‘Understanding Prostate Health’ booklet and PSA guidelines launched

Tuesday 11 February 2025: Bermuda Hospitals Board today launched an ‘Integrated Health Care: Understanding Prostate Health’ booklet and PSA testing guidelines as part of the outcome of work undertaken to develop an integrated prostate cancer care pathway in Bermuda.

The booklet aims to provide information to help men better understand prostate issues, prevention, risk and treatment for many prostate conditions including cancer, in Bermuda. Click here to read the booklet.

The PSA testing guidelines establish a standardised approach in Bermuda.  Click here to read the guidelines.

The Minster of Health, the Hon. Kim Wilson JP MP, comments: “Prostate cancer is the number one cancer affecting men. In fact, it makes up 33% of cancer diagnoses in men in Bermuda with over 50 new cases identified in Bermuda each year. It needs our attention now because mortality rates in Bermuda for prostate cancer are twice that compared to the OECD average. It is critical we understand and improve our care pathways for prostate cancer so we can deliver the most effective screening and the best, most efficient treatment for men who are diagnosed.”

CEO & President of BHB Scott Pearman said: “This integrated prostate cancer pathway follows on from similar work completed for breast cancer that has seen improvements in the pathway for women. We are also working with Johns Hopkins on pathways for trauma and burns care, which we hope will also improve the efficiency and effective of our trauma and burns response. The central purpose of the cancer pathways is about making a difference in the lives of people in Bermuda. We want to make screening more effective and available, to catch cancers as early as possible when there is the best chance of a full recovery.  We also want to raise awareness about risks and prevention, and to improve the care pathway for men diagnosed with prostate cancer so that we can improve outcomes and save lives.”

BHB Consultant Urologist and founder of the DailyMale charity, Dr Jonathan Makanjuola, noted: “I would specifically like to thank the following individual got validating the pathway and guidelines. Dr Fosker from the Bermuda Cancer & Health Centre for helping validate the pathway. Dr. Michael E. Czerwinski, Consultant Urologist, Island Urology Services. Dr. Michael E. Brooks, Consultant Urological Surgeon, Dynamic Urology Services. Dr. Jeff MacLeod and Dr. Adil Ladak, Island Health Services FPG. Dr. Kyjuan H. Brown, President, Bermuda Medical Doctors Association and Dr. Ayoola Oyinloye, Director of Population Health Innovation and Strategy, Bermuda Health Council.”

He added: “The message I’d like to leave you with today is that when detected early, most prostate issues, including cancer, are highly treatable, and men have a range of options to regain their health and peace of mind. So please read this guide if you are a man or to share with the men in your life.My hope is that this information will empower you to take charge of your prostate health and encourage you to make screenings a regular part of your wellness routine. Together, by staying informed and proactive, we can make a big difference in men’s health in Bermuda.”

Celebrating blood donors this Christmas

Monday 16 December 2024: The Bermuda Blood Donor Centre will be thanking people who give blood over the holiday season in December with a gift kindly donated by the St George’s Group.

Everyone who donates always gets a drink and cookie as they rest for a short period after their donation. Through this month, they will also get a bar of Cadbury’s chocolate.

Chief of Pathology and Consultant Haematologist Dr Eyitayo Fakunle says they are grateful to the St George’s Group for helping them bring some holiday spirit to donating.

“The holiday season is very busy for many people and so we appreciate even more than usual the generosity of our donors, who give up half an hour of their time to donate blood,” he says. “Giving gifts is in the spirit of Christmas and we want to celebrate those who give the gift of life this year by donating.”

People who want to donate can contact the Bermuda Blood Donor Centre at 236-5067, WhatsApp at 533-9553 or email blood.donor@bhb.bm. Clinics run Monday to Friday, 8am to 3pm.

BHB and Johns Hopkins work together to improve local trauma care

Wednesday 11 December 2024: BHB staff and community surgeons were working last week with a trauma specialist from Johns Hopkins, Dr Kent Stevens, to improve the care and outcomes for trauma patients in Bermuda. This work is being undertaken as part of BHB’s clinical affiliation agreement with Johns Hopkins Medicine International.

Dr Stevens was joined by BHB staff from the Emergency Department, Intensive Care Unit, Surgery, Pathology, Pharmacy, Imaging Services and Executive Team and community surgeons to discuss local service improvements and a possible transatlantic clinical collaboration that will give local physicians access to Johns Hopkins specialists when managing the most challenging individual cases.

CEO & President, Scott Pearman, comments: “BHB’s vision is to pursue excellence through improvement, to make Bermuda proud and this week has seen our vision in action as we focused on improving trauma care for patients on island. We have amazing staff and community surgeons who work round the clock – literally – to save the lives of people injured through accidents, crashes, shootings, and stabbings. All of us in Bermuda rely on these individuals if we experience a medical trauma and it’s great to see our clinical affiliation with Johns Hopkins Medicine International provide the support our local providers need as they work to make improvements.”

Acting Chief of Staff, Dr Anna Neilson-Williams, adds: “This has been a fantastic few days of work with all the BHB departments and external surgeons who are part of the trauma response teams working together with Johns Hopkins to improve care for our patients in Bermuda.

