to Monitor and Control Infections, Antibiotic use and Resistance in Healthcare Facilities in the EU Member States

Transcription

1 New Strategies to Monitor and Control Infections, Antibiotic use and Resistance in Healthcare Facilities in the EU Member States Brussels November 2010 A meeting of European experts, jointly organised by:

2 CONTENT INTRODUCTION...3 PROGRAMME 8 November...5 PROGRAMME 9 November WORKSHOP 1 How to begin, how to implement and how to sustain a national hand hygiene campaign...6 WORKSHOP 2 Indicators of hospital infection control and antimicrobial management... 9 WORKSHOP 3 To roll out a common European methodology for PPS of HAI and antimicrobial use in acute care hospitals...13 WORKSHOP 4 Infection prevention and prudent use of antimicrobial agents in long-term care facilities...17 PROGRAMME 10 November...20 PRACTICAL Getting there...21 Walking from Brussels North train station to Hotel SHERATON...22 Conference venue: catering, rooms and places...23 Walking from Hotel SHERATON to LE MÉRIDIEN...24 Leaving Brussels...25 BAPCOC Travel costs reimbursement policy...26 BAPCOC Travel costs reimbursement form...27 ACKNOWLEDGEMENTS This meeting is kindly supported by: The European Commission Directorate-general for Health & Consumers (DG SANCO) Belgian Presidency of the Council of the European Union 1 July - 31 December WHO First Global Patient Safety Challenge: Clean Care is Safer Care, incorporating SAVE LIVES: Clean Your Hands global annual campaign 1

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4 INTRODUCTION Dear participant, The Belgian Antibiotic Policy Coordination Committee (BAPCOC) wishes you a warm welcome to Brussels. Back in November 2001, during Belgium s past presidency of the EU-Council, BAPCOC organised its first European conference focussing on antibiotic use and resistance in Europe. This conference marked the launch of the European Surveillance of Antimicrobial Consumption (ESAC) project and coincided with the unanimous approval of the Council Recommendations on the Prudent Use of Antimicrobial Agents in Human Medicine by the Health Council. Since then, numerous initiatives have been launched and many European countries have, for instance, organised public antibiotic awareness campaigns. During the last decennium, the prevention of healthcare-associated infections and containment of antibiotic resistance have become increasingly important. Therefore, it was decided that during this Belgian EU Presidency, we will discuss how we can collectively tackle these threats to our European citizens. During this conference we will share our expertise in areas such as antibiotic use and resistance, hand hygiene campaigns in hospitals, indicators of hospital infection and Point-Prevalence Surveys in hospitals and Long-term care facilities. The conference is organised together with the European Center for Disease Prevention and Control (ECDC) in Stockholm. The programme will provide a unique opportunity for debate, discussion and exchange of important ideas and information in this field. We will design and roll out common European strategies to better manage and control healthcare-associated infections and antibiotic resistance in European healthcare facilities. Once again, it is a great pleasure and privilege to welcome you to Brussels and we wish you a fruitful meeting. We hope that this combined Belgian EU Presidency and ECDC Conference may become another milestone in the fight against healthcare-associated infections and antibiotic resistance. Prof. Dr. Herman Goossens University of Antwerp, Belgium Vice-President BAPCOC Dr. Christiaan Decoster Federal Public Service Public Health President BAPCOC 3

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6 November 8th, 2010 Plenary session Lunch & Registration Welcoming Herman Goossens (BE) Dominique Monnet (ECDC) Preventing antimicrobial resistance and healthcare-associated infections: moving from evidence to action Chaired by Anne Simon and Marc Struelens Introductory lecture to Workshop 1: Engaging Nations in a Commitment to Hand Hygiene Promotion Didier Pittet (CH) Questions Introductory lecture to Workshop 2: Indicators of Hospital Infection Control and Antimicrobial Management Questions Coffee break Introductory lecture to Workshop 3: From Point Prevalence Surveys to Continuous Quality Improvement Jean-Christophe Lucet (FR) Peter Davey (UK) Questions Introductory lecture to Workshop 4: Infection prevention and prudent use of antimicrobial agents in long-term care facilities Questions Maria Luisa Moro (IT) Conclusions and presentation of the workshops Herman Goossens (BE) End 5

