About Anna Nowak

BHB and Brown Darrell Collaborate on CT Service

Bermuda Hospitals Board today announced that it will be working with the Brown-Darrell Clinic to deliver a CT service while both its CT scanners undergo repairs.

Dr Daniel Stovell, Chief of Radiology, comments: “Many times patients who are scanned using a CT, such as stroke patients, can use alternative modalities, such as MRI. For patients whose only option is a CT scan, we are very grateful to the collaboration with the Brown-Darrell Clinic who will carry out the CT scan for us. If patients who attend Emergency require a CT, they will be transported by ambulance to Brown-Darrell, then return to KEMH where diagnosis and treatment will resume.  We apologise for anyone who is impacted. It is very unfortunate that both CT scanners have been impacted at the same time and we are working closely with the manufacturer, GE. The parts will be on-island this week and we expect the service to resume by next week.”

27 January 2022 Home Page, News

UCC temporary changes to evening hours only on week days

Wednesday 12 January 2022: Bermuda Hospitals Board today announces that there will be evening-only hours from 6pm to 10pm Monday to Friday at the Lamb Foggo Urgent Care Centre (UCC) from Thursday 13 January, to assist with ensuring adequate staffing levels are available in the Emergency Department at KEMH. The weekend hours will remain the same from 9am to 9pm.

Dr Chikezie Dean Okereke, Chief of Emergency, comments: “The temporary change in the weekday hours are due to a number of factors, including staffing issues, with some existing vacant positions and COVID-19 quarantine absences. We are extremely busy in the main Emergency Department at the moment. We are seeing many very unwell patients who need admission. This is not primarily driven by COVID-19 infections, but pre-existing medical conditions.

“We are struggling to get patients discharged in a timely manner from inpatient units, as they need community services, nursing home placements or family support. This has resulted in an increasing number of people waiting in the Emergency Department following admission, delays in timely assessment and management of the new patients attending and a high overall number of patients in the ED needing care. We are managing, but the reduced staffing numbers and the high acuity patients attending means that the Emergency Department service delivery is under a lot of pressure.”

Judy Richardson, Chief of Nursing, comments: “As community infections rise, so does the number of BHB staff who are impacted. BHB currently has nearly 150 staff off work due to positive results or as close contacts. While generally we have maintained services to date, the reduced UCC hours allow us to redeploy a full time nurse back to the ED which will assist in delivering care where the most unwell people are in need. We continue to review our situation as more people are impacted by positive cases. While hospitalised COVID patient numbers have been relatively low with omicron, they are rising, and with staff levels under pressure we may have to review the delivery of care in non-urgent outpatient areas should the situation continue to escalate.”

12 January 2022 Home Page, News

BHB updates community on Electronic Medical Record Programme

Wednesday 29 December 2021: BHB today updates the community on its Electronic Medical Record Programme, which aims to replace an old, outdated clinical system that is no longer supported by the company, with the Cerner Millennium electronic medical record (EMR).

The project officially kicked off in April this year, after a year-long delay due to the COVID-19 pandemic. First announced in the budget debate speech given by the Minister in March 2020, the integrated EMR at BHB will give each patient one record, no matter which BHB service they use, helping reduce duplication, delays and improve coordination of care, and access to full information for the patient and clinical team. It has the potential to have greater connectivity outside of the hospital.

Throughout 2021, about 350 staff members have been involved in the project in over 1,000 EMR workshops and meetings.

Michael Richmond, CEO & President, comments: “BHB staff and physicians have been working hard since April 2021 in order to implement our first integrated EMR. We appreciate that they have been keeping this project moving even as we have gone through the waves of the pandemic. The pressure of time is on us as our current clinical system, also from Cerner, is old and no longer supported. Implementing a full EMR as the solution will help us upgrade, and meet the standards of care expected in hospitals around the world. EMRs are a tool for staff to use in the delivery of care that puts the patient at the heart of all we do, it helps us in our mission to deliver the highest quality and safest care each day.”

