Bill Shields appointed as BHB chief financial officer

3 April 2017: Bermuda Hospitals Board today announces that it has appointed Mr Bill Shields as Chief Financial Officer following an extensive local and international recruitment process.

The CFO at BHB is a legislated position in the Bermuda Hospitals Board Act 1970 and, as such, this appointment is approved by the Minister responsible for Health. The CFO is responsible for financial strategy and reporting, and manages the Finance, Admitting, Materials Management, Procurement and IT Directorates. The position reports to the Chief Executive Officer and the Board.

Chief Executive Officer Mrs Venetta Symonds comments: “I’m very pleased to welcome Mr Shields to BHB as Chief Financial Officer. As our recent budget debate highlighted, BHB is facing major challenges as Bermuda works to control healthcare costs and improve its financial position. A key focus for the coming fiscal year will be developing a clinical services plan that will help us make critical decisions about services going forward. BHB needs a financial executive who understands hospital finances and how they connect to the health system, and has experience in optimizing financial and operational performance to support clinical quality on the front line of patient care. Mr Shields comes with an impressive record within the NHS and we look forward to him bringing this expertise and experience to the team.”

Coming from the UK, Mr Shields joins BHB after over a year working as Executive Director of EY, a health advisory practice that focuses on performance improvement and optimization. In this role he worked with numerous NHS hospitals to transform and improve financial and operational performance. Prior to this position, he worked in the NHS for almost 29 years, most recently with the Imperial College NHS Trust, where he led a recovery of the Trust’s financial and operational performance where he held subsequent positions of Chief Financial Officer and Chief Executive.

Mr Shields comments: “I am looking forward to working with the team at BHB. They have worked very hard over the last few years to improve their financial stability, and I know that together we will be able address the current challenges to support BHB’s stated triple aim goals of improving the patient experience, improving population health and reducing the per capita cost of care.”

Having gained his professional qualification from the Chartered Institute of Public Finance and Accountancy, Mr Shields also has an MA in Social Sciences from the University of Glasgow. He has won numerous awards, including the HFMA Finance Director of the Year, 2013, HFMA Governance Award, 2013, and Health Service Journal Finance Team of the Year 2013.

CEO Venetta Symonds on bed capacity at KEMH

23 March 2017: Bermuda Hospitals Board CEO Venetta Symonds updates the public on bed capacity at King Edward VII Memorial Hospital in this short video. KEMH continues to experience a surge in demand, which has led to the hospital being over capacity.

Wherever possible, the public is asked to help hospital staff and the community by using services appropriately and maintaining their health wherever possible:

• If you have a close relative at KEMH who is ready to be discharged, please work with the hospital teams to get them home without delay.
• If you have a minor illness or injury, book an appointment with your GP or visit the Lamb Foggo Urgent Care Centre. You will avoid long waits. If you are in an Emergency situation, however, please do not hesitate in seeking care at the hospital.
• If you know which specialist you need and it is not an Emergency, make an appointment directly with the specialist. If you need a referral, see your GP.
• Manage any chronic conditions you might have, for example, make sure you take your hypertension or diabetes medication to avoid an emergency.
• Look after yourself: eat healthily, exercise and wash your hands regularly to try and avoid infections and optimize your wellbeing.
• Drive safely at all times – and don’t drink and drive! You can avoid Emergency and an admission by not ending up in a road accident.

BHB urologist performs Bermuda’s first laparoscopic kidney removal

Dr Gordon Kooiman

28 February 2017: Hundreds of nephrectomies (removal of kidney) have been performed in Bermuda over the years, but the Bermuda Hospitals Board (BHB) can now report the first case of a patient having the procedure done laparoscopically.

Urologist , MBBS MSc FRCS(Urol), joined BHB last December. A specialist not only in urology but also laparoscopic surgery, he quickly received a referral from another local urologist.

Forty-three-year-old Elizabeth DeSilva said she wasn’t in pain, but when she learned that her left kidney “was completely filled up with large stones” her physician told her it would be best to have it removed. “He called me up and said I should get a second opinion from Dr Kooiman at the hospital,” said Mrs DeSilva. “[He] explained that if he did the surgery I would have a scar about 12 inches long but that Dr Kooiman might be able to do it where the scar would be much smaller.”

Mrs DeSilva said after meeting Dr Kooiman she and her husband opted for him to remove her kidney laparoscopically.

“He was a really wonderful doctor,” she said. “He made both my husband and I feel at ease with the surgery he was going to perform. He was really warm and friendly.”

Elizabeth DeSilva

A mother of three and grandmother of two, Mrs DeSilva said her entire family was concerned about her health. “And I was very nervous,” she added.

She had the nephrectomy on 15 December 2016.

“I was fine when I came out,” she said, “although I was sore. It took some time, but I eventually felt better.”

Dr Kooiman said: “Removing a kidney via the laparoscopic (keyhole or minimally invasive) approach is available in most urology centres worldwide. Three or four small 5-10mm wounds allow a camera and thin, long instruments to be used to free the kidney from the surrounding structures. The kidney is then removed by extending one of the small wounds. Because the main wound is smaller, laparoscopic nephrectomy is associated with less post-operative pain, quicker discharge from hospital and quicker return to work.”

