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Faster and more efficient laundry now in operation

Monday 27 February 2023: Bermuda Hospital Board’s upgraded laundry department has come through its testing phase with a clean bill of health.

CEO & President Michael Richmond commented: “Every single patient care area requires clean, sanitised laundry. I can’t emphasise enough how important it is to have an effective and efficient laundry service supplying the required linens, gowns, towels and other items in the delivery of patient care. In fact, about 6,000lbs of it is cleaned, dried and pressed every day at BHB.

“Prior to the upgrade, our laundry staff were hampered by old equipment that was prone to breaking down. They had to work with an infrastructure that hadn’t been properly upgraded in over 60 years. The ultimate beneficiary of the upgrade is patient care, so my thanks go to all involved in making this project a success and special appreciation for our laundry staff for all they do each day to help us deliver the highest quality and safest care to our patients.”


Laundry Manager Kizzy Philips gave special thanks to the laundry staff and the BIU: “We’ve had six months of the upgrade, and many years of working with old equipment and infrastructure. Taking us through to today, the laundry staff have been fantastic, and we couldn’t have asked for a better working partnership with the BIU. I’m excited to see a laundry facility that helps laundry staff support the clinical services across all our campuses. The new equipment makes a huge difference to our productivity and efficiency, and we are proud knowing that we are now meeting international laundry standards.”

Director of Hotel Services Jerome Swainson added: “The laundry processes all linens, gowns and clothes used by newborns through to those near the end of life, the curtains used across the hospital, microfibre cloths used by Environmental Services, as well lab coats and scrubs for staff. For safety and comfort patients and staff need clean laundry items constantly and we can now deliver this through a more efficient service.”

The project started in July 2022 and cost $6.6 million, in line with its original budget. The impact of the costs on BHB, however, was eased by a $1.3 million donation by a single donor through the Bermuda Hospitals Charitable Foundation (BHCF).

Executive Director of BHCF Kim Pratt noted: “We are very grateful to our donor, the Pritzker/Schwartz, Vlock family, who could see the importance of a modern laundry to the delivery of high quality patient care. The donor had originally reached out during COVID to see how they could help, but responded when they heard BHB needed to upgrade and expand the laundry facility. The donor stated that they know this would have a long-lasting effect. The following is a direct quote: ‘We love Bermuda and the hospital as it is such an important resource for the island we love so much.’”

Vice President of Hotel Services, Facilities and Property Management Danny Moore gave special thanks to the facilities staff and vendors working on the project: “Working with such old infrastructure is extremely challenging and this project was not without its surprises and challenges. It’s great credit to all our partners on the project and internal staff that we worked through them, and managed to keep to the budget. The new laundry is a credit to all involved in the project.”

About the BHB laundry and upgrade project:

What is cleaned in the BHB laundry?

All linens, blankets, curtains, clothes, such as patient gowns and babywear, staff scrubs, microfibre cloths and washcloths. About 6,000lbs of laundry is cleaned, dried and pressed every day.

Which areas does laundry support?

All BHB facilities, including KEMH, MWI, group homes, Agape House and the Lamb Foggo Urgent Care Centre

Number of laundry staff

33 including full time, part time and casual

What new equipment is in the new laundry?

  • Six new washing machines – one 450lb machine, five 160lb machines and one smaller 55lb machine for baby linens and scrubs. There used to be three machines.
  • Six new dryers – five 200lb dryers and one 80lb dryer. There used to be three dryers.
  • Two new folding machines.

What were the infrastructure upgrades?

