and future developments.

All Careum Working Papers may be obtained free of charge: in electronic format online at www.careum.ch > Careum Foundation > Publications or as a hard-copy brochure from Careum Publishing at verlag@careum.ch.

The first 5 Careum Working Papers No. 1: “Ageing Workforce in an Ageing Society” How many health professionals will the Swiss health system need by 2030?

Hélène Jaccard-Ruedin, France Weaver (Swiss Health Observatory, Neuchâtel) No. 2: “Where do the best come from?”

Global competition in education. Who trains the competent health professionals of the future?

Eva-Maria Panfil (University of Applied Science St. Gallen), Beat Sottas (Careum) No. 3: “Where do the best go?”

Global competition for healthcare professionals – What role does migration play in their career future?

Gaudenz Silberschmidt (Federal Office of Public Health, Berne), Clémence Merçay (University of Neuchâtel) No. 4: “Global healthcare?”

Perspectives and theses on international competition for patients and the future of medical and wellness tourism.

Stephan Sigrist & Sophie Fenner (W.I.R.E. Think Tanks of Bank Sarasin and of Collegium Helveticum of ETH and the University of Zurich) No. 5: “Who is the fastest?”

Global competition for product and process innovation. What are the success factors?

Bernhard Bührlen (Fraunhofer Institute, Munich)

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Summary of Careum Working Paper 1 – “Ageing Workforce in an Ageing Society” “Shortage of nurses” and “primary care deficits” are among the main concerns, for many studies confirm that there will be a significant shortage of qualified health professionals in the medium and long term. However, in the health sector the workforce cannot be increased in the short term. The training of health professionals is a long-term undertaking – and when demand starts to rise, it takes the best part of ten years before a sufficient number of health professionals is available and the required skills have been consolidated to ensure that the healthcare quality levels are maintained.

The imminent retirement of the baby boomers and the stagnating number of graduates in educational institutions provided the starting point for Working Paper 1. For this reason, Careum has, in cooperation with the Swiss Health Observatory (Obsan), focused its attention on the expected developments between 2020 and 2030.

The results can be summarised as follows: • Currently 190 000 persons work in the three most important healthcare segments: hospitals (60%), retirement and nursing homes (30%), home-based nursing care (Spitex, 10%).

• (Over) ageing of the workforce is a reality: the retirement rate will quickly increase from the present rate of 1% per year to 2% after 2020.

• The number of employees over 55 is comparatively low, i.e. early retirements are more common than hitherto assumed.

• Nursing homes and home-based nursing care are much more strongly affected by the retirements than hospitals. This poses a special challenge, because in these segments, personnel demand will go up enormously due to the ageing population.

• The average time employees remain in their job is currently (too) short; large numbers leave their jobs, although this tendency is difficult to quantify.

• There are no significant productivity gains, because more productive hospitals provide more sophisticated and intensive healthcare; in addition, increased technology requires additional qualified personnel.

• According to Obsan, between 120 000 and 190 000 additional healthcare professionals will be needed by the year 2030.

• Almost 90 percent of these additional healthcare professionals will have to be recruited in the segment of long-term nursing care (homes, home-based nursing care).

In its interpretation of the results, Careum draws the conclusion that the Obsan model extrapolates its predictions primarily on the basis of today’s situation and that therefore its

estimates are probably too conservative. For the following reasons, real demand is likely to be at the top end of the prognosis, i.e. it will amount to 190 000 or more additional healthcare professionals, because: • Early retirement is popular.

• Part-time work to make allowance for family and leisure time is becoming the dominant lifestyle.

• In addition to a complete change to another field of work (drop-out), health professionals frequently have multiple jobs, for example in the wellness segment, in alternative medicine and other industries.

• The medical profession is becoming more feminine in that there is a strong tendency towards more women doctors working part-time.

• In the health sector, demand is increasing at a higher rate than in other industries.

• Healthcare provided by relatives is decreasing.

• Because the number of school leavers will decrease markedly by 2030, there will be a general labour shortage leading to increased competition from other industries in the foreseeable future.

• The restrictive general conditions in the health sector – high pressure on budgets and inflexible salary structures – exacerbate the effects of the ageing workforce.