7 November 9th, 2010 WORKSHOP 1: How to begin, how to implement and how to sustain a national hand hygiene campaign Facilitators Anne Simon, Université Catholique de Louvain, Belgium Anna-Pelagia Magiorakos, ECDC, Sweden Benedetta Allegranzi, WHO, Switzerland Rapporteur: Bjørn G. Iversen, Institute of Public Health, Norway Background This is a workshop that will focus on hand hygiene promotion in EU Member States. The main aim of this workshop is to provide an opportunity to share experiences and knowledge gathered at the national level. The technical content of the workshop will build upon experiences of hand hygiene campaigns at national level, the ECDC key role of supporting Member States in improvement in infection control practices, and concepts, recommendations and strategies promoted by WHO. Participants will be national representatives identified as focal points for antimicrobial resistance by ECDC, and national coordinators of existent European hand hygiene national campaigns. Aims To learn from country experiences in the promotion of hand hygiene To identify strength and weaknesses of each national and sub-national campaign To become familiar with the WHO hand hygiene improvement strategy and toolkit To identify key elements for success and difficulties to begin, to implement and to sustain a hand hygiene campaign Deliverables Lists of key elements for success and difficulties to begin, to implement and to sustain a hand hygiene campaign Assessment of the key learning points and future perspectives for planning and acting at a national level 6

8 Session 1 - Sharing national experiences Chaired by Claire Kilpatrick & Anna-Pelagia Magiorakos Welcoming, presentation of the participants and objectives of the workshop Implementing a campaign based on the WHO multimodal hand hygiene improvement strategy and tools Anne Simon (BE) Angelo Pan (IT) Making hand hygiene a key national indicator Pierre Parneix (FR) How to effectively sustain a hand hygiene national campaign Coffee break Results from a long-standing campaign: the CleanYourHands campaign including strengths and weaknesses of patient participation Reflections on the on-going intervention: how to improve hand hygiene? Anne Simon (BE) J.P. Nolan (UK) Jette Holt (DK) Hand hygiene in primary care Mar Fernandez (ES) Lunch break Session 2 - How to begin, How to implement, How to sustain: practically Presentation of the WHO implementation toolkit Benedetta Allegranzi (WHO) Participants divided in 3 groups: Group 1 - How to begin Group 2 - How to implement Group 3 - How to sustain Coffee break Session 3 - Round Table Chaired by Benedetta Allegranzi, Anna-Pelagia Magiorakos & Anne Simon Report from Group 1 - How to begin Rapporteur Report from Group 2 - How to implement Rapporteur Report from Group 3 - How to sustain Rapporteur Global discussion and conclusions End 7

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10 WORKSHOP 2: Indicators of hospital infection control and antimicrobial management Facilitators Bart Gordts, ZNA Antwerpen, Belgium Marc Struelens, ECDC, Sweden Klaus Weist, ECDC, Sweden Background EU policy and Member State practice Structure and process indicators (SPIs) play a central role in the evaluation of EU strategies for the prevention of antimicrobial resistance and healthcare-associated Infections (HAI). In November 2001, the Council Recommendation on the prudent use of antimicrobial agents in human medicine (2002/77/EC) asked Member States and EEA countries to put in place specific strategies for the prudent use of antimicrobial agents with a view to containing antimicrobial resistance. The recommendation also invited: 1. the development of indicators to monitor prescribing practices of antimicrobial agents using the evidence based principles and guidelines on good practice for the management of communicable diseases; 2. the evaluation of these indicators once developed with regard to potential improvements of prescribing practices and feedback to prescribers. On April 10, 2010, the Commission published its second report to the Council based on Member State reports of the implementation of this recommendation in Sixteen countries had a national strategy in place for containing resistance. Of those, twelve had developed a variety of national indicators to monitor their action plan, including structure and process indicators (SPI) in five countries. Twenty-two countries had in place a national programme for hospital infection control. National guidelines were available for the prevention of HAI in a majority of countries but only few actually monitored compliance with these guidelines. Some EU Member States have implemented mandatory reporting of HAI/AMR outcome or structure and process indicators, with or without public disclosure of institutional data. The national experience from these countries shall be integrated in this workshop. The Council Recommendation of June 9, 2009 on patient safety, including the prevention and control of healthcareassociated infections, invites Member States to adopt and implement HAI prevention programmes at national, regional and healthcare institution levels. Here again, the Council encourages MS to monitor implementation of these programmes by use of structure and process indicators (SPI). The recommendation invites Member States to report on the implementation of these strategies by 2011 and the Commission to produce an implementation report to the Council by In 2010, the ECDC has undertaken a survey of structure and process indicators that are in use in Member States for the national evaluation of hospital antimicrobial stewardship and infection control programmes. These data will be presented at the workshop. 9