  • Changes to infrastructure allow a workflow that means soiled linen is sorted in a separate area away from clean linen
  • New hot and cold water lines, steam piping and exhaust ductwork
  • Old boiler room demolished, with new building to house the new hot water system to allow the washers to operate more efficiently
  • New infrastructure design makes repairs and maintenance easier, with access to the back of the dryers, for example
  • New fire suppression system

Project partners:

  • Greymane
  • BAC
  • Noesis
  • ABM
  • Direct Machinery
  • Bermuda Commercial Laundry
  • Especially for You Laundry

History of laundry renovations:

  • The part of the hospital the laundry is in was built in the 1960s and there have been no major infrastructure upgrades since then
  • There was an upgrade in 2004 (18 years ago) when three new 175lb dryers and two new 275lb washers were purchased along with a new air conditioning system, and upgraded steam supply and electrical distribution system
  • In 2008 (14 years ago), a large 450lb washer, two folding machines and new software were purchased
27 February 2023 Home Page, News

BHB looks forward to PEARL benefits

Tuesday 3 January 2022: Bermuda Hospitals Board today outlined what’s in store for the new electronic medical record (EMR), called PEARL (Patient Electronic & Administrative Records Log) and reviewed the project’s success.

Cerner at-the-elbow support helped trouble shoot with staff

PEARL is a replacement for a number of BHB systems, most notably BHB’s main clinical system, which was so old, it was no longer supported by the vendor. Replacing it addressed a critical risk to care, but the full investment in PEARL has been made to catalyse improvements in care across BHB and for Bermuda.

PEARL went live on 29 October 2022 and is now used in all clinical and support areas, and within the billing areas of Finance. Two months following go-live, BHB is transitioning from the implementation phase to a period of optimisation, in which improvements are made based on experience using the system to better work for staff and patients. Future phases are also planned, and this includes the introduction of a portal for patients to view their medical information.

CEO & President Michael Richmond comments: “PEARL is a national investment that has been significantly funded by internal cost savings at BHB, with our capped revenue being flat for the last four years. Our focus has been on ensuring the implementation was successful and that patient quality and safety is enhanced through its use. We are taking this moment to reflect on the programme and look forward to what is ahead. EMR implementations are extremely complex projects and research indicates more than 50% of similar implementations either fail or fail to be properly utilised(1). Given the level of investment required, failure or significant and costly delays were not an option and BHB staff along with our partners have worked tirelessly for over 18 months to deliver the system effectively.

Cerner subject matter expert helps BHB nurses through go-live

“The biggest thank you must go to our staff, who have shouldered a vast amount of work, from design and build workshops to extensive training, and adjusting to a new way of working. They have been working on this project since April 2021, and continued through some of the most devastating COVID waves.

“Although the work leading up to and including go-live was always anticipate to be the hardest part of the PEARL project, this is really just the beginning. We have addressed most of the issues that emerged as we went live with the new system, and our work now focuses on where PEARL can be optimised and improved for staff and patients to create value in the system.”

Chief of Staff Dr Wesley Miller adds: “We did everything required to ensure go-live succeeded, but what happens next excites us the most, not just in the coming weeks and months, but throughout the ten year contracted term. We are very appreciative of the community’s understanding as PEARL has gone live. Improving the care and experience of patients at the very heart of this project, but it does take time. We started looking at how to realise the benefits of PEARL this year, and so we are ready to act and ensure our community gets the best value possible out of the new system.”

The EMR implementation had to navigate numerous COVID waves, including the delta wave which was by far the hardest period for BHB, as well as a hurricane in the countdown to go-live. The project adapted to ensure key milestones were met, and staff had increased support for the implementation to succeed. Activities and issues were all reported through a project governance structure up to the Board.

  • About $1.3 million was saved in costs by nearly all the design and build workshops and EMR meetings (over 1,000 meetings in 2021 alone) being hosted remotely, due to COVID-19.
  • The go-live date was reassessed once, moving from the beginning of September to the end of October, based on readiness assessments in early summer 2022. This was mostly due to the impact of COVID throughout the project’s duration.
  • Additional resources were recruited to support the project as COVID impacted internal resources and increased reliance on partners.

PEARL super user helps acute care unit as PEARL goes live

Chief Hospital Information Officer Keltie Jamieson explains: “Right now, we are going into a period of PEARL optimisation. This is when we take the experience of actually working in the system to identify any additional adjustments and actions to support better processes and staff utilisation of the system. We are also moving towards future phases which will see other parts of PEARL go-live, such as the patient portal. Beyond that, it is about using PEARL every day to make improvements and that continues for the next ten years. We look forward to sharing more in 2023.”