In conclusion, the ageing workforce, in combination with those dropping out of the health sector, poses a major challenge to the healthcare and education system: • Switzerland will have to train and recruit the same number of healthcare professionals between now and 2030 as are currently working in the three most important segments (hospitals, retirement and nursing homes, home-based nursing care).

• Immigration is not a viable solution, because the shortage of healthcare professionals is a global phenomenon.

• The demand by far exceeds current training capacities.

• The potential within Switzerland by 2030 amounts to approximately 66 000 newly trained health professionals.

• This means that Swiss educational institutions can only cover one third of the demand.

A great effort will have to be made in the area of basic and advanced health training. In addition, the boundaries between professions and institutions must be overcome or redrawn if Switzerland is to provide high-quality healthcare for all inhabitants in 15 to 20 years’ time.

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Promotion and Dissemination Careum promotes and disseminates teaching and learning contents and produces teaching materials

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Careum Publishing teaching materials stand the test of time

Careum Publishing has established itself in the most important health professions with its new teach­ ing materials. The response is extremely positive.

Some users comment on their experiences.

With its teaching and learning aids for vocational colleges and higher-level vocational colleges, Careum Publishing, together with its partners, makes a key contribution to professional education in the health and social sector. Careum Publishing also publishes the Careum Books and in the year 2009 published the Careum Working Papers (more information on pages 18/19).

This year’s annual report does not contain a list of established and new products. Instead, our partners and our customers, i.e. the actual users of the various publications, are given an opportunity to comment on them.

Our success obliges us to constantly create added value through improvements.

Felix Dettwiler Head of Careum Publishing

Experience with the textbook for healthcare specialists (FaGe) in the course for mature students “It is striking that students in the preparatory course understand and follow the texts very well.

Even trainees for whom German is a second language find that this textbook is written in a way that is understandable and suitable for improving their German. The glossary is especially valuable for non-native speakers of German.

In courses designated for mature students, participants are required to work through a substantial amount of material on their own. For this purpose, a clear formulation of the goals and tasks in the individual learning booklets is a great help. This means that, especially in courses for mature students, we are able to tell course participants that the contents of the booklets provide a guideline for the final exam, both in terms of material covered and level required.”

Lecturer teaching courses for mature students

Experience with the textbook for pharmaceutical assistants “It is a real pleasure to work with this textbook. The analytical idea, one of the central demands of the reform, pervades the entire book in my opinion.”

Lecturer for pharmaceutical assistants, Dr. pharm.

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There’s been an accident Caregivers support accident victims in overcoming the experience “This book offers extended knowledge for all caregivers wanting to provide better support to injured and traumatised patients following an accident. Theory is explained through practical examples, and case histories illustrate the various steps of the care-giving process.”

Registered Nurse Höfa II, MScN

“The textbook succeeds in presenting the complex psychological aspects which are crucial in coming to terms with an accident in such a way as to make the processes comprehensible to both nursing professionals and students. Using a number of examples, the book documents how nursing intervention can systematically support and guide accident victims in working through their experience.”

Registered nurse MScN, qualified adult educator

Death and Dying An inter-professional analysis “ ‘Death and Dying’ discusses the problems arising in the immediate surroundings of a person when they make the transition from life to death, as well as all the central issues in the process of letting go of a beloved person. Historical, medical, ethical and psychoanalytical dimensions, as well as issues relating to nursing, law, police and forensic medicine are taken into account and religious aspects are discussed.

The inter-professional contributions compiled here are highly suitable as an introduction to the subject matter and as a basis for discussion for all health professionals who come into contact with the dying and their relatives, and even for those with a general interest in these issues.”

Dr. med. FMH in Forensic Medicine

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Support and Networking

Careum supports, networks and cooperates with other partners

26 Careum, 2009 Annual Report

Harkness/Careum Fellowship Program: research on the health policy of the USA and Switzerland

Swiss healthcare professionals can now apply for a prestigious scholarship to fund their research in the USA. Thanks to the Harkness/Careum Fellow­ ship Program, every year one experienced health­ care professional is able to conduct research in the USA. In 2009, for the first time ever, Careum offered the “Harkness/Careum Fellowship Program” for an experienced professional working in the Swiss healthcare sector. In partnership with the American “Commonwealth Fund”, each year one fellow is given the unique opportunity of spending 12 months in the United States. Benefiting from top conditions, the successful applicant can conduct a research project which must have relevance to either Swiss or American health policies. In addition, he or she will participate, together with 12 to 15 scholarship holders from other industrialised countries, in a series of exclusive seminars on health policies. Long-term experience in other countries shows that Harkness fellows later become decision-makers and hold key positions in which they have a direct influence on the health policies of their countries.

