Since its creation, our Department has enjoyed significant quantitative and qualitative growth in the areas of patient care, teaching and research. Cancer is an increasingly common illness; we offer high-quality care linked to clinical and translational research, applying the knowledge of basic research to the prevention and treatment of clinical cases. This means we can see patients from outside our catchment area who can participate in clinical trials. We are a reference centre in all areas of clinical oncology.

These diseases are complex to diagnose and treat, making a multidisciplinary approach essential. That is why our Department works to incorporate a range of professional techniques and contributions to tackle all aspects of care and integrate them into the care process. This means we can improve the care process and ensure quality. Examples of this are our genetic counselling and high-risk illness prevention clinics.

In accordance with the analysis and forecasts included in the latest version of the Catalan Health Plan and the Oncology Master Plan, we must bring forward priority actions in the field of oncological disease in Catalonia. Vall d'Hebron University Hospital is especially equipped to offer a comprehensive Oncology Care Plan, with different services all working in coordination. This is possible thanks to our specialised departments such as Medical Oncology, Radiation Oncology, Clinical Haematology, surgical specialties, medical specialties, Pathological Anatomy, Image Diagnostics and Primary Care. Our professional expertise and ability to work in collaboration are the key to fulfilling this mission.

This is why care for people suffering from oncology is structured into processes in place for all operations, with appropriate timing based on a holistic vision of the care process. At our Department, we incorporate everything these patients need in terms of prevention, diagnosis, treatment and follow-up.

We base this oncological care on three central pillars: our staff, equipment and clinical research. On the one hand, we guarantee the excellence of our staff through internal training programmes in the field of hospital care, as well as establishing collaboration and training exchanges with other renowned, prestigious centres. On the other hand, we offer the latest equipment and carry out clinical, translational and basic research.

We are working to incorporate primary care into the network of oncology treatment at the Hospital, as we believe holistic care in oncology requires incorporation and coordination of all the different healthcare areas involved in treating patients.

As mentioned previously, research is one of the key pillars of our Department, and we are present at the most prestigious international forums where future research and oncological care are discussed. We participate in Cancer Core Europe, the largest cancer platform in Europe, where our Department is one of just seven European departments present.

We have a biomedical research centre made up of scientists and doctors who work together to link basic science with clinical research: the Vall d'Hebron Institute of Oncology (VHIO). Our main purpose is to promote and develop excellence in research into oncological diseases.

The VHIO also works to increase our contribution to the development of new therapies that improve the treatment of cancer. Its goals also include modelling scientific practices in the clinic for the benefit of oncology patients, excellence in scientific research in the fields of basic, translational and clinical research, and scientific cooperation between national and international cancer research institutions. By promoting all activities related to cancer research, we contribute to improving the quality of life of our patients.

Our Department has a long tradition of applying diagnostic techniques in the various fields of neurophysiology, and we provide services to patients from a large number of medical and surgical specialties, such as neurology, neurosurgery, traumatology, rehabilitation, pneumology, paediatrics, internal medicine, ENT, intensive care medicine, ophthalmology, urology and family medicine, etc.

The incorporation of new diagnostic techniques, ever greater complexity and advances in the area of knowledge have all furthered the Department’s specialisation in a range of areas of knowledge:

• Electroencephalography, to measure the electrical activity of the brain
• Electromyography, to verify the health of the muscles and nerves that control them
• Evoked potentials, a diagnostic technique that is used to explore the nerve pathways that bring information from the sensory organs to the brain
• Sleep Unit 

The main objectives of this Department are:

• Support in diagnosing diseases of the nervous system, in which we offer the patient and the requesting doctor maximum guarantees and expertise in carrying out diagnostic techniques.
• We ensure there will be no functional damage to the nervous system pathways in risky procedures, such as surgery (neurosurgery, spinal column and peripheral nerve).
• We help further knowledge of the physiopathology of nervous system diseases in order to be able to transfer this knowledge to the clinical field.
• We also participate in passing on knowledge by training professionals.

At the Neurosurgery Department, we apply the most advanced technologies and a multidisciplinary approach in a context that allows us to train neurosurgeons with strong ethical and moral values. All this, as part of the public health system that is accessible to all citizens.

Our Department is divided into three physically separate care sections located in three areas of the Vall d'Hebron hospital complex: the General Hospital, the Traumatology, Rehabilitation and Burns Hospital and the Maternity and Children's Hospital. Finally, the Neurotraumatology and Neurosurgery Research Unit, which integrates all of the Department’s translational research, complements these three care sections, applying the knowledge garnered from basic research to the prevention and treatment of clinical cases.

