Progress Update for the SNF Health Initiative - November 2020
26 November 2020

Now more than ever, the CΟVID-19 pandemic has underscored the importance of a strong and well-prepared National Health System for all.

As part of the SNF Global Relief Initiative for the COVID-19 Pandemic totaling $100 million, the Stavros Niarchos Foundation (SNF) has allocated a major portion of its grants to Greece to support the health sector. This support is spearheaded by a grant currently under implementation for 174 new ICU and High-Dependency (HDU) beds in 15 hospitals across Greece (as mentioned in the SNF press release issues on 11/20/2020), totaling €16.4 million.

33 of the aforementioned beds will be added to Evangelismos Hospital. In the midst of the first wave of the pandemic in Greece in May 2020, a grant of €7.7 million to support Evangelismos was fulfilled as part of the SNF’s Health Initiative. As described in more detail later in this update, this grant additionally secured the procurement of more than 850 beds (for the replacement of all hospital beds), of which 53 are intended for ICUs, HDUs and Stroke Units, as well as 150 pieces of medical equipment.

Separate from the grant to Evangelismos Hospital, the Health Initiative includes a series of infrastructure, equipment procurement, and educational programs. The Initiative’s ultimate objective is to strengthen and upgrade the public Health Sector in Greece by empowering the country’s medical staff and ensuring a high-level of medical care and treatment services are available for all citizens.

The Initiative, with a budget exceeding $400 million, is implemented in collaboration with the Ministry of Health. Its implementation has continued uninterrupted and at an intensive pace since 2018. The individual projects will each be delivered to the Greek State upon completion of their respective works and procedures.

In the spirit of transparency, SNF is committed to providing regular updates with timely information on a range of projects included in the Initiative. At SNF, we are guided by the principle that the process we follow is equally important as the finalized project.

Infrastructure Projects

Construction work for the three new Hospitals in Komotini, Thessaloniki, and Sparta, totaling $366 million are underway & Approval of an additional SNF grant to enrich the clinical program of the new General Hospital of Komotini, totaling €5.5 million

The infrastructure projects include the design, construction, and outfitting of three new hospitals in Komotini, Thessaloniki, and Sparta. Renowned architect Renzo Piano and the Renzo Piano Building Workshop (RPBW), designers of the Stavros Niarchos Foundation Cultural Center, will design the infrastructure projects internationally. Their participation in the project will introduce a new philosophy for harmonizing treatment areas with the natural environment.

The Initiative’s infrastructure works also include the renovation of the 2nd Intensive Care Unit (ICU) and the Emergency Department at Evangelismos Hospital.

> New SNF General Hospital of Komotini
Following the ratification under law of the Grant Contract between SNF and the Greek state by the Hellenic Parliament in February 2020, as well as the completion of the final design, the project is under an implementation study by the architectural firm Renzo Piano Building Workshop (RPBW).

Komotini

Recently, in collaboration with the administration and personnel of the hospital, SNF investigated additional support for the clinical program approved by the Ministry of Health, as well as possible collaborations with university bodies to achieve the best possible services from the new Hospital.

The hospital’s potential collaboration with the university bodies could not proceed beyond the first exploratory meetings. Regarding further support for the hospital’s medical services, SNF’s Board of Directors approved additional design, infrastructure, and equipment costs up to EUR 5,500,000, the provision of a Magnetic Resonance Imaging (MRI) machine, a Breast Imaging Department, a Cath Lab, a Gamma Camera machine, three additional operating rooms, and a space for therapeutic practice and rehabilitation. These extensions of the hospital’s clinical program have been submitted to the Ministry of Health.

The issuance of the hospital’s building permit is already underway. The infrastructure project studies for the roads and the hospital’s connection to the public utility networks of the Greek State (GS) have been completed, while their tendering by the GS is expected to be completed by February 2022.

According to the current timetable, the new SNF General Hospital of Komotini is expected to be delivered to the Greek State and, subsequently, the Greek people, during the first quarter of 2025.

> SNF University Pediatric Hospital of Thessaloniki
After the preliminary study for the SNF University Pediatric Hospital of Thessaloniki was completed, RPBW is proceeding with the project’s final design.

Thessaloniki

The Ministry of Health has approved the hospital’s clinical program. Meanwhile, in close collaboration with the Medical School of the Aristotle University of Thessaloniki and with SNF’s initiative, support for the hospital’s existing clinical program is also under consideration by the Health Initiative SA. SNF would like to thank the Aristotle University of Thessaloniki for their partnership in this work.

Simultaneously, SNF and the GS are processing the individual Grant Contract to be ratified under law by the Hellenic Parliament following the completion of talks with the Medical School of the Aristotle University, as the results of the talks may further shape the clinical program of the new Pediatric Hospital, provided the assistance, cooperation and relevant approvals from all participants (University, Ministry of Education, Ministry of Health, SNF). These discussions are expected to be completed by the end of the year.

The infrastructure project studies implemented by GS for the roads and the hospital’s connection to the public utility networks are complete. Their tendering by the Greek State is imminent, scheduled to be completed in December 2022.