Applications must be received by September, with the assessment of the nominated candidates being made in the following January. For more information, go to: www.commonwealthfund.org/fellowships www.careum.ch The testimonials below illustrate the experiences of two fellows during the one-year programme. The first is an interim report of the first-ever Swiss fellow, Sandrine Motamed, Chief Resident, Division of Primary Care Medicine at the University Hospital of Geneva, and Chief Scientific Resident, Faculty of Medicine at the University of Geneva. The second testimonial is an interview with Mr Jörg Haslbeck, who was the first German health service academic to live in the USA with his family as a Harkness/B.Braun Foundation fellow in 2008/2009. He took up a position in Careum’s “Patient Education” project in January 2010.

Thinking about the future of health and care 27

“I feel honoured to be the first Harkness/Careum fellow in the field of Health Care Policy and Practice. For the first time, the Commonwealth Fund, a leading private foundation working towards building an effective health system in the USA, has accepted a Swiss fellow.

For one year, I will work in Washington D.C., at the George Washington University School of Public Health, Department of Health Policy. When it comes to promoting international relations, this is the ideal place to follow the debates on healthcare reform in the USA. In the field of research, I am exploring the potential impact of community participation in national health policy reform, and I get to meet numerous leaders in health politics and practice.

In the course of the year 2009, the Commonwealth Fund organised several important conferences.

In September, an informative seminar took place in New York on the US health system and current health policy issues, and the International Symposium on Health Policies was held in Washington D.C. in November. The Commonwealth Fund brought together health ministers and leading healthcare experts from Australia, Canada, Germany, France, Holland, New Zealand, Norway, Great Britain, the USA and Switzerland. The occasion provided a unique opportunity to talk informally with decision-makers, including ministers in the health sector. I was especially pleased with the warm welcome given to the Swiss delegation. Thomas Zeltner, Director of the Swiss Federal Office of Public Health and State Secretary led the delegation. I was able to participate in a debate with him in the Capitol on the Swiss health system, which had been organised by our ambassador Urs Ziswiler for ThinkSwiss, an initiative promoting the exchange of knowledge between the USA and Switzerland. The USA is interested, in connection with its healthcare reform, in learning about other systems. It was very interesting to hear the views of Thomas Zeltner and the American experts on issues of public and private healthcare.

Other inspiring conferences will follow. I look forward to sharing my experiences as a Harkness/ Careum fellow in the next annual report.�

Sandrine Motamed, MD, MPH Sandrine.Motamed@unige.ch

Thinking about the future of health and care 29

Looking back on a year as a Harkness fellow Jörg Haslbeck was the first German healthcare academic to live in the USA with his family as a Harkness/B.Braun Foundation fellow in 2008/2009. He took up a position in Careum’s “Patient Education” project in January 2010.

Mr. Haslbeck, what makes a Harkness Fellowship so interesting?

From a European viewpoint, the Harkness programme is especially attractive because – not least from a family perspective – it offers excellent conditions for investigating a relevant topic in the USA. In addition, you get to meet outstanding experts, since the Commonwealth Fund has an excellent professional network and thus makes possible great contacts. This broadens one’s views on certain issues.

Where in the USA did you spend your research year?

I was a postdoctoral fellow at Yale University School of Nursing in New Haven, Connecticut, where I worked with Ruth McCorkle. My co-mentor was Penny Hollander Feldman from the Visiting Nurse Service of New York. This combination of nursing science and health policy expertise provided the perfect perspective from which to explore my own subject.

What was the subject of your research at Yale University?

I looked into the issue of “Self-management support for chronic illness”, focusing on the situation of vulnerable groups, using elderly people living on their own as an example. Apart from a systematic study of the relevant literature, I interviewed experts working in the health and social sector in the USA on the subject.

What were the key experiences for you during your stay?

We met extremely helpful and open-minded people, both in our private and professional everyday life. We were very impressed with the extent to which personal and professional commitment is appreciated. My wife and children were also privileged to experience this appreciation in their (school) careers, and they, too, greatly benefited from my Harkness Fellowship. And of course the election and inauguration of Barack Obama as President of the USA was a unique event.