“When a patient is hurt due to an accident, crash or violent incident, there are many moving parts in the medical response. The timing of all of these parts coming together is critical in getting a patient diagnosed and treated efficiently and effectively. Following a traumatic incident a fast response is often crucial to save their lives whether they can be fully treated in Bermuda, or require stabilisation before being sent overseas. Our focus has therefore very much been on how we can coordinate our response more effectively and quickly, and discussing solutions to the limitations of living on a small island where we don’t have on-the-ground specialists to cover every single trauma need. I’m looking forward to the next steps of working together to take all the issues, comments and ideas raised this week and turning them into improvements on the frontline that will directly benefit our patients.”

Dr Stevens comments: “It really has been a pleasure to visit Bermuda and meet with local healthcare professionals to improve the trauma pathway. I’ve been impressed with the facility and staff. Bermuda should already be proud, but in healthcare, improvements are always possible. I’ve been able to share knowledge about the quality standards and processes we use at Johns Hopkins and my experience of dealing with very similar issues faced by the teams here. I look forward to exploring additional opportunities to support local service improvements.”

Mr Pearman concludes: “The trauma care pathway is one of the many care pathways we are working to improve at BHB. The heart of this work is about collaborating with other providers and patients in Bermuda to make improvements that really make a difference to patient experience and outcomes. So far, we have developed integrated stroke, breast cancer, and prostate cancer care pathways. Johns Hopkins is currently helping develop improved pathways for trauma and burns at this time, much in same way this partnership has helped BHB establish its primary stroke centre programme.”

BHB publishes guide to help identify when medical care is needed for measles

Monday 25 November 2024: Bermuda Hospitals Board today issued a patient self-assessment guide to help patients and carers identify when medical advice and hospital care is needed for patients with suspected or confirmed  measles infections. Click here for the guide.

Chief of Emergency & Hyperbaric Services Dr Chikezie Dean Okereke comments: “While most patients can get through a measles infection by staying hydrated and taking fever medication, such as Tylenol and Ibuprofen, the complications of measles can be extremely serious and people need to know when medical advice or hospital treatment is needed.

“In recent US outbreaks, 20% (one in five) of unvaccinated people who had measles were hospitalised. It is an extremely infectious disease. You can catch measles by walking into a room that someone infected with measles left two hours before.”

The Measles Patient Symptom Self-Assessment Guide has been designed to help people decide when they should stay at home, and when they need to call for medical advice or emergency treatment.

Dr Okereke stated how it important it was that even when emergency medical care is needed, no one with measles or suspected measles should just turn up at the Emergency Department. Patients or carers should call in advance so the Emergency Department can safely attend to the patient in need without putting other people at risk.

“We also want to remind people that prevention is the best form of protection. History is full of stories of measles tragedies that vaccination for the most part has eradicated. We need to do all we can to stop it re-emerging as a threat to our children and families.

“On the back of the positive measles cases in Bermuda, we are encouraging masking in hospital waiting areas, and in the Emergency Department it is now a requirement.

“Vaccination remains best and safest way to safeguard against measles and its complications. It is extremely effective (97%) and according to the World Health Organization, has saved about 60 million lives since 2000. The vaccine is readily available here in Bermuda from your GP, paediatrician and the Government clinic (278-6460). It requires two jabs one month apart for the highest level of protection, but even after the first jab your protection from this disease will be vastly improved.”

Free public event to focus on treatments for urinary incontinence

Wednesday 16 October 2024: Bermuda Hospitals Board is partnering with Lahey Hospital & Medical Center, Optimum Wellness and the Bermuda College Division of Nursing & Allied Health to offer a free, public panel discussion about the latest treatment options for male and female incontinence.

The free event will take place from 3pm to 5pm on Saturday 19 October in the Bermuda College Lecture Hall H-100. The goal is to share the latest treatments for urinary incontinence and improve understanding about this common issue. No registration is required; people can just turn up.

The following experts will provide short presentations, followed by a Q&A panel discussion in which attendees can ask questions.

• Dr Jonathan Makanjuola, Urology Consultant, Bermuda Hospitals Board
  Learn how your family doctor can assess you for lower urinary tract symptoms,
  and become familiar with questions you can ask about your urinary habits.

• Dr Jessica Mandeville, Director of Endourology, Lahey Hospital and Medical Center
  Learn about medical and surgical treatment options for an enlarged prostate.

• Dr Arthur Mourtzinos, Vice Chair Division of Urology, Lahey Hospital and Medical Center
  Learn what the current surgical options are for managing urinary incontinence for men and women.

• Michelle Monk, Registered Physiotherapist and Pelvic Floor Provider, Optimum Wellness
  Learn more about the pelvic floor, treatment approaches, common misperceptions,
  what the common dysfunctions are and how to treat them early.