The SNF University Pediatric Hospital of Thessaloniki is expected to be completed and delivered to the Greek people during the first quarter of 2025.

> New SNF General Hospital of Sparta
Architecture firm RPBW has completed the preliminary design of the new SNF General Hospital of Sparta.

Sparti

The Central Archaeological Council has approved the location of the new hospital. The GS has taken over responsibility for the infrastructure studies to improve the road links and the hospital’s connections with public utility networks. These studies are slated to be commissioned in the near future in order to be completed and tendered by February 2022.

The new SNF General Hospital of Sparta’s clinical program has been approved by the Ministry of Health. Meanwhile, the investigation into further enrichment for the program is underway in collaboration with the Hospital’s administration and personnel, before the project enters the stage of the final architectural study. Discussions and the subsequent determination about additional enrichment of the hospital’s services are expected to be completed by the end of November 2020.

In the context of the aforementioned investigation, SNF proposed a partnership between the new SNF General Hospital of Sparta and the Department of Nursing at the University of Peloponnese as part of its effort to support the nursing sector in Greece, and the Foundation’s belief that developing excellent, state-of-the-art medical infrastructure to better serve citizens requires cooperation between agencies. However, the SNF’s proposal to investigate this possibility, for which the SNF was prepared to incur significant additional construction costs through the increase of its existing grant, was not accepted by the Department of Nursing and the University of Peloponnese. As a result, the SNF abandoned its proposal, leaving it to the discretion of the State, nevertheless continuing support for the wider nursing sector in Greece within the Health Initiative.

Following the existing timetable, the new SNF General Hospital of Sparta is expected to be completed and delivered to the Greek State and, subsequently, the Greek people, during the first quarter of 2025.

As part of the transparent process the SNF follows and in the spirit of providing the public with timely and valid information on the progress of the projects, which are moving forward in the interest of local communities, since June 2019, the SNF, in collaboration with local municipalities has organized as series of open discussions. The next meetings will take place virtually due to the pandemic, in collaboration with the three municipalities, on Thursday December 10th.

> Support for the Renovation of the 2nd Intensive Care Unit and the Emergency Department at Evangelismos General Hospital
The grant to strengthen Intensive Care Unit (ICU) 2 and the Emergency Department at Evangelismos Hospital is underway, in collaboration with the Athanasios and Marina Martinou Foundation and Aliki Perroti.

More specifically, following a tender, the relevant project team of the hospital, completed the selection of a contractor for the study and supervision of the renovation. The contractor has completed the preliminary study, and discussions are taking place between the study team, the hospital’s competent project team, and the co-funders to finalize the projet’s timetable and the manner of implementation. In these discussions, priority was given to the renovation of the 2nd ICU, therefore bringing forward the reform of the hospital’s Emergency Department.

Procurement of Equipment

Complete delivery of four EKAV Air Ambulances & Educational Equipment for the Nursing Schools at the National Kapodistrian University of Athens and Evangelismos Hospital expected by March 2021.

> Equipment Installation at Evangelismos Hospital
As mentioned above, the Initiative’s individual grant for equipment procurement for Evangelismos Hospital was completed in May 2020. In addition to the aforementioned procurement of new beds, the grant also supported the purchase of 150 pieces of medical equipment.

Evangelismos

The equipment includes, among others, specialized ultrasound diagnostic machines and portable X-ray machines, as well as a number of innovative, state-of-the-art machines, such as a microbe ionization detector for the Hematology Department and an ionization robot for the disinfection of operating rooms and, consequently, the prevention of in-hospital infections. More than 10 of the Hospital’s Departments are strengthened and upgraded through the SNF grant, including the ICUs, DHUs, Stroke Unit, Emergency Department, Artificial Kidney Unit, and Operating Rooms.

> Enhancement of the Nursing Sector
Following the finalization of the purpose and budget by SNF and the Ministries of Health and Education’s project teams for the supply of equipment and design of educational programs for the Nursing Schools of Evangelismos Hospital and the National and Kapodistrian University of Athens (NKUA), the relevant grant contracts were ratified under law by the Hellenic Parliament at the end of January 2020.

Currently, the tender for the equipment suppliers’ selection is in progress and the relevant process is expected to be completed by the end of December 2020. The equipment includes: specialized simulations of medical and nursing interventions with the possibility of interactive control from a control room, simulators/models for adults, children and infants, cardiopulmonary resuscitation simulators, digital anatomy tables, digital echocardiograph machines, portable ultrasound machines, bronchoscopes, a microplate spectrophotometer, flow cytometers, microscopes, freezers, a general surgery table, a complete anesthesia machine, and more.

According to the existing timetable, the equipment is expected to be delivered to the three educational units of the Evangelismos Hospital and the Nursing Department of NKUA in March 2021.

> Specialized Medical Equipment (PET/CT) across Greece
The tender process for the selection of a contractor to supply PET/CT (positron emission tomography) equipment at the University Hospitals of Heraklion, Ioannina, Larissa, and Alexandroupolis is in progress. The process is expected to be completed by the end of next month, while SNF expects the recruitment of the required staff to be carried out by the GS.
As a reminder, following the Ministry of Health’s suggestion it was decided to exclude the supply and installation of radiopharmaceutical production units in four public hospitals in Greece from the individual grant contract. Following this, at the end of February 2020 the Hellenic Parliament ratified under law the amendment to the contract to reflect the related developments.