To what extent did the Harkness Fellowship influence your professional career? What skills did you acquire in the course of your Fellowship?

The year was definitely a career booster for me! It was through my research scholarship that I was able to establish contact with Careum and, shortly after my return from the US, I received an offer to work for the foundation in the area of “patient education”. In addition, my time at Yale University allowed me to further extend my skills in terms of conducting systematic research into scientific literature. Regular exchanges with US scientists further helped me to gain a better understanding of the North American scientific culture and offered me insights into the communication patterns there. Back in Europe, this may well be an advantage in networking with international experts.

Dr. Jörg Haslbeck Careum Patient Education

30 Careum, 2009 Annual Report

Careum Congress 2009: Moving boundaries: global healthcare – national challenges

Concrete approaches to national health systems in the globalised health community: this topic was discussed by 120 opinion leaders and health experts from all over the world at the Careum Congress 2009. International quality comparisons clearly show deficits, and Switzerland is no exception here.

The globally connected health community The health community is increasingly characterised by its global connections. The opportunities and forces that this entails demand that the traditional boundaries between disciplines, professions, institutions and countries are transcended. The boundaries between the range of medical services and citizens, market and regulation, doctor and patient, and between service provider and consumer must be redefined as well. At the Careum Congress 2009, 120 opinion leaders and high-ranking experts from Switzerland and abroad discussed the significance of these developments for the various national health systems. Lectures, panels, discussions, model descriptions and workshops enabled an intensive exchange of ideas. The congress took place in the Radisson Blu Hotel at Zurich Airport from 12 to 13 November. It was entitled “Moving boundaries: global healthcare – national challenges”.

Health politics panel With his keynote lecture, Thomas Zeltner, Director of the Swiss Federal Office of Public Health, set the scene for the discussion on the opportunities and and challenges faced by national politics as a result of the global market. This lecture was followed by a top-notch panel discussion giving insights into the specific issues facing a region (Christoph Koellreuter, Director of Metrobasel, Switzerland), the European medical profession (Daniel Mart, former President of the Standing Committee of European Doctors, Luxembourg), the economy (Markus R. Neuhaus, CEO of PricewaterhouseCoopers Switzerland and a member of the Global Leadership Team of PWC, Switzerland) and science (Magda Rosenmöller, IESE Business School Barcelona, Spain).

In particular, the discussion emphasised the imminent shortage and increasing mobility of healthcare professionals. European countries are not ready to deal with this challenge.

Healthcare Reform in the USA Up-to-date presentations gave participants at the Careum Congress the opportunity to hear two different views on the healthcare reform in the USA: Robyn Osborn, Vice President and Director of the International Program in Health Policy and Practice, Commonwealth Fund, USA, and Rich Bagger, Worldwide Public Affairs and Policy of Pfizer Inc., USA, shared their prognoses and assessments with their audience. Participants thus gained fascinating insights into one of the most important debates on health politics today.

Comparative studies On the basis of international comparative studies – conducted by the Commonwealth Fund, P W C, McKinsey and Health Consumer Powerhouse – the congress also illustrated just how similar the challenges facing healthcare systems in all countries actually are and the extent to which international trends influence decisions at national level. The studies presented all the suggested similar solutions: health systems need more transparency, access to the services provided by the public health service must be based on new patient-oriented medical care models and prevention must be promoted. Switzerland has a great deal of catching-up to do in all three areas!

Comparisons of quality Johan Hjertqvist, Director of the Health Consumer Powerhouse, presented the evaluation of the Euro Health Consumer Index 2009. This index compares the quality of the health systems from the viewpoint of consumers. Switzerland was ranked fifth behind Holland, Denmark, Iceland and Austria. If, however, the costs are taken into account as well, Switzerland only comes out 13th. “Just because we pay more doesn’t necessarily mean we get a better service as a result”, Hjertqvist said.

Thinking about the future of health and care 31

Intensive workshops The four workshops of the congress probed the issue of global competition in the health sector. Competition in the training programmes for health professionals, professional migration in the health sector, the opportunities provided by medical and wellness tourism, as well as global competition for product and process innovation, were among the issues explored. For each of these areas, Careum Working Papers were prepared.