11 International proposals of structure and process indicators (SPI) for hospital infection control and antibiotic stewardship. Recently, several EU-supported projects have produced expert consensus recommendations for SPI in the field of hospital infection control and antibiotic stewardship. These include the Improving Patient Safety in Europe (IPSE), Antibiotic Strategies International (ABS International) and European Surveillance of Antimicrobial Consumption (ESAC) healthcare subproject proposals. ECDC is following-up these proposals together with external experts alongside the development of evidence based guidance on effective strategies. Introducing indicators is an evolving process, i.e. indicators change as guidance is updated and implementation is progressing. Aims and Deliverable Workshop participants will contribute to develop an expert position paper on current concepts, practices and level of applicability of structure and process indicators of infection control & antimicrobial stewardship in hospital care. This paper will address the following aspects: to describe the value of structure and process indicators of healthcare-associated infection control and antimicrobial stewardship as tools for quality evaluation and improvement on different levels to review examples of structure and process indicators that are currently in use by EU Member States for the evaluation of national hospital antimicrobial stewardship and infection control programmes to assess national experience with public reporting of local indicator data to review international quality of care indicators from EU projects (IPSE, ABS, ESAC) and categorize them for either local or national evaluation to define for each indicator the purpose, level of use, ownership, and target audience Session 1 - Indicators of hospital infection control and antimicrobial management Welcoming, presentation of the participants and objectives of the workshop Concepts and practice of quality indicators in Europe Chaired by Bart Gordts Structure and process indicators for antimicrobial steward-ship (ABS) programmes Structure and process indicators for prevention and control of healthcare-associated infections (HAI) 09:25 Inventory of ABS & HAI quality indicators in EU Member States Coffee break Bart Gordts (BE) Franz Allerberger (AT) Silvio Brusaferro (IT) Klaus Weist (DE) 10

12 Indicators for use at national / EU level Chaired by Klaus Weist 10:15 Council recommendation on patient safety and HAI: The concept of quality indicators for monitoring national HAI prevention and control programmes: Value of structure and process indicators of infection control and antimicrobial stewardship for national policy evaluation Antoon Gijsens (DG SANCO) Jean-Michel Azanowsky (FR) Questions Klaus Weist (DE) Indicators for use at hospital level Chaired by Marc Struelens Successful use of process indicators to improve quality of antibiotic use Successful use of process indicators to improve quality of HAI prevention Multi-centre efforts to improve quality of care: antimicrobial prophylaxis in surgery Q &A Presentation of the subtopics for the two groups Lunch break Winfried Kern (DE) Vlastimil Jindrák (CZ) Inge Gyssens (NL) Marc Struelens (ECDC) Session 2 - Review of Infection control (IC) & antimicrobial stewardship (ABS) structure and process quality indicators for use at local, national and EU levels Group 1 - IC and ABS quality indicators at national or EU levels Coffee break Session 3 - Round Table Chaired by Bart Gordts Group 2 - IC and ABS quality indicators for use at hospital level Moderator: Hilary Humphreys (IE) Rapporteur: Michael Borg (MT) Moderator: Gunnar Simonsen (NO) Rapporteur: Dilip Nathwani (UK) Report from group 1 Michael Borg (MT) Report from group 2 Dilip Nathwani (UK) General discussion All Conclusions Marc Struelens (ECDC) End 11