Chief Financial Officer Arthur Ebbin comments: “Every effort has been made to ensure we had a successful go-live so that the project remained affordable. We’ve had a tight governance and accountability framework in place, reporting through senior committees up to the Board. We have also been proactive in getting the support our staff needed to succeed, and worked hard to make the cost savings needed to pay for the project. The major contract with Cerner is paid over ten years, so it is a lot in total, but is affordable for us over time. EMRs help make savings too and the work now takes place to ensure this happens. Cost savings are achieved through system integration, automation of processes, digitisation of records, more efficient services reduced delays and duplications, and the retirement of a number of legacy systems that PEARL replaces.”

EMR background information:

Hospital Incident Command Centres were set up at KEMH and MWI to ensure issues were quickly logged and addressed

Who is the main vendor for BHB’s electronic medical record PEARL?
The main contract is with Cerner Oracle who is the vendor for the electronic medical record, Millennium. The contract runs over ten years to 2030 and includes implementation and operational costs. Phase 1 of the project saw the successful go-live across all BHB locations and services. Future phases of the project will include the implementation of already-paid-for packages, including a patient portal.

How was Cerner Millennium selected?
A competitive request-for-proposal was issued in 2018. Over 100 staff helped evaluation bids and the recommended vendor then went to the Board for approval.

Who are the other vendors associated with the implementation project?
BHB had the assistance of two main vendors, S&P Consultants and Channel 3, who had extensive electronic medical record implementation experience. They provided design, build & project advice, on-the-ground-support, as well as governance and assurance checks to ensure we were ready for a successful go-live. Channel 3 also assisted with a benefits realisation process to help us get the best value from PEARL after go-live. There were a few vendors who helped with system interfaces. Contracts for these vendors went through a competitive selection process.

BHB IT staff ensured the network remained stable and that staff could access the new system as they logged on for the first time

How has BHB paid for the electronic medical record?
EMR implementations are known to be complex and challenging, even outside of pandemics. BHB has managed most of the costs of the project within its capped revenue budget set by Government, which has remained static for the last four years, supported by a programme of cost savings over multiple years. There was one $4.5 million grant for government that was reallocated from an MWI capital project to the EMR in 2021, but there have been no other additional grants or supplemental payments.

How much will the EMR actually cost in total to BHB?
There are many cost savings anticipated, including efficiencies and the retirement of multiple older systems. The net cost of the project over ten years is expected to be in the order of $30 million.

PATI listed contracts in 2022 related to the EMR:

  • To support BHB staff, especially with delays and resource issues caused by COVID, BHB entered into contracts with two main support consultants, S&P and Channel 3. Contracts in the PATI listing 2022 were for this support, with contracts for just over $3 million.
  • Work with other vendors related to building interfaces that were needed to connect to PEARL accounted for $513,000.
  • An executive administrator managed all the meetings and arrangements for the EMR implementation project and go-live of $110,000.
  • On-the-ground support and training from our overseas partners in the period leading up to and just after go-live cost $1.7 million. This includes the Hamilton Princess Contract in the 2022 PATI listing, although other hotels and accommodations were used. This was less than the expected $3 million budgeted for on-island support throughout the project as most pre-go-live meetings were held remotely. Intensive in-person support is critical for the success of any EMR go-live, so could not be done remotely. Staff must be fully trained ahead of go-live and needed subject matter experts immediately available to trouble-shoot issues so that care can continue to be safely delivered through the go-live transition. Unlike hospitals overseas, BHB cannot transfer care or emergency services to another hospital during a transition, so continuity of safe services was even more critical. On-the-ground support included over 160 additional people on-island over the go-live period.


(1) Barriers to Electronic Health Record System Implementation and Information Systems Resources: A Structured Review by Jaillah Mae Gesulga, Alamarie Berjame, Kristelle Sheen Moquiala, Adrian Galido


3 January 2023 Home Page, News

BHB COVID update

Wednesday 28 December 2022: Bermuda Hospitals Board today reports that two of its long term care units are being quarantined due to a number of positive COVID test results in the resident population. There have been both resident and staff positives. As per BHB protocols, all staff in the affected units have been tested.