One guest provided an insight into concrete implementations which prompted a stimulating discussion.

New healthcare models: retail clinics The Careum Congress even featured the presentation of solution approaches hitherto unheard of in Switzerland. For example, Marcus Thygeson from Consumer Health Solutions reported on so-called retail clinics in the USA: at as many as 1,200 locations in supermarkets, shopping malls and large pharmacies, patients can now get low-priced medical treatment without the need for an appointment. “Studies in the USA show that the quality of these medical care centres is as good as that of the average GP – but cheaper”, Thygeson said.

Patients as a power factor The congress also looked into the new role of patients and policyholders. The presentation of concrete examples and a panel discussion with international speakers clearly showed that patients will play a decisive role in the health systems of the future. They will demand transparency, increasingly base their decisions on the quality of the services offered and become active participants in the healthcare process. This development not only necessitates new healthcare models which integrate patients but also novel approaches to imparting healthcare-related skills. Former German Health Minister Andrea Fischer made clear just how important a sound legal foundation is for patient input in the health sector. These issues will be further discussed and developed in the Careum Congress 2010 “The power of patients – patient’s role in shaping the healthcare system of the future”.

Careum Congress – Thinking about the future of health and care The Careum Congress offers an annual platform for the exchange of knowledge and experience to all those who would like to consider and help shape the future of the health system. Worldwide, health systems are undergoing changes. The implications of international trends call for innovative solutions for national healthcare systems. The Careum Congress aims to provide decision-makers with an opportunity to discuss and develop such innovative solutions.

For more information, go to www.careum-congress.ch.

32 Careum, 2009 Annual Report

Careum Forum 2010: No appreciation without a positive self-image

Do good things and talk about them: health pro­ fessionals should become ambassadors for their own cause. This is one of the conclusions drawn by the Careum Forum 2010. For the profession’s often negative self­image damages the reputation of the health sector in general and makes it even more difficult to recruit young people to the health profession.

The Careum Forum 2010 held on 4 February was entitled “Health Professions = Future Professions – How are they positioned within society?” It took as a basis the negative press and alarming prognoses about the future shortage of qualified personnel in the health sector. The core subject was the conflicting portrayal and perception of health professionals. One of the goals was to avoid merely complaining about the rising standards and pressures and instead to talk about the opportunities which arise from foreseeable developments. In addition, the question was raised as to where the various health professions could improve the underlying conditions.

The speakers covered a wide spectrum of analyses from concrete promotional measures to societal perception and appreciation.

In the introduction entitled “If only it weren’t for the underlying conditions…”, Dr. Beat Sottas, a member of the Board of Trustees and of the Management Committee of Careum, illustrated the contradictions as well as the great potential on the basis of the conclusions drawn in the Careum Working Paper “Ageing Workforce in an Ageing Society” (also see page 19).

Using press comments and advertising campaigns to illustrate his points, Peter Marbet, Director of the Berne Education Centre for Nursing Care (Berner Bildungszentrums Pflege), showed in his lecture “Doing good things – saying bad things about them?” what effect the self-critical attitude of the nursing care profession has on the public. One striking aspect was the great extent to which the industry is struggling with innovative professional marketing, because health professionals see this as a violation of political correctness.

Under the title “Recognition is a plant that predominantly grows on graves”, Beatrice Kutter, Head of Competence Assessment for the Professional Qualification of Mature Students in the Canton of Zurich (Kompetenzenbilanz für die berufliche Nachqualifikation) described the ambivalent feelings of (unskilled) persons who work at the bottom end of the qualification ladder: while talking about their work with enthusiasm, they have a negative image of their employer, for example because employees get no support or because routine procedures which have been carried out for years are suddenly banned. Beatrice Kutter showed how recognition can enhance employee self-esteem and commitment, and that it tends to extend the average duration of employment.

Heidi Berger, Managing Director of OdA-Gesundheit Zurich, asked the difficult question whether “health professions can be communicated”. Taking the results of the international “Nurses’ Early Exit Study” (NEXT) as her starting point, she explained the measures that were taken in her organisation to direct messages specifically at young people. The discussion of the different motivation factors of healthcare specialists (FaGe) and experts from vocational colleges (Fachpersonen HF) was especially revealing.