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14 WORKSHOP 3: To roll out a common European methodology for Point-Prevalence Studies (PPS) in acute care hospitals Facilitators Herman Goossens, University of Antwerp, Belgium Carl Suetens, ECDC, Sweden Rapporteur: Peter Zarb, National Antibiotic Committee, Malta Background In July 2008, the coordination of the dedicated surveillance network (DSN) for the surveillance of healthcareassociated infections (HAI) in Europe IPSE (Improving Patient Safety in Europe) was transferred to ECDC. The external ECDC evaluation of IPSE which constituted one of the elements of the ECDC-IPSE transition plan, recommended that The European HAI surveillance needs to cover other types of nosocomial infections besides surgical site infections and ICU-acquired infections in order to estimate and monitor the complete HAI disease burden and Since the implementation of an expanded continuous incidence surveillance is very resource demanding, hospital-wide prevalence surveys are efficient approaches to address it. The IPSE transition plan and hence the 2009 work plan of ECDC consequently included the elaboration of an agreed EU protocol for Point Prevalence Survey (PPS) of HAI in acute care hospitals, in view of its piloting in early 2010 and implementation in EU Member States in In 2008, ECDC performed an analysis of current or recent methods of national and regional point prevalence surveys of HCAI (and antimicrobial use) in European countries (presented at ECCMID 2009). From this analysis of 17 European protocols, it was evident that major methodological differences between protocols make data comparison or pooling at the EU level impossible and that probably all countries with a protocol in place would have to adapt it to an agreed EU protocol, with or without having to sacrifice retrospective comparability with previous national results. The first discussions regarding the PPS were held at a joint expert meeting on case definitions and integrated activities for surveillance of HAI, antimicrobial resistance and antibiotic use, held at ECDC on January It was recommended at this meeting that, in the future, PPS for HAI and antibiotic use in hospitals (as currently performed by the ESAC (European Surveillance of Antimicrobial Consumption) hospital-pps subproject) be combined. 13

15 The majority of the participants to the January meeting also advocated the use of IPSE/HELICS case definitions for HAI in surveillance and PPS of HAI, and to complement them by CDC case definitions where they don t exist. However, at the same time it was recommended to conduct a concordance study between IPSE/HELICS and CDC/NHSN definitions in order to be able to estimate differences in case classification. In accordance, a call for tender for the latter study was published on 15th of June 2009 and the project started in November The protocol provides a standardized methodology to Member States to respond to article II.8.c of Council Recommendation 2009/C 151/01 of 9 June 2009 on patient safety, including the prevention and control of healthcare-associated infections. It also integrates the main variables of the ESAC hospital-pps protocol, thereby also providing support to Council Recommendation 2002/77/EC of 15 November 2001 on the prudent use of antimicrobial agents in human medicine. Aims Discuss the pilot study of the European point prevalence survey of HAI and antimicrobial use in acute care hospitals and interpret the results Present the final protocol of the European PPS of HAI and antimicrobial use in acute care hospitals Present PPS training material developed for training of both local data collectors and national or regional coordinators Agree on periodicity and synchronization of PPS in EU Member States Explore marketing of the study and motivating participation, in view of large-scale implementation of the European PPS in all Member States Discuss the expected outputs of the EU-wide PPS and the use of the results Deliverables Proposed plan for repeated periodicity and synchronization of EU-wide PPS Proposed plan to ensure wide participation to the PPS in all MS Proposed plan for use of the results of the EU-wide PPS 14

16 Session 1 - Healthcare Associated Infections and Antimicrobial Use Point Prevalence Surveys (HAI-AM PPS) Chaired by Herman Goossens & Carl Suetens Welcoming, presentation of the participants and objectives of the workshop Herman Goossens (BE) Organisation of the pilot HAI-AM PPS Herman Goossens (BE) Report on feasibility assessment Summary of frequently asked questions Arno Muller (BE) Peter Zarb (MT) Analysis of Pilot PPS data Carl Suetens (ECDC) Herman Goossens (BE) Final Protocol and related issues for HAI-AM PPS Bruno Coignard (FR) Carl Suetens (ECDC) Coffee break PPS training material including case studies Susan Hopkins (UK) WebPPS Arno Muller (BE) Nico Drapier (BE) HelicsWin Karl Mertens (BE) Lunch break Session 2 - Examples of National Experiences Belgium Latvia Greece Lithuania Session 3 - Round Table Mat Goossens (BE) Uga Dumpis (LV) Achilleas Gikas (GR) Rolanda Valinteliene (LT) Organisation and timeline of PPS in the USA Shelley Magill (USA) Organisation and timeline of PPS in Europe Herman Goossens (BE) Coffee break Country training for PPS Susan Hopkins (UK) Use of results at European, national and local level Bruno Coignard (FR) Communication strategies by ECDC Carl Suetens (ECDC) Conclusions of the Workshop Peter Zarb (MT) End 15