According to the existing timetable, this grant is expected to be completed by spring 2022.

> The National Center for Emergency Care’s (EKAV) Air Ambulance Services
Upon completion of the tender process and the selection of the contractors to supply two new helicopters and two new airplanes, the individual grant contracts were ratified under law by the Hellenic Parliament in mid-June 2020. The GS will be responsible for the operation and maintenance of the aircraft. The assembly of the four aircraft will be completed this month, while their conversion into air ambulances has begun gradually.

Delivery of the above four air ambulances will begin next month, with an expected completion date of March 2021. The project is proceeding according to its original timetable, the detailed schedule of which is presented below:

Milestones Helicopters (2) Airplanes (2)
MoU Signing and Law 4564  

March 21, 2018 and September 21, 2018

Provision of new equipment and maintenance of existing equipment for strengthening the capability and efficiency of EKAV’s
air ambulance services

 

Law 4618 /June 10, 2019

Provision for the repair of existing helicopters Provision for the purchase of new airplanes
Tender August 2019 – January 2020 August 2019 – January 2020

Law 4693 (June 17, 2020)

Purchase of 2 helicopters
Contract signing with contractors and their ratification by the GS

Purchase of 2 airplanes
Contract signing with contractors and their ratification by the GS

Construction July 2020 – November 2020 July 2020 – February 2021

Delivery to the GS

December 2020 – January 2021 March 2021 – April 2021

 

Below are photos from the construction and control process of the two airplanes, in Kansas (USA) before their transport to North Dakota (USA) for the installation of medical equipment and additional checks, with representatives of the Hellenic Air Force present:

Helicopter

Design and Implementation of Educational Resources

Launching of Part of the Five-Year Training Programs for the Treatment of Trauma & the Prevention of In-Hospital Infections.

> Five-Year Educational Programs for the Treatment of Trauma
The five-year educational programs for trauma treatment have been designed by the nonprofit Regeneration & Progress, and include:
1. The Advanced Trauma Life Support (ATLS) educational program for medical students
2. The Advanced Trauma Care for Nurses (ATCN), which includes a separate Scrub Nurses Training program
3. A training program for doctors at the largest trauma center in the world, Chris Hani Baragwanath Academic Hospital, located in South Africa
4. A training program for surgeons using laparoscopy and arthroscopy simulators
5. The Prehospital Trauma Life Support (PHTLS) educational program for the training of EKAV rescue personnel
6. Advanced Pediatric Life Support (APLS) seminars for pediatric patients.

Advance Pediatric Life Support

The ATLS, ATCN and PHTLS programs have been under implementation since mid-September 2020, aiming to be completed by the end of next month for a total of 15 seminars (ATLS, ATCN, ΑPLS and PHTLS) with 336 participants. At the end of the five-year duration of the programs, a total of 13,700 medical students and professionals are expected to be trained.

> Educational Programs to the Prevent In-Hospital Infections and Nursing Programs (Three Educational Nursing Units at Evangelismos Hospital & the Nursing Department of the School of Health Sciences of the National and Kapodistrian University – NKUA).

The educational program to prevent in-hospital infections aims to train nursing staff in nine public hospitals across the country. The program is implemented in collaboration with the National Organization for Quality Assurance in Health (ODIPY), the Hellenic National Public Health Organization (EODY), and NKUA’s Nursing Department through the electronic platform of the Center of Continuing Education and Lifelong Learning (KEDIVIM). Following the definition on behalf of the National Organization for Quality Assurance in Health (ODIPY), the educational programs’ implementation teams are collaborating with both the GS and the SNF project team regarding the programs’ implementation. The educational programs are expected to roll out gradually, beginning in next month and completed in five years.

The Nursing Training Programs are implemented in collaboration with NKUA’s Nursing Department. They comprise seven educational program and four research programs, while also supplying educational equipment for the laboratories. Furthermore, this SNF grant also covers 10 academic scholarship programs, to strengthen the clinical, educational, and research work of the Nursing Department. These programs are expected to start rolling out gradually from the beginning of January 2021.

Due to the nature of the programs, which were scheduled to start in September 2020, and despite modifications to their original design that consider the conditions and constraints posed by the pandemic, their execution may deviate from the above timetable, depending on COVID-19 developments.

> Support for the Child and Adolescent Mental Health Sector in Greece
The SNF is in the final stages of finalizing the collaboration the Child Mind Institute in the US and local partners in Greece, for the development of a program to strengthen and support Greece’s mental health sector for children and adolescents, with the aim of creating a National Reference Center and become a new pillar of the Health Initiative. This program will complement the services provided by the three new Hospitals under construction, with emphasis on the SNF University Pediatric Hospital of Thessaloniki. At the same time, it will focus on providing targeted training programs and further clinical support to all health professionals and child and adolescent support workers.

Discussions on this new pillar of the SNF’s Health Initiative are expected to be completed by the end of next month.