With an inspiring keynote lecture entitled “We need all talents! What does it take?” Dr. Christian Schär, President of the Association of Educational Institutions in the Health and Social Sector (Verband Bildungszentren Gesundheit und Soziales, BGS), launched the panel discussion on the subject “Making the professions of the future fit for the future!”

The panel of speakers was – as in previous Careum forums – skilfully moderated by radio journalist Cornelia Kazis, who made sure that the various statements were placed in a context and in relation to each other. A special dimension was added to the discussion by students Sabina Schönbächler and Daniela Vollenwyder. They demonstrated in a refreshing way what it is they don’t like about a discussion that tends to emphasise negative aspects and how they deal with it. To wrap things up, Cornelia Kazis introduced the conclusion with an aphorism by writer and philosopher Lichtenberg “I don’t know if things become

Thinking about the future of health and care 33

better when they change, but they must change to become better.”

The results of the Careum Forum 2010 can be summed up in the following statements: • Repeatedly mentioning problems results in a catch22 situation which does not improve the conditions in the health sector but rather leads to self-disqualification.

• The underlying conditions are in fact being dealt with actively by means of an open educational system, planning instruments, new incentives, parttime work and better remuneration systems.

Whether these measures are generally implemented and whether they are sufficient to ensure that personnel levels are maintained is being critically assessed.

• The high prestige and high demands of health professionals contrast with their conservative selfimage. It is also a management task to make this self-image more dynamic and to correct it where appropriate, so that the health sector appeals to young people and they don’t opt for other industries which are perceived as more modern.

• Much more important than making a neat distinction between various profiles and health qualifications is the recognition and appreciation of the people working in the health sector by their superiors.

Recognition is “nourishment”!

• In this context the debate, taken up again of late, on the status of experts is extremely counterproductive. For it is precisely when comparing the health sector with other industries that health professionals ruin their image themselves: well-trained and highly motivated young professionals are called “novices” and treated as such for years by their older colleagues.

Modern concepts and competencies aim at counteracting such a condescending attitude. As part of these modern concepts, the knowledge acquired and the transfer from theory to practice are seen as accomplishments, and the young health professionals are respected for what they do. By the time they join the workforce, they have acquired expertise in nursing, physiotherapy, medical radiology and so

forth – after all, it is for this and because of this that they have received a qualification authorising them to work as health professionals!

• The public’s perception and esteem of the health profession will improve again only if health professionals once more become advocates for their own cause: they must begin to believe in themselves again and make a point of communicating in a positive way their undisputedly important contribution to high-quality healthcare, illustrating it with success stories.

Thinking about the future of health and care 35

Careum – What’s behind it?

36 Careum, 2009 Annual Report

Careum – What’s behind it?

Careum was founded 127 years ago as the “Nursing School and Hospital Foundation of the Red Cross Zurich­Fluntern” (Stiftung Schwesternschule und Krankenhaus vom Roten Kreuz Zürich­Fluntern) and can look back on a rich and varied history. The current motto of “Thinking about the future of health and care” has been the guiding principle of the foundation since its inception.

Origins shaped by pioneers The founders of this institution felt an affinity with the progress of the bourgeoisie of their times: the establishment of the Swiss Confederation in 1848, freedom of thought and speech, modern science and a type of humanism reflecting the intellectual currents of the period. All these are values to which Careum has remained faithful to the present day. It was out of this mindset that the nursing school emerged allowing young women, for the first time in Swiss history, to become nurses independent of religious institutions.

For many years, the foundation was predominantly seen, both in Zurich and its surrounding areas, as the successful operator of the private Red Cross Hospital at the Gates of the University Hospital of Zurich, in which entire generations of locals drew their first breath. In contrast, the modern school for training nursing staff led a rather shadowy existence.

Careum is called into life Therefore, the decision taken in 1997 to close the Red Cross Hospital and to reorganise the foundation had a fundamental impact on future developments.

In the following 10-year transition phase, the Board of Trustees reverted to its original objective of “promoting education in the health sector through innovation and development” and resolved to concentrate on the pressing issues in basic and advanced training in the health industry. This decision was given concrete shape with the construction of a multi-use building complex on the foundation’s own land: the Careum Campus. The Careum Campus has since attracted a number of different health and education institutions, thereby boosting the exchange of information and ideas on the campus even more. As of

2004, the activities of the foundation were reflected in its new name “Careum” an amalgamation of the words “care” and “lyceum”.