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18 WORKSHOP 4: Infection prevention and prudent use of antimicrobial agents in long-term care facilities Facilitators Béatrice Jans, WIV/ISP, Belgium Dominique Monnet, ECDC, Sweden Nabil Safrany, European Commission, Luxembourg Rapporteur: Carmel Hughes, Queen s University Belfast, Northern Ireland (UK) Background Since the late 1960s, European hospitals have been challenged to meet the healthcare needs of an increasing number of elderly patients from an ageing population, in general. Today, the number of patients in long-term care facilities (LTCFs) is already larger than the number of patients in acute care hospitals and this trend will continue. Residents in LTCFs often present endogenous and exogenous risk factors for the acquisition of healthcareassociated infections (HAI) and of antimicrobial-resistant micro-organisms. They often receive antimicrobial therapy for acute or chronic infections. The IPSE (Improving Patient Safety in Europe) project and its work package 7 focusing on LTCFs, highlighted that, despite increasing evidence in the scientific literature, LTCF still represented a sadly neglected frontier for infection control (IC) with only few EU countries having given sufficient attention to the issue of HAI in LTCFs. Resources for IC were poor and specific experience with national infection surveillance systems was rare. Since data on antimicrobial use in LTCFs are scarce, the ESAC-3 Nursing Home sub-project (collaboration between the University of Antwerp and the Scientific Institute of Public Health, Brussels ESAC is funded through a grant from ECDC) worked out a methodology in order to measure the prevalence and the characteristics of antimicrobial use in European high-skilled nursing homes with two point prevalence surveys (PPS) in April and in November The recent HALT (Healthcare Associated infection surveillance in LTCFs) project is based on the same PPS methodology. The project started in 2009 and is funded through a grant of ECDC. It aims at developing a methodology for measuring HAI, antimicrobial resistance (AMR), antimicrobial use and available resources for IC and antimicrobial stewardship in LTCFs. The results from both ESAC-3 and HALT, as well as parallel activities from experts, will provide basis data for the workshop. 17

19 Aims Based on the experience from the IPSE, ESAC-3 and HALT projects, the aims of the present workshop are: to review existing national IC and antimicrobial stewardship programmes for LTCFs to review existing local IC structures and resources, and antibiotic policies in LTCFs, and the existing structure and process indicators of IC and antimicrobial stewardship in LTCFs to propose key elements for IC and antibiotic stewardship in order to improve the safety of LTCF residents by the prevention of HAI and AMR in European LTCFs Deliverables Draft proposal for a framework plan to improve the safety of LTCF residents in Europe by the prevention of HAI and AMR and key elements for IC and antimicrobial stewardship for the development of coherent European and national IC and antimicrobial stewardship programmes for LTCFs, including the following areas: IC structure and process indicators Antimicrobial stewardship structure and process indicators Infection control training for LTCF personnel Surveillance of HAI and antimicrobial use 18