Chief of Staff Dr Wesley Miller is one of the co-executive sponsors of the project. He explains: “Clinicians will use the EMR to write up their notes, review test results, make diagnoses, make referrals, prescribe medications and communicate with other people in the care team, or to other departments involved in a patient’s care. One patient, one record, wherever you go in BHB.

“It actively encourages safe care because of the safety alerts built into the system, which help clinicians make timely decisions. Someone with clinical indicators that suggest sepsis or stroke, for instance, can be immediately flagged: these are conditions in which a fast therapeutic response is critical to the outcome of patients. Medication alerts can be flagged that stop errors in doses or contraindications with other medications the patient is on.”

Bill Shields, Chief Financial Officer, is the other co-executive sponsor of the project: “We are so grateful to all the people working on this project to date as they managed the EMR commitment and the pandemic. Next year, starting in the Spring, over 1,000 staff in departments across BHB and all physicians who work within the hospital will be involved with training and testing, so the hardest part of the implementation is still ahead of us.

“We are aware that this is a big investment and would note that while we must replace an old clinical system, the EMR will replace many of our other systems, helping us integrate records with other actions such as scheduling, referrals, prescribing, and testing. Whilst the core cost of the implementation is about $30 million, when we go live we will save many millions of dollars in costs over time associated with the purchasing, updating and maintenance of many separate systems. The contract payment terms are over ten years. Of even more importance, however, is how the EMR will support our frontline staff as they strive to deliver the best care possible, and help BHB in its pursuit of excellence through improvement, to make Bermuda proud.”

Following an internal competition, BHB’s integrated EMR is now named ‘PEARL’ (Patients Electronic & Administrative Records Log) and will be used in all clinical, support and administrative areas across KEMH, MWI and Lamb Foggo Urgent Care Centre after it goes live next year.

PEARL’s history
Cerner’s Millennium was selected as BHB’s EMR in an RFP back in May 2019, after a vendor search and selection process that started in late 2018. A full business case to implement an EMR to replace the old clinical suite and improve the delivery of care at BHB was approved by the Board in November 2019. After the initial planned start in 2020 was postponed due to the pandemic, the EMR programme at BHB launched in April 2021. PEARL is expected to go live in fall/winter of 2022, following a major testing and training schedule for all staff.

29 December 2021 Home Page, News

BHB moves to Disaster Alert Level 3

Friday 22 October 2021: Bermuda Hospitals Board today confirmed it has reduced its alert level from 4 to 3, in response to the reduction in COVID-19 patients needing critical, emergency and acute care services. This is a cautionary move, as there are still people in hospital with COVID-19, and one overflow ICU is still open. Visiting restrictions will remain in place for this alert level, as will the suspension in routine elective surgeries, but preparations are underway for a gradual relaxation if numbers continue to decline.

BHB CEO Dr Michael Richmond comments: “This has been a very difficult period for our staff. Much was asked, much was given and we have a deep appreciation for their efforts. We are all hoping for a period to gradually recuperate. I would, on behalf of all our staff, want to thank the many donors who sponsored meals for our staff. Not only did you help people under immense pressure, but you gave us a feeling of connection with our community, a sense of being supported, that helped us through an extremely challenging time. Thank you.

“While I know people want to visit their loved ones as soon as possible, or have their planned routine surgeries, we are moving cautiously at this alert level. Our staff are recovering, especially those who worked directly or in support of acute, emergency and critical care areas. We also have an overflow ICU open, which is usually a post-anaesthetic care unit for surgery. It feels very much like the period immediately after a major storm at BHB – there is some restoration needed, and we need to be sure that the worst is past before we return to more normal functions.

“Thank you again for your support and understanding.”

22 October 2021 Home Page, News

Last week to see MWI client art and photography at BSOA

Tuesday 12 October 2021: This year’s art and photography exhibit by clients of Mid-Atlantic Wellness Institute (MWI), called the MindFrame PhotoVoice Exhibit, will be open until Tuesday 19 October for viewing at the Bermuda Society of Arts in City Hall.