Family members are being contacted and visitation will be paused until the quarantine is lifted. Anyone who is thinking of visiting a long term care unit resident should call the unit before attending.

Chief of Staff Dr Wesley Miller comments: “We have very well established processes to follow when residents in our long term care units test positive that protect residents, staff and families. While many COVID protocols have relaxed, we have continued with regular surveillance testing for residents on long term care units, as well as testing all patients admitted to acute care areas both at KEMH and MWI. This is a reminder that COVID, along with flu and other respiratory infections are circulating in Bermuda and we still need to protect the people most vulnerable to complications.”

BHB refers queries about exact COVID figures for Bermuda to the Ministry of Health.

28 December 2022 Home Page, News

Three babies born on Christmas Day

Sunday 25 December 2022: There were no babies due to be born on Christmas Day this year, but three special Christmas bundles of joy had arrived by the afternoon.

Troyleta Franklin and Bilal Binns were not expecting a Christmas arrival for their baby. Everything was in place for Christmas day and Santa had delivered all his gifts ready for their children, but a new baby brother decided to join his siblings Jayden Binns and Ari Cannionier early on Christmas morning. Lucki was born at 4:26am at 7lbs and 9.1oz.

“All the presents were ready for our Christmas morning,” Ms Franklin said. “It was so unexpected.”

Photographed from left to right: Troyleta and Lucki, Jayden, Bilal and Ari


Daryl Dill and Staphen Dill were enjoying Christmas morning with daughter, Aren Dill who is five.

“We had finished opening gifts on Christmas morning, but then there were clear signs I had to get to hospital,” explained Mrs Dill. “We thought we were going to have a regular Christmas as the baby was due on 2 January.”

Instead, Justice Rose Dill was born at 9:32am at 6lb and 12oz.

“Her middle name was given by her sister,” said Mrs Dill. “Aren has been calling her little sister ‘Rosie’ for many months.”

Photographed from left to right: Daryl, Justice, Staphen.

A third baby was born in the afternoon. Rebecca Ezekiel and George Scott welcomed a son on Christmas Day at 3:17pm, weighing 7lbs.

Maternity nurses decorated the baby cribs so that every baby born on Christmas Day felt celebrated.

25 December 2022 Home Page, News

BHB jobs fair attracts over 300

Thursday 22 December 2022: Bermuda Hospitals Board (BHB) hosted a successful job fair and speed interviewing event on Tuesday 20 December at the Hamilton Seventh Day Adventist Church Hall. The jobs fair ran all day from 9am to 6pm, and over 300 members of the community attended. Organised by BHB’s People Directorate (Human Resources), over the course of the day over 600 interviews were conducted with job seekers to fill vacancies in administrative, nursing aide, facilities, maintenance, food and environmental services departments.

Deputy CEO R Scott Pearman commented: “We are really pleased to see such a good turnout for the job fair. It has been a win-win event. For people looking for work or looking to join BHB, it was an great opportunity to get interviewed. For BHB, these are critical positions for the safe and effective running of our hospitals. They are not new positions but existing ones, and filling them helps the us run more efficiently.

“The purpose of the job fair was twofold: first, we want to put Bermudians back to work, and there is no better time than Christmas to give opportunity for the new year. Secondly, the job fair is part of our strategy to advance recruit for positions that may become available in the coming months. Delays in filling posts increase operational costs therefore we now have a rich pool of talent to fill future vacancies within a shorter time period. Even if participants don’t get an immediate follow up call for January, future opportunities may become available.”

Mr Pearman added: “The People Directorate team observed that 122 of the attendees are currently unemployed, so we are pleased to offer them an opportunity to get back on their feet and contribute to their country, as several expressed during their interviews. There were many older and mid-career applicants, and a substantial number of hungry young applicants. On a positive note, there was a rich, ready-made talent pool of certified nurse assistant applicants who had been through the Bermuda College programme, highlighting the benefit of such courses at the College. We encourage members of the community to explore healthcare, dietary and facilities management training programmes on offer at the Bermuda College as they prepare people for future job openings at BHB.