The General Hospital is home to most of the Neurosurgery Department’s activity, housing most of its human resources, patients, beds and financial resources. The team is made up of a chief clinician, seven specialist doctors and a Head of Department. Three of the doctors share their activities with the Maternity and Children's Hospital, and form the main group of physicians devoted to paediatric neurosurgery. The other doctors also collaborate on neuropaediatric care, both with emergency care and low-prevalence pathologies, in which our Department is super-specialized. Adult patients are admitted here who have had cranioencephalic trauma and a programmed pathology of the rachis (spine).

Portfolio of services 

The care offered by the Neurosurgery Department covers three fundamental aspects: general neurosurgery (adult patients), neurotraumatology and paediatric neurosurgery. Despite this differentiation, we are a cross-cutting department that addresses the following diseases:

General neurosurgery in adult and paediatric patients

• Neurooncology
• Haemorrhagic neurovascular pathology (cerebral aneurysms, arteriovenous malformations, hard fistulas)
• Ischemic neurovascular pathology (decompressing surgery in malignant infarction of the middle cerebral artery, cerebral revascularisation)
• Hydrocephaly and complex pathology of the dynamic of the cerebrospinal fluid that surrounds the brain and the spinal cord
• Malformations in the craniocervical hinge
• Surgery of the base of the skull
• Evacuation of abscesses and treatment of infectious pathologies of the central nervous system
• Neuroendoscopy
• Radiosurgery
• Spasticity not responsive to pharmacological treatment
• Acute and degenerative spinal pathologies
• Repair of congenital malformations of the nervous system

Neurotraumatology in adult and paediatric patients

• Acute surgery of cranioencephalic trauma
• Multimodal neuromonitoring in severe cranioencephalic trauma
• Surgical repair of cranial fistulae of cerebrospinal fluid
• Surgery to repair cranial vault injuries (cranioplasty)

Teaching

The educational mission of any neurosurgery department at a high-tech hospital does not end with the training of undergraduate students and specialised training, but rather we are devoted to continuing training of all doctors with links to neurosurgery.

Our Department organises several clinical sessions, as well as annual doctoral courses and different continuing education programmes aimed not only at residents and neurosurgeons in the Department, but also specialists in intensive care, anaesthesia and, in some cases, nursing staff. On the other hand, most of our sessions offer a considerable number of continuing education credits.

The training programme for residents at the Neurosurgery Department includes a general educational programme, a rotation scheme, a plan detailing the objectives and surgical skills that must be acquired, the obligation to comply with the "Resident’s Logbook" and an appropriate evaluation system.

One essential aspect that is often overlooked is the importance of the role of nursing staff in neurosurgical care. We are keenly aware of this, and for years now the neurosurgery nursing staff at the General Hospital and the Neurotraumatology ICU have been integrated in the educational activities of the Department. Also, a symposium specific to nursing is included in the International Symposium on the Monitoring of Intracranial Pressure and Cerebral Haemodynamics that is celebrated biannually. The management of this event, as well as the contents and speakers chosen, falls to the nursing staff, who have total autonomy in organising their Symposium.

At the Nephrology Department we have a highly qualified team that is well coordinated with other Hospital and primary care services to offer a comprehensive approach to patients with kidney disease, ranging from prevention and early detection to treatment of the disease.   

We admit 1,000 patients annually, hold 15,000 consultations and have a peritoneal dialysis programme, a haemodialysis unit, extracorporeal cleansing techniques, and in addition over the last year we carried out 130 kidney transplants.

We are a Reference Centre of the Spanish National Health System (CSUR) in complex glomerular diseases.

Research 

Our research is based on patient follow-up and the study of mechanisms and markers of the prognosis for different kidney diseases as reflected in various publications. The Department participates actively in international clinical trials.

Teaching

This includes the teaching of undergraduates and postgraduates, training nephrology students and continuing education.

The Internal Medicine Department is the cornerstone of medical care at Vall d'Hebron University Hospital. It is key in providing support to the other medical and surgical departments and the Accident and Emergency Department.