Jordan Fairn, Art Psychotherapist, who runs the art therapy sessions at MWI, says: “MWI clients were asked to submit art and photography on the theme of ‘Weathering the Storm’ and we have some wonderful and creative pieces. It’s unfortunate that this year our exhibit coincided with the worst COVID-19 surge Bermuda has experienced, so we couldn’t have the usual opening night. However, the theme of resilience, of managing through the tough times, is something that is perhaps even more meaningful after the last few weeks and even years, as we all take a closer look at our mental health and stamina throughout the pandemic. I hope people can visit the Bermuda Society of Arts before we close.”

As in previous years, the MindFrame PhotoVoice Exhibit gives clients of MWI a space in which to share their expressions, perspectives and experiences through a variety of different media. This year there is drawing, painting, collage, photography and sculpture. Works can be purchased, and the artists receive part of the profits.

“Every individual has a unique perspective on the world and the MindFrame PhotoVoice gives our clients a space in which to share their creativity and thoughts with the wider community,” Says Jordan. “It is a unique exhibition, and we hope people come by. The gallery is open 10am to 4pm weekdays and 10am to 2pm on Saturdays.”

 

12 October 2021 News

Lamb Foggo Urgent Care Centre temporarily reduces weekday open hours (weekend hours remain the same)

Sunday 3 October 2021: Bermuda Hospitals Board today announced that there will be a temporary change of weekday Lamb Foggo Urgent Care Centre (UCC) hours so that staffing resources can be directed to the Emergency Department. From Monday 4 October 2021, hours will be from 5pm to 10pm weekdays, Monday to Friday. Weekend hours will remain the same from 9am to 9pm. The need for the reduced weekday hours will be reassessed in two weeks (Sunday 17 October).

Dr Chikezie Dean Okereke, Chief of Emergency, comments: “We do all we can to meet the demand in our Emergency Department and UCC, but at times when our staffing is stretched, we have to focus on the Emergency Department first as this is where the most unwell patients who need the most urgent attention are. We are keeping the UCC open every evening in the week even though the hours are reduced, and weekend hours will remain the same. We strongly recommend that people who have non-COVID illnesses or injuries that are minor, but cannot wait for a GP appointment, still make use of the service. There will not be an x-ray service at the UCC at this this time. It is also important to remind people that for most minor and on-going chronic complaints, you can contact your GP first. As soon as we are able we will return to our usual operating hours for the UCC, and will provide an update in two weeks.”

3 October 2021 Home Page, News

Free virtual panel to support and inspire recovery from substance abuse

Wednesday 29 September 2021: BHB today announces a free virtual panel being offered to the community as part of Recovery Month by the Turning Point Substance Abuse Programme. The theme is ‘Recovery is for everyone: every person, every family, every community’, and the discussion will be on Thursday 30 September from 1pm to 2pm.

The goal is to share wisdom, experiences and insight to inspire and encourage people in Bermuda who have loved ones or are themselves on the journey of recovery.

Hosted by Dayla Burges, Addiction Counsellor at Turning Point, the panel members are: Juanae Crockwell, holistic counsellor of ‘A Little Girl Grows Up’; Shervin Hollis, recovery advocate; Gordon Johnson, community recovery advocate; and Michaela Smith, certified fitness instructor of Hope Fitness Bermuda.

Shirley Place, clinical director of substance abuse at MWI, comments: “We want to offer to the community an opportunity to hear from people who can help support and inspire anyone with an interest in substance abuse recovery. We all have a part to play, whether we have an addiction, or it is a loved one or friend. Recovery needs community support and understanding. Having an open panel allows us all to learn, be encouraged and have their questions about substance abuse recover answered.”

People can attend via zoom meeting ID 894 045 3622 at 1pm on Thursday 30 September, or go to the BHB Facebook page for a live stream. There will be set questions for the panel at the start, and a segment for attendees to ask questions too.

29 September 2021 Home Page, News

BHB morgue service impacted by the pandemic

Tuesday 28 September 2021: Bermuda Hospitals Board (BHB) today highlighted the need for people to work together when someone dies to help manage the large numbers of deceased, following a rise in deaths related directly to the COVID-19 pandemic.