“On behalf of BHB, I would like to thank all of the applicants who came forward to offer their services, and I would also like to thank my People Directorate team for organising the event for the community to attend. BHB and our union partners look forward to on-boarding new employees from this event in 2023.”

People who could not attend the event but are interested in working at BHB can find BHB vacancies and apply at BHB Jobs Now on this website.

22 December 2022 Home Page, News

BHB updates COVID guidelines

Monday 5 December 2022: Following the end of the public health emergency laws, BHB updated its COVID-19 guidance for patients and visitors from 1 December. BHB has also returned to alert level 1 (the lowest level), for the first time since 2020.

Chief of Staff Dr Wesley Miller comments: “Although public health emergency laws ended on 30 November, COVID-19 and other respiratory diseases, such as flu and respiratory syncytial virus (RSV), are still dangerous, especially to vulnerable people who are older, immunocompromised or unwell.

“The winter months have long been challenging for BHB, even prior to the pandemic, with increased emergency visits and admissions. This means, while we have returned to alert level 1, we remain cautious. We are, for example, maintaining precautions for staff during patient interactions, so people will find that BHB staff are masked when they have their treatments or tests, or if someone enters their inpatient room.

“There is certainly a balance between protecting our vulnerable patients, while accepting that the community is returning to normal practices throughout Bermuda. The public health emergency is over, but if you are visiting a loved one in hospital they may be more vulnerable to an infection due to age or illness. We are asking you to help protect them by wearing a mask in their room as you are in close contact for longer periods of time.

“People should also feel comfortable remaining masked throughout any other areas as a precaution. Masking in communal areas is recommended, though not mandatory, and we will continue testing patients before admissions and surgery, and regular surveillance testing in long-term care areas.”

Overview of precautions for visitors and patients from 1 December:

General masking at BHB:

  • Masking is recommended but not mandatory in most communal areas of the hospital outside of patient rooms.
    There will no longer be mask and temperature checks at the door.

When masks should be worn:

  • BHB staff will continue to mask for patient interactions, including outpatient consults, testing and in inpatient/resident rooms.
  • Patients and visitors who are vulnerable themselves should wear a mask in all areas of BHB.
  • For parents and visitors, masks must be worn in the Special Baby Care Unit (SCBU), and masking is strongly recommended in all of Maternity.
  • Patients who have cold- or flu-like symptoms must wear masks if they need a service that cannot be rescheduled, for example, a dialysis treatment or emergency visit.
  • People visiting patients or long-term care residents who are on isolation must wear the appropriate protection as advised by BHB staff before entering an isolation room.
  • People visiting patients or long-term care residents are strongly recommended to wear a mask while in patient rooms as patients and residents are more vulnerable to serious complications of a respiratory infection.

Other protections that will remain:

  • Symptom checking surveys will continue for people attending BHB outpatient services.
  • Patients who have symptoms or have tested positive for COVID-19 should reschedule hospital appointments if possible. If it is urgent for someone with symptoms to attend BHB (eg a dialysis treatment or emergency visit), they should advise staff and wear a mask.
  • All patients admitted to BHB inpatient units and people undergoing a surgical procedure will be tested for COVID-19.
  • Surveillance testing for residents in long-term care units across BHB will continue every two weeks.
  • Staff, patients and residents in any area of BHB who exhibit symptoms will be tested for COVID-19.

BHB visiting guidelines remain as follows:

Emergency Department and Lamb Foggo Urgent Care Centre:

  • Patients will be allowed one support person while in the Emergency Department or Lamb Foggo Urgent Care Centre.
  • Vulnerable adults and all children will be allowed up to two support people.
  • For patients near the end of life, up to two support people can attend.
  • If someone dies in Emergency or is brought to the hospital after passing away, only one person and one support person for that individual can attend. Up to three people can be in the family room. Other family and friends should not attend, as there is not adequate space to gather safely and the ability to offer viewings is very limited.