The first great success came at the beginning of 2005 following the education mandate from the Canton of Zurich to the Careum bidding consortium to set up and operate the Careum Training Centre for Health Professions (Careum Bildungszentrum für Gesundheitsberufe, CBZ). As is still the case today, the bidding consortium at the time consisted of Careum, Eleonorenstiftung – Children’s Hospital Zurich, Stiftung Diakoniewerk Neumünster – Swiss School of Nursing, and Kalaidos Bildungsgruppe Schweiz. Today, only five years later, the education centre is the largest of its kind in Switzerland.

Since then, Careum has developed a curriculum based on the methodological and didactic principles of “problem-based learning” to modernise the contents of training in the health professions, which has now become the standard for training programmes in the health sector. The foundation’s own textbook publishing house (Careum Publishing) succeeded straight away in its countrywide launch of standardised textbooks for use in training programmes for healthcare specialists (FaGe) – an unprecedented move.

Partnerships define Careum The construction of Careum Campus gave rise to close cooperation – both in terms of knowledge contents and physical proximity – with the Medical Faculty of the University of Zurich. Operated by the University of Zurich, the Careum Library of Medicine, which is the product of a merger between the libraries of the Faculty of Medicine, the University Hospital and the Careum Training Centre, is now the hub of the Careum Campus.

Careum and the Dean’s Office of the Faculty of Medicine are absolutely convinced that inter-professional teaching and learning are a vital precondition for fruitful cooperation in the future. Inter-professionalism in the way it developed on the Careum Campus will determine the future of education in the health sector.

In a number of projects, Careum enters into partnerships with both national and international institutions, in order to reinforce the effects of its efforts.

Thinking about the future of health and care 37

Thinking about the future of health and care Today, the health sector is in a historically unprecedented phase of change and is faced with enormous challenges. Increasingly, the health community is globally linked, meaning that the traditional boundaries between disciplines, professions, institutions and countries are being redrawn. Similarly, the relationship between the range of medical services and citizens, market and regulation, doctor and patient and between service provider and consumer is being redefined.

New approaches and models for strategies in the health sector must take into account all the challenges arising in the areas of basic and advanced vocational train-

ing, market systems, socio-economic developments and new technologies and research, if they are to make a relevant contribution to the health systems of the future.

In the future, Careum will continue to demonstrate how these trends can be converted into concrete education policy projects. The aim is to provide relevant inspiration and to develop solution approaches as to how the future healthcare world, and particularly education in the health sector, can be dealt with and how an active contribution can be made to help shape these areas.

Careum prepares for the future Training in the health sector Careum provides education, training and advice for teachers and students as well as partners in the education system Careum conducts research and develops teaching and learning materials as well as pedagogical concepts for healthcare education

Education and Training

Support and Networking

Research and Development

Promotion and Dissemination

In spring 2009, the Board of Trustees passed the “Strategy of the Careum Foundation”, thereby defining the general direction of Careum’s development for the next five years. As part of this strategy, four business segments were defined, and the strategic goals that will guide Careum’s activities over the next few years were laid down. These include advanced vocational training, making stronger efforts to involve

Careum promotes and disseminates teaching and learning contents and produces teaching materials Careum supports, networks and cooperates with other partners

patients in their recovery process, intensification of research and development, and further networking.

Thanks to its intellectual, organisational and financial independence, Careum is able to assess and support projects and ideas, irrespective of their origin.

Careum sees this unique position as an opportunity and an obligation in the implementation of its objective.

38 Careum, 2009 Annual Report

Careum Congress 2009

Thinking about the future of health and care 39

Careum Forum 2010

40 Careum Jahresbericht 2009

Stiftungsrat und Ausschüsse Stand: April 2010

Gut Hans, Präsident, SR, LA Dipl. Ing. ETH, MS Herrliberg ZH (SR seit 1999)

Birchler Urs, SR, EA Dr. oec. publ.

Direktionspräsident Inselspital Bern Bolligen BE (SR seit 2003)

Bliggenstorfer Andreas, SR Pfarrer, Präsident Stifter-Verein Dietlikon ZH (SR seit 1993)

Brühwiler Barbara, SR Direktorin Pflege und HRM USZ, Zürich Zürich (SR seit 2001)

Burkolter Max, SR Dr. theol.