20 Infection prevention and prudent use of antimicrobial agents in long-term care facilities (LTCFs) Chaired by Nabil Safrany and Dominique Monnet Welcoming, presentation of the participants and objec-tives of the Beatrice Jans (BE) workshop Patient safety including infection prevention and prudent use of antimicrobials: a European perspective Nabil Safrany (DG SANCO) Session 1 - Infection control resources in European LTCFs Infection control resources in LTCFs in Europe: experience from the Maria Luisa Moro (IT) IPSE project Promoting hand hygiene in LTCFs in Finland Maija Rummukainen (FI) Incidence of HAI in German nursing homes Nicoletta Wischnewski (DE) Do we need new specific definitions for the surveillance of HAI in Gaetan Gavazzi (FR) LTCFs in Europe? Coffee break Session 2 - Antibiotic stewardship in European LTCFs Measuring current resources for antibiotic stewardship and Barry Cookson (UK) infection control in LTCFs in Europe: the HALT process indicator tool MRSA in nursing homes in Northern Ireland: evaluation of Carmel Hughes (UK) prevalence and an infection control intervention The need for efficient communication on antimicrobial resistance Marie José Veldman (NL) between acute and chronic care facilities: how to share information and experience? A framework plan for resident safety in LTCFs in the European Béatrice Jans (BE) Union, including infection prevention and prudent use of antimicrobial agents Lunch break Session 3 Working groups Defining the needs for effective infection control and antimicrobial stewardship in LTCFs Group 1 - National/regional basic needs Group 2 - Local basic structural & functional needs Group 3 - Specific training needs Group 4 - Surveillance needs and communication strategy Barry Cookson (UK) Béatrice Jans (BE) Gaetan Gavazzi (FR) Maria Luisa Moro (IT) Session 4 - Plenary session Reports from working groups Presentation of the suggestions from each group (15 minutes + 15 min discussion) Report from Group 1 - National/regional basic needs Rapporteur Report from Group 2 - Local basic structural & functional needs Rapporteur Coffee break Report from Group 3 - Specific training needs Rapporteur Report from Group 4 - Surveillance needs and communication Rapporteur strategy Final suggestions for a framework plan for resident safety in LTCFs Carmel Hughes (UK) Conclusions of the workshop End 19

21 November 10th, 2010 CONCLUSION SESSION Conclusion session Chaired by Herman Goossens and Dominique Monnet Introduction to the conclusions Dominique Monnet (ECDC) Workshop 1: How to begin, how to implement and Bjørn G. Iversen (NO) how to sustain a national hand hygiene campaign Questions Workshop 2: Indicators of hospital infection control Dilip Nathwani (UK) and antimicrobial management Questions Coffee break Workshop 3: To roll out a common European Peter Zarb (MT) methodology for PPS of HAI and antimicrobial use in acute care hospitals Questions Workshop 4: Infection prevention and prudent use of Carmel Hughes (UK) antimicrobial agents in long-term care facilities Questions General conclusions Christiaan Decoster (BE) Lunch End 20

22 PRACTICAL Getting there HOTEL DIRECTIONS Hotel Sheraton, Brussels city center Place Rogierplein 3 B-1210 Brussels - BELGIUM Website: WALKING FROM BRUSSELS NORTH RAILWAY STATION Exit the station on Place du Nord/Noordplein side (towards track 1) Take the Rue du Progrès Vooruitgangstraat in front of you for 500 m, until Place Rogierplein. Hotel Sheraton is on the right side of the square A map is available on the Hotel s website (above). FROM BRUSSELS INTERNATIONAL AIRPORT Trains depart every 15 minutes from basement level -1 towards Brussels North rail-way station. Taxi company Autolux is ensuring regular shuttles between the airport and Brussels city center and can be contacted by phone for a pickup at the airport (+32 (0)2/ ); all means of transportation are detailed on the airport s web-site: FROM BRUSSELS SOUTH CHARLEROI AIRPORT Take TEC bus line A to Charleroi South railway station. Trains depart every 30 min. during the day from Charleroi South to Brussels North (train direction is Antwerp-Central, via Brussels). All means of transportation are detailed on the airport s website: FROM BRUSSELS SOUTH RAILWAY STATION Metro lines 2 and 6 (towards Simonis Elisabeth) are directly going round Brussels and stop at Rogier. Underground tram lines 3 and 4 (towards Nord/Noord) are cut-ting through Brussels and halt at Rogier, but are usually more crowded. The metro stop is at the foot of hotel Sheraton. A metro plan is available on STIB s website: Taxis are also waiting in line outside the station, on Place Victor Hortaplein side. LOST? Call Mr Norbert Eggermont on the day of your arrival: +32 (0)479/

