European Network

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Countries, Patients and Centers of Fresenius Medical

Care's European Network

Fresenius started its activities as a dialysis provider at the end of 1996 following the merger of its dialysis business with the leading service provider in the US, the National Medical Care (Boston, Mass., USA). The creation of Fresenius Medical Care in Europe (FME) started from the original group of National Medical Care clinics in Portugal and Spain, and then FME decided to develop a European network in order to become a global player. Through strategic acquisitions, the construction of de novo clinics, privatizations and participation in public tenders, FME was able to build a network currently (end of August 2006) involving more than 320 clinics located in 15 countries and treating more than 24,000 patients, which corresponds to 9-10% of all HD patients in those countries (fig. 8).

Fig. S. Distribution of FME centers across Europe.

Support Organization and Central Departments

The management of the network is realized thanks to a bidimensional organization in which line managers can rely on some international functional departments. From the clinical point of view, the department Clinical Management Europe (CME) is responsible for the coordination of specific activities in the whole European region. CME has several responsibilities, from clinical governance to technical coordination as well as the allocation of training resources. It works with local reference people, including a Country Medical Director and persons responsible for nursing and data quality in each country organization. CME provides the consolidation and assessment of the clinical data collected and channels clinical studies and publications.

Other functions directly involved in the provision of dialysis services are: (1) Innovation and Technology Dialysis Care which supports and coordinates the construction of new facilities and the implementation of new technical solutions, whilst experiences derived from millions of treatments per year are analyzed and channeled to Research and Development; (2) Water Technology and Fluid Management Department; (3) Quality, Environmental and Regulatory Management which is responsible for the implementation of the Integrated Management System (IMS, see below), and (4) Nursing Care Management for the improvement of dialysis practices and procedures.

It has to be stressed that FME only expands its dialysis network in those countries where a subsidiary is already present to ensure a minimum standard of organization already exists.

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