Systemic autoimmune diseases are the main specialty of the Department. We have more than 30 years’ experience in these illnesses and are a leading centre in both Catalonia and Spain as a whole. In terms of care, teaching and research our professionals are leaders in diseases such as systemic lupus erythematosus, scleroderma, dermatopolimyositis, systemic vasculitis, Sjögren's syndrome and Behçet's disease. We have a multidisciplinary team of professionals offering expert, personalised care for patients with these diseases, both in diagnosis and in treatment and subsequent follow-up at the Outpatient Clinic. We also offer support to the Obstetrics Department in the management of pregnancy for women with these diseases and with primary antiphospholipid syndrome.

The Vascular Risk Unit is a leading point of reference in the diagnosis and treatment of dyslipidemia and arteriosclerosis and their complications, and collaborates with all the other hospital departments involved in the management of these patients.

The Ageing and Chronic Patient Section is made up of the Geriatrics Unit of the General Hospital and the Orthopaedics Unit of the Hospital of Traumatology. This Section, in collaboration with the Primary Care Section, has recently inaugurated a new centre for chronic care (Chronicity Integral Support Team, or ESIC) that is located in the Casernes building in Sant Andreu, whose mission it is to bring the hospital expertise closer to the patients, thus avoiding unnecessary hospital trips and hospitalisation. This pioneering section is but the start of a whole network of such centres in the city of Barcelona and surrounding areas.

The Ageing Division coordinates and collaborates with centres for subacute patients and social-health centres in our region, in particular with the Pere Virgili Health Park.

The ultimate goal of our entire organisation is to ensure that the patient is at the heart of every action taken, to ensure continued care both in Primary Care and in our Hospital, as well as after the patient has been discharged.

Research

The Departmental Research Unit, which is part of the Vall d'Hebron Research Institute (VHIR), brings together basic research projects in immunology, systemic autoimmune diseases and ageing from the various Departmental teams, and participates in national and international clinical trials, and projects with public and private funding.

Teaching

In terms of teaching, it is the mission of the Internal Medicine Department to help train doctors at the Vall d'Hebron Teaching Unit of the Autonomous University of Barcelona, to train residents in internal medicine and geriatrics and to train Postgraduate and continuing education students in systemic autoimmune diseases and in clinical gerontology.

Research

Teaching

Research

Teaching

Research

At the Infectious Diseases Department, our care is structured into the following areas: hospitalisation, outpatient care, nosocomial infection control (infections contracted during a hospital stay), prevention and treatment of infection in HIV- immunodepressed patients (with solid or haematological neoplasia, bone marrow transplant or solid organ); international health and imported infections, and the HIV+ patients ward.

Our Department handles approximately 10,000 outpatient visits a year. There is also a day hospital where all types of prolonged antimicrobial treatments can be carried out, as well as a large number of diagnostic tests, in order to reduce hospital admissions.

In the hospitalisation division, between 550 and 600 patients are admitted a year, with an average hospital stay of about nine days. We admit immunodepressed patients with serious infections or requiring clinical isolation, as well as patients with serious infections that can be helped by our specialised care.

The priorities of the nosocomial infection control division are to identify and reduce the risk of transmission of especially complex infections and to ensure effective treatment. This latter aspect is key across all of the Department’s areas of care. Antimicrobial treatments are complex and one of the main responsibilities of the group is to ensure that they are administered as accurately as possible. To this end we are careful to constantly carry out a cost-benefit assessment.

Monitoring of infection in immunodepressed patients, both for HIV and others, is handled by two wards that treat patients with especially complex, serious infections, bearing in mind the type of infection and number of patients being treated at the Hospital. We aim to provide comprehensive care, handling prevention, diagnosis and treatment of infectious pathologies, especially opportunistic infections, that this type of patients suffer. One example is the Anal Dysplasia Unit in the HIV+ population, inaugurated in 2009 for the prevention, diagnosis and early treatment of anal cancer secondary to chronic infection by the human papilloma virus.

The international health and imported infections division, which works in coordination with the Tropical and Imported Diseases Unit of the Drassanes primary care centre and various local NGOs, is dedicated to providing overall care for patients affected by these infections. Thanks to telemedicine, we make regular contact with the regional Nossa Senhora da Paz Hospital in Cubal (Angola) to carry out joint sessions.

The Infectious Diseases Department was created in 1996 and consists of 14 doctors on staff, with resident doctors, predoctoral and postdoctoral doctors carrying out research and other key healthcare professionals all a part of its structure. The main characteristic of the Department, therefore, is our transversality. We firmly believe in the importance of having members of the Department collaborate with the different medical and surgical teams of the Hospital, both in terms of healthcare and research.

