Improving IC bed ratio
An increase in the number of beds, not strictly for intensive care but for additional care in general, is the proposal of Haralambos Roussos, professor of pneumonology and intensive care at Athens University, and chairman of the Central Health Council’s committee for intensive care. Roussos pointed out the shortages of trained staff and nurses for intensive care wards. «The backbone of a general hospital,» said Roussos, «is a well-organized emergency unit, abundant surgeries and intensive care beds, as well as an imaging department (CT and MRI scans and radiology), for prompt treatment of serious cases.» Three stages As Roussos explains: «Intensive care wards are not like ordinary wards. Special care is required, divided into three stages, depending on the seriousness of the case. «Experience has shown that in ideal circumstances, and depending on the type of hospital, 10-20 percent of the beds in a hospital should be set aside for intensive care. For example, at Johns Hopkins, IC beds account for 15-18 percent of the total, at the Onassis Cardiac Surgery Center, more than 15 percent and at Errikos Dunan, 20 percent. «Though there are great shortages in Greece, efforts have been made in the past 15 years and the number of IC beds has increased considerably. And we must not forget the cost factor. It takes 73,000-88,000 euros to set up each bed, which has running costs of 587-1,760 euros a day. According to calculations by European hospitals with the proper number of IC beds, the cost accounts for 25-40 percent of the total running expenses of the hospital. We also need doctors and nurses to staff these wards, and that’s where the State should place the greatest emphasis. Intensive care is part of general medicine and uses high technology, both theoretical and considerable practical knowledge.» Doctors and nurses must possess nursing skills, as Roussos says. «IC wards in Greece are understaffed, but this is the most serious problem facing Greek hospitals in general.» Selection of patients Another important question Roussos raises is how patients are picked for IC wards. «There are huge medical and ethical problems over which patients we help in IC. Of course, you don’t put an elderly senile patient with widespread cancer into IC when a youngster injured in an accident is waiting, because that is not practicing medicine. It harms the patient, their relatives and is against Hippocrates’ philosophy. But things are not black and white. What the doctor does is the outcome of one thing only: education,» says Roussos.