Acute care patients in the Acute Care Wing units (Ace Barber, Ascendant Partner Re, Catlin Lindo):

  • Patients who are not on isolation can have up to two visitors in their room at any one time between noon and 8pm.

Mid-Atlantic Wellness Institute acute inpatient care units (adult, child and adolescent services):

  • Pre-identified support people can visit for one hour each day between noon and 6pm.
  • Support people must check in at the front desk.
  • One person can visit a patient at any one time, and visitation will be in a public space, such as a family conference room.

Long-term care units (KEMH and MWI, including group homes):

  • Up to two people (one at a time) can visit each resident for two hours each day between noon and 7pm.
  • No more than two visitors are allowed in rooms with more than one resident at any given time.

Isolation patients in all areas of BHB:

  • Two designated support people pre-identified by the patient can visit for up to two hours per day, wearing required protection as advised by BHB staff.

Intensive Care Unit:

  • Designated support people may visit for two hours between 10am and 2pm, or 4pm and 8pm. Visitors must be on the ICU visitors list.

Maternity Unit:

  • Symptom screening is required for support people and visitors. If they have symptoms, they will not be allowed to attend.
  • One designated support person may stay as long as needed after the birth.
  • If the mother is not discharged within 24 hours, visitors will be allowed to visit between noon and 8pm.

Gosling Unit:

  • Up to two parents may visit minor patients.
  • Adult patients can have up to two designated visitors (one at a time), between noon and 8pm.
5 December 2022 Home Page, News

PEARL Implementation Update

Sunday 13 November 2022: Bermuda Hospitals Board today provided an update on its progress with the implementation of its first BHB-wide electronic medical record system, called PEARL (Patient Electronic & Administrative Records Log).

Chief Executive Officer & President Dr Michael Richmond noted that the first two weeks had not been without their challenges, but that activity was beginning to return to normal.

He said: “The success of the implementation has been carried by our staff, external physicians and our partners, who prepared all they could, then have worked through the early expected issues that a major system implementation experiences. It has been a true team effort, as PEARL connects all parts of the hospital from pharmacy, diagnostics, finance and support areas to emergency, acute and critical care at all campuses.

“The good news is that we are on track and, after two weeks of having a slow down in our planned and outpatient activity, services will be running at normal capacity from Monday, including the number of elective surgeries. These are still early days, but issues have been managed, staff are mastering the new system, and we wanted the community to be fully informed about our progress.”

Despite a planned slow down in planned and outpatient activity, over the first two weeks after go-live there were still 3,267 encounters in ambulatory care (outpatient clinics and diagnostics), 150 surgeries (elective and emergency) and 20 babies born. In areas where activity could not be controlled, the normal activity levels were experienced. There were 1,011 people who attended the Emergency Department and Lamb Foggo Urgent Care Centre, and 142 admissions to an inpatient ward. This reflects KEMH and MWI wards.

In the Emergency Department, the average length of time between arrival and discharge did increase in line with expectations in the first week, but has gradually decreased since then (see data below).

Dr Richmond added: “I would like to extend my appreciation to the community for their understanding. We know it has been a challenge at times for patients in Emergency with longer average stays than normal, and elective procedures were reduced in the first two weeks. But the great promise of PEARL is to that as we work through this period we will be able to improve our care, smooth transitions, and use the system to help us deliver a better, safer care experience.”

PEARL went live in the early hours of Saturday 29 October, when information was transferred and then validated. Staff in different departments started using the system from the early afternoon.

The following is the ED length of stay (from arrival to discharge) for each day following go-live. The average length of stay up to 29 October in ED was 198 minutes (3 hours and 18 minutes).