Portfolio of services

The portfolio of services offered by the Infectious Diseases Department responds to the health needs of the population and the demand for services generated at Vall d'Hebron University Hospital, guaranteeing accessibility, equity and quality of care, in a way that satisfies the expectations of the clients following the strategic lines of the Catalan Health Institute.

Open hospitalisation ward in infectious diseases

These wards are used to treat patients with systemic infections acquired in the community, including:

• Sepsis and primary bacteraemia

• Zoonoses with organic complications

• Parasitosis requiring hospital admission

• Febrile syndromes of unknown origin with severe systemic repercussions

• Organospecific infections requiring hospital admission due to systemic or organic repercussions

• Human immunodeficiency virus infection and infections secondary to other primary or secondary immunodeficiencies, for the diagnosis and treatment of opportunistic infections.

Day hospital

This area cares for patients with infections acquired in the community, offering treatment with acute clinical symptoms.

• Systemic infections
• Organospecific infections requiring hospital admission due to systemic or organic repercussions
• Organospecific infections with pre-admission and early discharge due to having completed treatment and under supervision of the acute incident away from the hospital, such as with infectious endocarditis or abscesses once removed.
• Human immunodeficiency virus infection and infections secondary to other primary or secondary immunodeficiencies, for the diagnosis, treatment and prophylaxis of opportunistic infections.
• Specific nursing consultation for patients infected with HIV. Follow-up programme for adherence to antiretroviral treatment, counselling, sexual counselling for serodiscordant couples and follow-up programme for seropositive pregnant women.

Outpatient Clinic for Infectious Diseases

This area covers:

• Patients with systemic or organospecific infections, previously treated in the hospitalisation ward for infectious diseases or in other Hospital departments, the day hospital or in a primary care centre, referrals to outpatient clinic for diagnosis, control and monitoring until discharge.
• Patients sent for initial study due to fever of unknown origin, without general effect.
• Patients with human immunodeficiency virus infection, for initial evaluation, diagnosis, treatment of HIV infection, prophylaxis of opportunistic infections and follow-up.
• HCV co-infection in patients with HIV infection.
• Patients with recurrent infections suspected to be secondary to other primary or secondary immunodeficiencies.

Prevention, diagnosis and early treatment of dysplasia and rectal and anal cancer in the HIV-positive population

This is a specific clinic included in the Pere Virgili Health Park, integrated into the policy for treatment of the HIV positive population.

Hospital combined clinics for infectious diseases

This area handles patients with any type of systemic or organospecific infection, nosocomial or acquired in the community, whichever part of the body is affected and in immunocompetent or immunodepressed hosts, whatever the cause. It includes the differential diagnosis of community and nosocomial febrile syndrome.

Nosocomial infection

Includes the following activities:

• Treatment of nosocomial infections, with special emphasis on those caused by multiresistant and especially aggressive microorganisms (for example, fungal infections), or in those that affect groups of patients in serious condition (for example, ICU, burns, transplants or oncohaematological).
• Clinical participation in surveillance and control programmes for nosocomial infections.
• Participation in activities carried out by the Infections Committee and the Antibiotics Subcommittee.
• Surveillance and control are carried out as part of the objectives defined by the Infections and Antibiotherapy Committee. They are carried out in coordination with the departments involved, and with those departments the Infection Committee and the Antibiotics Subcommittee decide on in their specific programmes.

Care programmes in the Primary Care area

Includes the following activities:

• Creation and following of protocols for diagnostic and therapeutic criteria with local primary care physicians for infectious community diseases, specifically in the process of intermediate-duration fevers, infectious respiratory disease, infectious urinary disease, infectious diseases carried by immigrants, as well as assisting in the treatment of tuberculosis.
• Guarantee of continued care.
• Coordination with non-hospital care in the integrated care process for patients infected with HIV.

Research

The Infectious Diseases Research Group (coordinated by Dr Benito Almirante) of the Vall d'Hebron Research Institute carries out clinical research that is closely linked to the care we provide, and which groups together the various Research Areas. We should also highlight our animal experimentation laboratory, within the Vall d'Hebron University Research Institute, which allows us to experiment and obtain results using various animal models, with the ultimate goal of trying to improve the prognosis of various serious infectious pathologies in humans. The current lines of research are:

• Nosocomial infection
• Serious community infection
• HIV/AIDS infection
• Infection in transplants
• Infection in oncohaematology
• Experimental models of infections

These lines of research are externally funded through research projects funded by the pharmaceutical industry or by public entities, as well as receiving funding as a member of thematic cooperative research networks organised by the Carlos III Health Institute (REIPI and RIS).