Deputy Chief Executive Officer R Scott Pearman comments: “The increase in deaths from the COVID-19 pandemic is a tragic situation for many families, first and foremost, and we feel deeply for the grief and pain so many are feeling in our community right now. The high numbers are also putting pressure on the individuals and organisations who would normally support the process from death to burial or cremation, and this includes BHB.

“Our concern is having enough space for all the deceased given the high numbers of deaths we are experiencing. We have already exceeded our regular morgue capacity and are using refrigerated overflow containers. BHB’s respectful goal is to maintain the dignity and safety of the deceased.  For us to meet this goal, however, we need help as some individuals are left with KEMH longer than necessary and this is increasing the number of people we need to have space for.

“Reducing the number of deceased individuals held by BHB will be greatly helped by families working with their chosen funeral director so their loved ones can be picked up from KEMH and be buried or cremated with as little delay as possible. Families are going through so much when someone dies and they may not always know what has to take place for their loved one to be released from KEMH. We have therefore spoken to Government and funeral directors, and developed an information sheet about the process to help families as they work through all the steps that have to take place, and help them prepare for the financial implications and decisions that need to be made.”

BHB Factsheet – When Your Loved One Dies

28 September 2021 Home Page, News

BHB Moves to Highest Alert Level

Friday 17 September 2021

Michael Richmond, CEO and President of BHB, comments:

“After an assessment of our current position at BHB, we are today moving to Disaster Alert Level 4. This reflects the high number of COVID-19 patients in hospital and in the ICU, the pressure on staff, and the impact of the pandemic on our staffing levels.

“Disaster Alert Level 4 is an internal hospital status that reflects the operational pressure we are under. Our staffing levels are being taxed, and we are having to cease all services that are not emergencies or critically urgent until further notice. The figures will be reported by Government later today, but at this time we have more admitted and sicker patients with COVID-19 in hospital than we have experienced at any time during the whole pandemic.

“We are redeploying all available staff to acute, critical care and emergency services. Our employees are professional and dedicated individuals, but they are also human beings and the risk of burn-out is increasingly evident.

“People in the community may not realise the extent of the impact on healthcare services, but they need to be aware that the increasing demand on the hospital may start to impact our ability to deliver the quality of care that we usually strive for each day.

“We are pleading with the community to follow all public health guidance, wear masks at all times inside and outside if within 6 feet of others. Avoid crowds and enclosed spaces. Get vaccinated, please. It is the best defence against serious disease and death.

“We also ask people to take medically fit for discharge family members home. With the hospital under tremendous pressure, we need the staffing and the space for the new admitted patients, both COVID and non-COVID related.”

Update on the impact of the surge on BHB services
· No visitors for long term and acute care patients, other than in exceptional circumstances such as end of life. Restricted visiting for other areas.

· For all BHB services – only emergency or urgent appointments and treatments will be undertaken.

· People should not attend the Emergency Department for a COVID-19 test. It is not a testing facility and needs to focus on people needing emergency care.

· The Emergency Department is under great pressure. People are reminded that with mild COVID-19 symptoms they can call their GP. If they think they must call the Emergency Department first at 239-1301. They should not just turn up.

 

17 September 2021 News

BHB visitor restrictions reintroduced due to delta surge

Tuesday 7 September 2021: Due to the surge in COVID-19 community numbers and increase in inpatient numbers, Bermuda Hospitals Board (BHB) is ceasing visitation of inpatients and long term care residents at KEMH and MWI from Wednesday 8 September, and cancelling elective surgeries from today. Maternity, Gosling (children’s) Unit and intensive care patients will be allowed limited visitation by designated individuals.

Dr Michael Richmond, Chief Executive Officer & President, said: “We appreciate the understanding and cooperation of patients and families as we respond to yet another surge. The pressures these surges bring to staff at the hospitals is immense. We are all working extremely hard to manage our bed capacity and focus resources where they are needed so we are able to care for all who need it, as medical emergencies still happen on top of the increase in COVID-19 cases. It not only adds to the clinical pressures felt by individuals and services, but brings continued financial pressures to BHB and the healthcare system, and we were under pressure even before the pandemic. BHB has worked extremely hard over the last few years to make savings, and we have achieved $11 million in fiscal year 2019/20, $30 million in 2020/21 and we are working to achieve $15 million more through efficiency programmes, contract reviews and management of assets. The financial costs of responding to the pandemic, on top of international increases of medicines and supplies, and the pressure to keep pace with international standards in healthcare to offer the people in Bermuda are immense.