23 Walking from Brussels North train station to Hotel SHERATON 22

24 Conference venue: catering, rooms and places 8 November - PLENARY SESSION AND REGISTRATION A welcome lunch is served in the hotel s «Crescendo» restaurant, located on the thirtieth (+30) floor, at 12:30. The plenary session is hosted in the «Nations» room, on the hotel s second (+2) floor. A welcome desk is located in front of the floor hall for registration. Coffe breaks during the plenary session will take place in the 2nd floor hall. For the participants who registered for it, a dinner is served in hotel «Le Méridien» at 20:00. Hotel Le Méridien is located in front of the Brussels Central Railway Station. A group departure is scheduled at 19:00 in the ground floor lobby of Hotel Sheraton; the group will walk through the heart of Brussels to hotel Le Méridien. 9 November - WORKSHOPS All workshops are taking place on the 2nd floor as well: Workshop 1: Room «Nations» (1/2) Workshop 2: Room «Nations» (1/2) Workshop 3: Room Watteau 1+2 Workshop 4: Room Tintoretto 1+2 Lunch is served in the hotel s «Crescendo» Restaurant on the 30th floor. As yesterday, dinner is served at 20:00 in Hotel «Le Méridien» for the participants who registered for it. A group departure is scheduled at 19:00 in the ground floor lobby of Hotel Sheraton; the group will walk through the heart of Brussels to hotel Le Méridien. 10 November - CONCLUSION SESSION The conclusion session is taking place in room «Nations». A lunch is served in the 2nd floor hall, with take-away packs for the participants who need to catch an early train or plane. 23

25 Walking from Hotel SHERATON to LE MÉRIDIEN 24

26 Leaving Brussels REACHING BRUSSELS INTERNATIONAL AIRPORT FROM THE HOTEL, BY TAXI Taxi company Autolux is leaving from the Brussels city center and can be contacted by phone (+32 (0)2/ ) for a hotel pickup. Other taxis can be booked at the hotel reception. FROM BRUSSELS NORTH RAILWAY STATION Trains depart every 15 min., usually from platform 7. Check the information screens on the platform before leaving. REACHING BRUSSELS SOUTH CHARLEROI AIRPORT FROM BRUSSELS NORTH RAILWAY STATION Trains are leaving every half-hour. Arrival in Charleroi South railway station is one hour after departure. FROM BRUSSELS SOUTH RAILWAY STATION Trains are leaving every half-hour. Arrival in Charleroi South railway station is 50 minutes after departure. Visit SNCB s website for train schedules: or ask the hotel reception 25

27 BAPCOC Travel costs reimbursement policy BAPCOC will only reimburse travel costs to participants who have not also been invited by the ECDC to its annual Meeting of National AMR Focal Points, taking place on the morning of November 8th. Only the average price on the day of purchase of a direct, return flight to and from Brussels, in economy class (1st class allowed for train tickets) will be subject to reimbursement. In order to claim reimbursement, the participant should send to BAPCOC by regular mail and before November 30th, 2010: ;; the reimbursement form provided in this brochure ;; the original plane tickets/boarding passes or train tickets ;; a proof of payment by the participant or its institution No reimbursement will be granted should any of the 3 above supporting documents be missing. Copies of the original travel documents will not be accepted. No request for reimbursement will be accepted beyond November 30th, By submitting and signing a claim for reimbursement, the participant agrees with and has read the present policy 26

28 BAPCOC Travel costs reimbursement form By filling in this reimbursement form, the participant certifies to have read and agreed with BAPCOC s travel costs reimbursement policy. Name of participant: Place of departure: Place of arrival (BRUSSELS INT. AIRPORT or BRUSSELS SOUTH CHARLEROI AIRPORT): Price paid: Currency: Name of account holder: Address of account holder: IBAN: BIC: DATE (dd/mm/yyyy): SIGNATURE OF PARTICIPANT: To be filled in and sent back via regular mail with supporting documents to: BAPCOC - Norbert Eggermont Bureau 01D234 Place Victor Hortaplein 40/ Brussels - BELGIUM 27

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30 Contact Norbert Eggermont - BAPCOC norbert.eggermont@health.belgium.be Copyright shocky - Fotolia.fr Helder Almeida. - Fotolia.fr Sebastian Kaulitzki - Fotolia.fr Epictura.fr V.U. / Ed. Resp. : Dr. Dirk Cuypers. Place Victor Hortaplein, 40/10, Brussel/Bruxelles. Grafisch ontwerp/conception graphique : Thierry Sauvenière