Teaching

Teaching represents a major part of the Department's activity. We collaborate and foster basic and continued training for students, professionals undergoing training (resident doctors) and predoctoral students in the area of knowledge of infectious diseases. This work is carried out both as part of hospital work and in academic and research activity.

It includes the following activities:

• Undergraduate training in infectious diseases, with three medical teacher positions and two associate medical teacher positions.
• Training for internal medicine residents and medical specialties that include training in infectious diseases as part of their curricula. The rotation is designed according to their needs, and includes residents from our Hospital and residents on temporary transfers from other hospitals. Every year, a maximum of two internal medicine residents who have completed their third year can be hosted, as the last two years of their period of training can be carried out in our Department, following a specific training programme in infectious diseases.
• Training for Primary Care doctors as part of continued education programmes. They are offered in the outpatient clinics and day hospital sections, where pathologies for non-hospital treatment are handled.
• Training for specialists from the Internal Medicine Divisions of other hospitals, as temporary transfers. Rotations are designed based on their training needs.
• Possibility of continuing postgraduate training for nursing professionals.

At the Psychiatry Department, our mission is to serve as the reference health care resource in the Barcelona Nord healthcare district for people with mental health problems and addictions. We offer a comprehensive service that is both effective and efficient, based on the professional quality of our staff, our modern facilities and coordination with all the mental health resources in the sector.

We currently have 10 beds in the Hospital, and thanks to a collaboration agreement with San Rafael Hospital, we also have an Integrated Adult Psychiatry Unit (UIPA), with 41 beds to admit acute psychiatric patients from the Barcelona Nord healthcare district.

Our goal is to lead the way in the design, study and research of more effective and efficient ways of addressing mental illness. We have created a model for the treatment of disruptive behaviours that is based first and foremost on the continuous advances made in neuroscience, clinical psychology and psychiatry regarding the knowledge of how the human brain works, and secondly on continuity of care throughout the whole therapeutic process.

We have four outpatient clinics (adults, addictions, children and adolescents and traumatology) and a Psychiatry Emergency ward with six bays, part of the A&E Department of the General Hospital:

• Community Psychiatry Section
• Liaison Psychiatry and Interconsultations Section
• Children and Adolescent Psychiatry Section
• Addictive Behaviour Section

Portfolio of services

• Addictions
• Sexual dysfunction
• Chronic fatigue
• Psychiatric genetics
• Adult psychiatric interconsultations and liaison psychiatry
• Infant and Child psychiatric interconsultations and liaison psychiatry
• Gender violence
• Dual pathology
• Cross-cultural psychiatry
• Suicide
• Smoking
• Borderline personality disorder
• Attention deficit disorder and hyperactivity in adolescents and adults (ADHD)
• Post-traumatic stress disorder
• Drug Dependency Care and Monitoring Centre (CAS)
• Treatment of mental disorders that require hospital admission
• 24/7 whole-life psychiatric emergencies
• Treatment of mental disorders during pregnancy and postpartum
• Foetal Alcohol Syndrome
• Mental disorders associated with 22q11 deletion
• Autism
• Tourette’s Syndrome

On the other hand, we also offer suprasectoral programmes for the diagnosis and treatment of highly complex patients who are unable to receive adequate treatment at their centre in the Mental Health and Addiction Network of Catalonia.

Intrahospital and sectoral programmes

• Adult liaison psychiatry and hospital interconsultations programme.
• Infant and child liaison psychiatry and hospital interconsultations programme
• Infant and child attention deficit disorder and hyperactivity programme
• Drug dependency programme at the Vall d'Hebron CAS (Care and Monitoring Centre).
• Sexual dysfunctions programme
• Whole-life autism programme
• Whole-life Tourette’s syndrome programme

Suprasectoral programmes 

• Adult attention deficit disorder programme
• Adolescent and adult borderline personality disorder programme
• Whole-life cross-cultural and immigration psychiatry programme
• Post-traumatic stress and victimology programme
• Gender violence programme
• Damage reduction and assisted venepuncture programme
• Smoking treatment programme
• Psychiatric care for pregnancy and postpartum programme
• Whole-life foetal alcohol syndrome programme
• Genetic Psychiatry Programme