“We know our colleagues in the Ministry of Health are similarly challenged. We are incredibly grateful for the donations from businesses and individuals that have supported the purchasing of supplies and the vaccine clinic, but the costs have exceeded these kind and generous donations. We are working closely with the Ministry of Finance and the Ministry of Health to ensure we can continue to deliver the services needed safely and at a high quality.”

Chief of Staff Dr Wesley Miller commented: “We do not take the return to these restrictions lightly, but are very concerned by the sudden increase in delta variant COVID-19 infections and hospital admissions. Three out of every four local infections are in unvaccinated individuals and, unfortunately, these people are more at risk of serious illness and hospitalisations. BHB is now experiencing an increase in emergency visits and admissions. Higher community transmissions also increases the risks of an individual visiting a loved one and not knowing they are infected. We have once more prepared our overflow ICU in the surgical area so that we can care for all those who need it. These actions divert resources and space, which impacts our other services. We apologise for the impact on patients and families as we manage this surge and thank everyone for their cooperation and understanding.”

Chief of Nursing Judy Richardson commented: “We have seen numbers surge in the community and this is now being seen in our hospitals too. We have been through surges before and know that timely action maximises the safety of all people in BHB units and group homes. We feel for all the people who will see less of their families and loved ones, but our first step is to strengthen the protections that help protect them. We need everyone to play their part in keeping our most vulnerable people safe, so thank the community in advance for their understanding and partnership in following all guidelines and precautions.”

Summary of current restrictions:

Anyone visiting or attending BHB facilities as an outpatient must first go through a temperature and mask check. They must use the available hand sanitisers, wear a mask and maintain physical distancing at all times, including in patient rooms.

Long term care residents, acute care unit and isolation patients on any ward will no longer receive visitors.

Gosling (children’s) Unit will allow limited visits by parents only, and Maternity visiting will stay the same as before, with one designated support person able to attend the birth and visit once a day if the mother stays longer than 24 hours.

The Emergency Department and Lamb Foggo Urgent Care Centre will return to allowing patients only to attend. A companion will only be allowed if the patient is a minor (under 18), a vulnerable adult who needs a carer, or is combative. Any person experiencing symptoms that could be COVID-19 are reminded to call first and not just turn up, as it puts other vulnerable patients waiting at risk.

Free wifi is available at BHB for patients and residents, so they can stay in touch by phone or video.

Inpatient visitation guidelines from Wednesday 8 September by area:

• Acute Care Wing inpatient units (KEMH)
(Ace Barber, Ascendant Partner Re, and Catlin Lindo)
No visitation, other than in exceptional circumstances (such as end of life).

• Intensive Care Unit
One designated individual between noon-2pm and 4-6pm.

• Gosling Ward
Only parents can visit.

• Isolation patients on any ward (MWI and KEMH) (Isolation patients either have a confirmed infectious disease, such as COVID-19, or are waiting for test results. All patients admitted are tested for COVID-19 and are on isolation until they receive a negative results)
No visitors, other than in truly exceptional circumstances (such as end of life). Individuals must be approved by the unit manager before visiting.

• Long term care residents (MWI and KEMH) and Curtis Ward
(KEMH: Cooper, Gordon, Curtis and Perry Units; MWI: Devon Lodge, Reid Ward and all group homes)
No visitation allowed, other than in exceptional circumstances (such as end of life)

• Agape House
No visitors for long stay patients at Agape House. Patients in their last phase of dying will be allowed two visitors in the room at a time who will be required to wear full personal protective equipment.

• Maternity
One designated support person can attend the birth and up to eight hours afterwards. If mom stays on the ward longer than 24 hours, the support person can visit for up to four hours once a day. Doulas will be permitted for labour and delivery only.

7 September 2021 Home Page, News