Pfarrer Wald ZH (SR seit 1999)

Kickbusch Ilona, SR, LA Prof. Dr. Dr. h. c.

Director Global Health Programme, The Graduate Institute, Genf Brienz BE (SR seit 2008)

Kühne René, SR, LA Dr. oec. publ.

Hurden SZ (SR seit 2002)

Lauper Bernhard, SR, AA Mitinhaber der Bauund Immobilienberatung Immopro AG, Zürich Feldmeilen ZH (SR seit 2008)

Satrapa-Schill Almut, SR Dr. phil.

Bereichsleiterin Gesundheit und Humanitäre Hilfe der Robert Bosch Stiftung, D-Stuttgart D-Grafenau (SR seit 2008)

Sottas Beat, SR, LA Dr. phil.

Berater Bildungs- und Gesundheitspolitik, formative works Bourguillon FR (SR seit 2008)

Thinking about the future of health and care 41

Buschor Ernst, BoT, AC Prof. Dr. oec.

Former Government Councillor Dübendorf ZH (Trustee since 2003)

De Geest Sabina, BoT Prof. Dr. Managing Director of Institute for Nursing Science, University of Basel Basel BS (Trustee since 2006)

Weibel Peter, BoT, AC Dr. oec. publ.

Member of Board of Directors of Credit Suisse Group, Zurich Zurich ZH (Trustee since 2008)

Zünd Gregor B., BoT MD, Professor of Surgery Director Research and Education, Managing Director ZKF, University Hospital Zurich Zurich ZH (Trustee since 2009)

Furler Lukas, BoT Vice Director and Head of Nursing of Waid City Hospital, Zurich Münchenstein BL (Trustee since 2001)

Gutzwiller Felix, BoT, CC Prof. Dr. med.

Director of Institute for Social and Preventive Medicine, University of Zurich Councillor of State for Canton of Zurich Zurich ZH (Trustee since 2000)

Holenstein Hildegard, BoT Dr. phil.

Berne BE (Trustee since 2001)

AC – Audit Committee BoT – Board of Trustees CC – Compensation Committee MC – Management Committee

42 Careum, 2009 Annual Report

Organisational chart As at April 2010

Board of Trustees Hans Gut, Chairman Urs Birchler Andreas Bliggenstorfer Barbara Brühwiler Max Burkolter Ernst Buschor Sabina De Geest Lukas Furler Felix Gutzwiller

Hildegard Holenstein Ilona Kickbusch René Kühne Bernhard Lauper Almut Satrapa-Schill Beat Sottas Peter Weibel Gregor B. Zünd

Audit Committee

Management Committee

Compensation Committee

Peter Weibel Ernst Buschor Bernhard Lauper

Hans Gut, Chairman Ilona Kickbusch René Kühne Beat Sottas

Urs Birchler Felix Gutzwiller

Careum Patient Education

Careum R+D

Careum Publishing

Jörg Haslbeck

Monika Schäfer

Felix Dettwiler

Projects

Administration Daniel Achermann

Careum AG Training Centre for Health Professions*1

Back Office Paula Büeler

Representatives on the Board: Hans Gut, Chairman Barbara Brühwiler René Kühne

Marketing/PR WE’G Hochschule Gesundheit* 2

Evelyn Willemin

Representatives on the Board: René Kühne Beat Sottas

Education and Training

Annotations: *1: Majority participation *2: Minority participation

Research and Developement

Promotion and Dissemination

Support and Networking

Administration

Thinking about the future of health and care 43

Publishing details Published by: Careum, Content/project management: Careum, Design: BieriDesign Zurich, Pictures: Julia Bruderer, English version: Apostroph AG Lucerne, Printed by: Z체richsee Druckereien AG, St채fa

Careum Pestalozzistrasse 3 CH-8032 Zurich Phone + 41 43 222 50 00 Fax + 41 43 222 50 05 info@careum.ch www.careum.ch

Education is given a clearer structure and made more efficient Education must focus more on the increasingly complex relationships between patients and professionals Working in a team and across professional boundaries is set to become even more important Knowledge needs to be constantly updated Looking ahead to the healthcare world of the future