Emergency average length of stay per day (midnight to midnight) in minutes

  • Saturday 29 October (partial day): 294
  • Sunday 30 October: 405
  • Monday 31 October: 442
  • Tuesday 1 November: 358
  • Wednesday 2 November: 485
  • Thursday 3 November: 366
  • Friday 4 November: 285
  • Saturday 5 November: 289
  • Sunday 6 November: 239
  • Monday 7 November: 289
  • Tuesday 8 November: 190
  • Wednesday 9 November: 160


13 November 2022 Home Page, News

PEARL Go-Live Milestone Celebrated

Saturday 29 October 2022: BHB’s CEO & President, Michael Richmond, provides this update on the go-live over the new electronic medical record, PEARL (Patient Electronic & Administrative Records Log) that took place overnight:

“I’m happy to state that BHB’s new electronic medical records system, called PEARL, is now being used across BHB in inpatient units and Emergency, at KEMH and MWI, including group homes. We are on target for the outpatient clinics to start using PEARL when they open on Monday 31 October. The system went live just after midnight and we had a very busy night with staff across MWI and KEMH working hard to input and validate data. As is expected with a new system of this complexity, we’ve had issues to address through the day, but the response by staff has been magnificent. PEARL is live and for the first time in BHB’s history, we have a BHB-wide electronic medical record. While our staff members are going to be a bit slower in these first few days as they get used to PEARL, we have multiple supports in place as they put their training and preparations into practice. Today is a milestone day in the delivery of care BHB and we are all looking forward to the benefits having an electronic medical record are going to bring to safety, quality and efficiency at BHB. I’m incredibly proud of what our staff have achieved – they have been at the forefront of this major change and have gone above and beyond the call of duty to make it happen. As we get through this adjustment period, it is something that Bermuda is going to be proud of too.”

29 October 2022 Home Page, News

BHB prepares for PEARL’s implementation

Thursday 27 October 2022: Bermuda Hospitals Board (BHB) today provided an update to the community about its first BHB-wide electronic medical record system, which goes live in the early morning of Saturday 29 October. The system has been called PEARL (Patient Electronic & Administrative Records Log) by staff.

Nurse on an acute care ward with a ‘workstation on wheels’ that can be used in patient rooms

PEARL is an electronic medical record system that makes patient information, from medical history to the latest physician notes and test results, immediately available to those who are involved in a patient’s care. This information will no longer be on paper or limited to fragmented systems. This means BHB staff caring for patients won’t have to wait for paper records to be delivered, check multiple systems for key information and results, or wait for information that might not have been filed yet. PEARL makes it easier to avoid duplications and delays because everything a clinician needs is immediately available in one place, and always up to date.

CEO & President Michael Richmond notes: “We are preparing for an exciting and significant transition in how we work. A big thank you must go to our staff across BHB for their hard work. PEARL’s implementation rests on the shoulders of hundreds of staff involved in designing, building and testing the system since the project started in April 2021, and over 1,400 staff who
are attending training, even as they meet their duties as care providers.

Staff involved in integrated testing earlier this year

“Our focus now is ensuring BHB maintains services safely throughout the go-live. There will likely be a couple of weeks where staff will be getting used to new processes, and we will run slightly slower than normal, but our ability to use PEARL will quickly become more sure and faster each day. Once we are used to using the system, the opportunities for improvements are going to help us soar.

“Going live with PEARL is just the beginning. PEARL is a tool our staff will use to deliver what they strive to do each day – the best possible levels of care and the best patient outcomes, something of which Bermuda can be truly proud.”

Key information about how BHB is managing PEARL’s go-live:

  • PEARL will be used across all BHB services – at King Edward VII Memorial Hospital, Mid-Atlantic Wellness Institute, Lamb Foggo Urgent Care Centre, and across all BHB group homes
  • All BHB services will continue throughout the go-live process, but it will initially take staff a bit longer to complete tasks as they put their training into practice
  • Elective activity (for example, non-urgent surgeries and outpatient appointments) will continue throughout, but there will be a phased reduction in work – at 50% of normal level in the first week after go-live and 75% of normal level in the second week after go-live. This will give staff some breathing room as they get used to using PEARL, minimising any potential patient safety or care risks. This is a best practice for implementing this kind of system, and follows advice from other hospitals and Cerner on how to successfully manage the transition
  • Emergency services will be open, but patients with minor conditions may experience longer waits. People are advised to see their GP if they have minor issues or need help managing their chronic illnesses
  • Additional Cerner employees and BHB staff who are PEARL super users will be positioned in departments, supporting staff ‘at the elbow’ in the first two weeks after go-live
  • A multi-level command centre structure is in place for the first two weeks in case there are issues that can’t be resolved at the department level, but need quick and effective resolution
  • After 10 November, we anticipate normal levels of elective activity will be restored, including surgeries

Chief of Staff Wesley Miller explains: “I am very proud to work with our staff as we prepare for this implementation. PEARL is going to transform what is possible in delivering the very best in safe, quality care across BHB. A system implementation of this size and complexity isn’t easy, but the reward of working through it will be in the enhanced ability to improve patient care and outcomes, which is at the heart of all we do.”