In the case of Mrs DeSilva, she spent only four days recuperating in the Acute Care Wing compared with a likely stay of seven to 10 days if she had undergone open surgery.

If you would like more information on laparoscopic nephrectomy, contact Dr Kooiman’s office on 239-5908 or email Gordon.Kooiman@bhb.bm.

Update on bed capacity at the King Edward VII Memorial Hospital

22 February 2017: Bermuda Hospitals Board (BHB) today updates the community on bed capacity at the King Edward VII Memorial Hospital.

Bermuda is currently experiencing higher levels of flu and respiratory illness. This, along with an aging and increasingly chronically ill community, as well as difficulty discharging seniors due to the lack of community nursing home facilities, has caused a sustained surge in demand. This is being felt in the Emergency Department, and admissions have increased for Acute Care Wing and General Wing units, leading to the hospital being over capacity.

In just three days (Saturday 18 to Monday 20 February), there were 279 Emergency Department visits. It took an average of 3.13 hours for Emergency patients to be seen, treated and discharged over this period. Thirty eight (38) Emergency patients were admitted to an inpatient ward just over this three day period. The maximum number of beds in the Acute Care Wing is 90. The wait to be admitted to an inpatient bed was 4.83 hours on Saturday, but on Sunday and Monday it took over 15 hours.

Delays are occurring in Emergency as people wait to be assessed, because the department has been filled with admissions awaiting transfer to hospital ward beds. A Fast Track service is running in the Emergency Department to reduce waiting times for patients. Although the Lamb Foggo Urgent Care Centre (UCC) remains closed for refurbishments until 1 March 2017, UCC staff are working in the Emergency Department to help cope with demand.

To cope with demand for inpatient beds, wards in the General Wing are currently being used for acute admissions. Additional space is being sought within the hospital to cope with the high number of inpatients and some elective (ie non-emergency) surgeries may be postponed as available bed space is optimized, although outpatient surgery will continue as usual.

Chief of Emergency, Dr Edward Schultz, comments: “Our hospital staff are working round the clock across departments to care for the current levels of unwell people in Bermuda. We ask for the community’s understanding and patience if they come to Emergency. We are doing all we can to ensure everyone can access the services they need. This is not about misuse of Emergency services as individuals coming to us at the moment are very sick. However, people who can wait to see their GP should, and we are asking GPs to refer non-emergency cases who need access to specialists directly to the specialist – for example, surgical lancing of abscesses can go directly to a surgeon for an outpatient appointment. This will help us focus on the people who truly need Emergency services.”

Chief of Nursing, Judy Richardson, comments: “Although the situation has eased slightly today, we apologise for the inconvenience caused by delays for patients being admitted to wards and for patients waiting to be assessed in the Emergency Department. As the Island’s only hospital we do whatever is needed to cope to ensure those who are sick or injured get the care they need. While delays are being experienced and people may not find themselves on the usual wards for acute care, I would like to reassure the community that they will be cared for. The surge is most significant in our senior population and the lack of community home beds is making it increasingly difficult to discharge people when they no longer need acute care services to free up capacity. This increase in inpatient numbers has to be staffed and support services increased to ensure safe clinical care, a clean environment and additional patient meals. I would like to thank all of our staff across the board who are working tirelessly and determinedly to keep services available for all those in need.”

The public is asked to help hospital staff at this time of high capacity by using services appropriately and maintaining their health wherever possible:

• If you have a close relative at KEMH who is ready to be discharged, please work with the hospital teams to get them home without delay.
• If you have a minor illness or injury, book an appointment with your GP – you will avoid long waits. If you are in an Emergency situation, however, please do not hesitate in seeking care at the hospital.
• If you know which specialist you need and it is not an Emergency, make an appointment directly with the specialist (if you need a referral, see your GP).
• Manage any chronic conditions you might have – for example, make sure you take your hypertension or diabetes medication to avoid an emergency.
• Look after yourself: eat healthily, exercise and wash your hands regularly to try and avoid infections and optimize your wellbeing.
• Drive safely at all times – and don’t drink and drive! You can avoid an Emergency visit and an admission by not ending up in a road accident.

Lamb Foggo UCC to reopen 1 March

22 February 2017: Bermuda Hospitals Board (BHB) will reopen the Lamb Foggo Urgent Care Centre (UCC) on Wednesday 1 March 2017. The east end facility was temporarily closed last month to install new vinyl flooring.

Marshall Minors, Vice President, Facilities Management & Estates, comments: “In addition to the flooring we also conducted minor repairs and upgrades to the facility. This included painting, installation of a shower stall, accreditation recommendations, and exterior glazing repairs, and storm water drainage improvements for the ambulance bay.

“The work was scheduled outside of hurricane season and ahead of the America’s Cup and busy summer season. We apologise for any inconvenience caused, but the public will be better served with the improvements now in place.”

BHB Chief of Emergency Services Dr Edward Schulz said: “We are happy to have our east end facility available to serve the community again. We are experiencing a busy flu season and the UCC reopening will certainly be convenient for many who require care at night and/or on the weekends.”

The public are reminded to use the BHB emergency services wisely and visit their GP if their situation is not urgent.