Dr Makanjuola comments: “In the UK it’s estimated that at least 7-10% of the population have urinary incontinence, but this could well be under-reported as people feel embarrassed. If the same is true in Bermuda, that translates to over 6,000 people. Women are five times more likely to experience it, but men are impacted too. We will be sharing some great information that will help people know what to ask their doctor, for example, as well as what the latest treatment options are available.”

Dr Mourtzinos comments; “Lahey is excited to help share the latest treatments available for incontinence for men and women.  Lahey is dedicated to helping care for the Bermuda community. Our specialist urology services along with the treatments and care available on island give patients not just hope but effective treatments when dealing with incontinence.”

Ms Monk adds: “I’m looking forward to sharing some of the physiotherapy options available to improve pelvic floor health and bring relief from urinary incontinence. If you or a family member is experiencing an issue, however minor, it’s a great opportunity to learn more about the latest treatments and therapies available. In fact, there are early treatments that can make a big difference so people shouldn’t wait.”

BHB and Lahey are also partnering to deliver a physician continuing medical education symposium in the morning providing an update on urology. Details about the morning session for physicians can be found on the BHB website under CME events. BHB delivers a year-round educational calendar for free to all local physicians on various medical topics in partnership with leading hospitals from overseas.

Watch on YouTube

Caring for patients at KEMH

Tuesday 15 October 2024: Bermuda Hospitals Board has posted a frequently asked questions (FAQ) on its website that explains how patients are cared for and by whom at King Edward VII Memorial Hospital (KEMH).

CEO & President Scott Pearman says: “We want to demystify as much as possible how care works at KEMH. BHB follows the same quality standards as the UK, US, and Canada, with inpatient acute care led by onsite hospitalists on our acute care inpatient units, with other specialists leading in critical and emergency care units. We often get questions from patients about their inpatient care, especially about the role of their general practitioners (GPs) while they are in the hospital. We hope the factsheet posted on our website will help.”

Acting Chief of Medicine and Director of the Hospitalist Programme Dr Nevin Williams explains: “A common question is about the role of a patient’s GP while they are in hospital. In KEMH, a patient’s care is led by the ‘most responsible physician’ (MRP) and this will be the main contact for the patient and family. At KEMH, your most responsible physician may vary depending on the area you are in, but it will always be an on-site physician specialist with the most appropriate training for your care.”

• In the Emergency Department, the MRP is an emergency physician.
• For a patient admitted after planned surgery, the MRP will be the surgeon.
• Patients admitted to an inpatient unit from the Emergency Department will have a hospitalist as an MRP.
• If a patient becomes critically ill and is moved to the Intensive Care Unit, the MRP will be one of the anaesthetists trained in critical care.

Click here for a factsheet and click here for a short animation about the role of hospitalists on the inpatient acute care units.

The MRP directs the clinical team of nurses, allied health staff (such as physiotherapists and dietitians), and other doctors who might need to advise on a patient’s care, like a cardiologist (heart specialist) or geriatrician (a specialist in senior care). A BHB physician is only the MRP while the patient is in the hospital.

Dr Williams continues: “There are over 3,100 inpatient acute care admissions to KEMH each year, mostly cared for by hospitalists. Hospitalists are doctors with special training in internal medicine and hospital care. They are on site 24/7, so they can quickly respond to any sudden issue a patient experiences.

“The hospitalist’s key focus is providing acute care until a patient is discharged home to their GP. For over 60% of our patients, the hospital stay is under seven days. The relationship between the hospitalist and GP is therefore very important. The patient’s GP is notified by email when the patient is admitted to an inpatient acute care unit under a hospitalist’s care and information is sent when they are discharged to ensure patient care is coordinated when they leave the hospital. We are working to improve this communication, especially using our electronic medical record, PEARL.”

Chief of Family Practice Dr Burton Butterfield, the GP representative on the BHB Medical Staff Committee, acts as the link between community-based GPs and BHB.

Dr Butterfield explains: “As GPs we know our patients well since we see them over long periods of time. Our expertise is in caring for patients with illnesses and injuries in the community, managing chronic illnesses, and knowing when a patient needs hospital care or a specialist. It is important that GPs get timely and accurate information when a patient is admitted. We may speak with the hospitalists in cases where our understanding of the patient’s history may help in making decisions, but most critical for us is getting the discharge summary so we can smoothly coordinate the patient’s care back in the community.”

Dr Williams notes: “BHB is responsible for sending a patient’s discharge summary to the GP listed on the patient’s admission file, but it’s very important patients confirm their most current information, including their primary GP. They should do this when they come to the Emergency Department or are admitted. It is not uncommon for members of our community to sometimes have more than one GP or change their GP over time. Making sure we have the right details ensures the information goes to the right GP.”

Currently, GPs receive BHB discharge summaries by fax, email or by having read access to the BHB electronic medical record, PEARL. BHB is planning to follow the lead in the UK by discontinuing the use of fax in the future due to issues of reliability and confidentiality . This requires collaboration between BHB and community physicians. The chief medical information officer position, held by Consultant Anaesthetist Dr Simon Morton, is being expanded to lead the work required, and a physician committee that includes GPs is already meeting to help optimise the use of PEARL in sharing secure and confidential patient information.