Chief Hospital Information Officer Keltie Jamieson adds: “Our focus over the next few weeks is on maintaining safe services as staff adjust. There will be a lot of on-the-ground support in departments as well as escalation processes for issues as our hard-working staff get used to something new. Patients and visitors in the first two weeks will see additional people in bright t-shirts who are the in-department support. We have done all we can to test and test PEARL again, but issues are normal in any major system implementation. The key is having robust structures to escalate and resolve them, which we have.

“There is so much to look forward to once we are through this implementation period, but step one is a successful implementation. That will give us the strong foundation we need to use PEARL as a tool of constant improvement in our pursuit of excellence.”

Click here for more information about PEARL


Editor’s Notes – PEARL’s development to date:

  • PEARL will replace multiple BHB systems, and was necessary as BHB’s main clinical system was old and no longer going to be supported by the vendor
  • Cerner was selected via a competitive process involving about 100 BHB staff starting in 2018, with final approval in 2019 from the Board
  • The project was due to start early in 2020, but was postponed for a year due to the pandemic
  • The electronic medical record project started on 1 April 2021
  • The system was designed and built by the vendor, Cerner, in partnership with over 350 BHB staff
  • There have been two extensive rounds of integrated testing, involving BHB staff who ran patient scenarios to test all parts of the system
  • Although the project was undertaken because BHB’s main clinical system is being retired by the vendor, electronic medical records are the international standard of care. With all information in one place and clinicians across BHB able to share real-time orders and notes, care processes – such as a patient visiting emergency and being triaged, tested, diagnosed and admitted to an inpatient ward – can take place more efficiently
27 October 2022 Home Page, News

Lamb Foggo Urgent Care Centre services to open weekends only for a month

Wednesday 19 October 2022: Bermuda Hospitals Board (BHB) today notes that the Lamb Foggo Urgent Care Centre (UCC) will close on weekdays from Wednesday 19 October, for at least a month. The UCC will remain open during its usual hours on weekends from 9am to 9pm. This only relates to urgent care services, and does not impact the weekly Integrated Healthcare Clinic that runs on Wednesdays.

Chief of Emergency Dr Chikezie Dean Okereke notes: “The closure on weekdays helps us focus emergency staff at KEMH to manage the pressures being felt in the emergency department. Emergency visits right now are high and bed occupancy within BHB is also under pressure, so we are focusing our nurse and physician resources where the most unwell patients are. This has happened to us before as we move into the colder months. The emergency patient numbers are not related to any one cause. They are multifactorial and include, among others, a generally unwell and increasingly aging population. We expect the UCC will remain closed on weekdays for at least a month, but we will continually review the situation.”

Chief of Staff Dr Wesley Miller adds: “There are ways we each can reduce the need for emergency visits that are better for our quality of life as well as reducing pressure in the hospital. We would urge people to manage their known chronic illnesses and see their GP as needed for advice and treatment, before it requires a hospital visit.

“We are also entering a time when respiratory illnesses are rising. People should do all they can to protect themselves by getting their flu and COVID vaccines, especially if they are older or have pre-existing conditions that make them vulnerable to serious complications. We also want to see people drive more carefully on the roads, avoiding unnecessary and sometimes very serious injuries.

“Finally, we ask that people who are ready for discharge are helped home or to a nursing placement by their loved ones and families. We still experience people staying in hospital longer than they need to be and this causes delays that impact emergency staff as patients wait there longer for an inpatient bed.”

19 October 2022 Home Page, News