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

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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

HAB donates biomedical van

Wednesday 12 October 2022: The Hospitals Auxiliary of Bermuda (HAB) today announces it has donated a van to Bermuda Hospitals Board’s (BHB’s) Biomedical Engineering Department.

Patrick Cerra, HAB executive member, commented: “HAB is delighted to donate this bio-medical van to the hospital. It should be noted that this is just part of our annual donation programme, in which we typically donate over $300,000 to the hospital to purchase off-budget medical equipment and supplies.”

The Biomedical Engineering Department is responsible for maintaining, installing and safely using healthcare technology at King Edward VII Memorial Hospital (KEMH), Mid-Atlantic Wellness Institute (MWI), Lamb Foggo Urgent Care Centre (UCC) and group homes. They perform routine checks to catch problems before they become life threatening or extend wait times for critical diagnostics, such as MRIs, CAT scans, X-rays and mammograms. They also respond to emergencies if medical equipment needs repairs. With the purchase of the new van, the team will be able to quickly respond to calls for assistance with technology.

“Every year the HAB works with BHB to assist with our goal to pursue excellence through improvement, to make Bermuda proud,” said BHB CEO & President Dr Michael Richmond. “We are grateful for this donation from the Hospitals Auxiliary of Bermuda that helps keep care services running.”

BHB Biomedical Engineering Manager E Michael Smith said: “On behalf of the biomedical team, I would like to thank the Hospitals Auxiliary of Bermuda for their thoughtful donation. This new vehicle will allow the biomed team to better serve our clients throughout all BHB facilities.

“We make weekly rounds to the UCC, MWI and KEMH as well as to the group homes to service the various types of medical equipment. We will no longer be challenged to provide the needed service to our clients in those locations with this new transportation, and for that we are very thankful.”

BHB’s electronic medical record to go live in October

Tuesday 20 September 2022: Bermuda Hospitals Board (BHB) is pleased to provide an update to the community on its electronic medical record project, which will go live on 29 October 2022.

Since the project started in April 2021, hundreds of BHB staff have been working within dedicated work streams with our vendor, Cerner. Staff have named the new system PEARL (patient electronic & administrative records log).

When PEARL goes live, there will be one electronic record for every patient across King Edward VII Memorial Hospital, Mid-Atlantic Wellness Institute and the Lamb Foggo Urgent Care Centre. PEARL will include medical history, test results, physician notes, and important information such as allergies, which will be available to clinicians, whichever service a patient is accessing at any time.

With all the information immediately at hand, care should be more efficient. With safety alerts built into the system, it will be safer too. PEARL will speed up access to critical data, centralise the scheduling of appointments for all BHB services and replace older paper-based processes such as referrals.

As staff members have to sign in to access PEARL, there is also greater confidentiality as the system records every person who opens a record even just to view it.

In line with plans, the patient portal will not be part of the initial go-live in October, but will be a benefit of the system and is planned for phase two of the project.

Progress on the electronic medical record implementation:

• The design and build of PEARL, which involved frontline staff across BHB, is complete.
• Integrated testing – in which BHB staff test the entire breadth of the system (including registration, scheduling, prescribing, referring, documenting, coding and billing) using differing patient scenarios – has been completed.
• Organisation-wide training started in June and continued through to go-live in October. About 1,400 staff have to be trained. The training is customised for different roles and professions within BHB. It includes different ways to learn, from videos and online simulations to intensive class room training.
• Over 200 BHB staff have been selected as PEARL experts, called super users, in each department. They will be on hand to support their colleagues in their department through and beyond go-live.

In the first two weeks after go-live on 29 October, staff will be adjusting to a new way of working so things may take a little longer than usual. Where pressure can be relieved by reducing activity for non-urgent appointments and consultations this is being planned, to avoid increasing delays or potential risks to care. This will also help ensure that emergency and urgent care continues as needed.

CEO & President, Michael Richmond, MD, explains: “While our need to implement an electronic medical record relates to the critical replacement of an old clinical system, PEARL is a true game-changer for patient care and is a major driver of our vision to pursue excellence through improvement, to make Bermuda proud. It has been a huge commitment for our staff through a very challenging period. I’m immensely proud of our progress so far, very appreciative of the hard work by staff, and very much looking forward to PEARL going live in October.”

Chief of Staff, Wesley Miller, MD, says: “BHB physicians have been part of the BHB clinical teams working with Cerner to design and build PEARL. Cerner’s Millennium product is used in hospitals across the world, so we have the benefit of starting with a system that has international standards of care and safety built in that BHB staff have helped adapt for Bermuda.”

Chief Financial Officer, Bill Shields, comments: “This is a major transformation of how BHB works and delivers care. Our focus for go-live is to have the internal system working well for staff to use. As we are working hospitals and Bermuda’s only hospitals, ensuring a smooth and safe transition is our priority. We look forward to keeping the community updated on our progress.”

Chief of Nursing, Judy Richardson, adds: “PEARL is going to be a great asset for staff. It is going to be a tool nurses can use to improve quality and safety, and the efficiencies it will bring means more of their time can be spent where it is most needed – with our patients.”

BHB awards $100,000 in scholarships to eight students

Tuesday 6 September 2022: Bermuda Hospitals Board (BHB) today announces the awarding of eight scholarships, worth $100,000 over one or more years. All the scholarships are administered and by BHB, with funding for one from GlaxoSmithKline Insurance Ltd, a Bermuda-based subsidiary of GlaxoSmithKline plc ($40,000).

Dr Michael Richmond, BHB President & CEO, comments: “Congratulations to all the scholarship recipients and I wish them all the best with their studies. It is important for BHB to provide funding for Bermudians to obtain post-secondary education while also providing them with a placement for summer internships. I would also like to thank our community partner GlaxoSmithKline who continues to support young Bermudians in the pharmaceutical field.”

Scholarships funded by BHB:

Britney Bannister attends Sheffield Hallam University, where she is studying to obtain her Master’s in Dietetics. She was awarded the BHB General Scholarship for $10,000 for one year.

Camia Pitcher attends Leeds Beckett University, where she is studying to obtain her Master’s in Dietetics. She was awarded the BHB General Scholarship for $10,000 for one year.

Naomi Lightbourne is attending the University of Essex and is obtaining her Master’s in Occupational Therapy. She received the BHB General Scholarship for $10,000 for one year.

Ivy Ingham is attending Kettering College and is obtaining her Bachelor’s in Nursing. She received the BHB General Scholarship for $10,000 for one year.

Paige Raynor is attending Barry University and is obtaining her Bachelor’s in Nursing. She received the BHB General Scholarship for $10,000 for one year.

Theresa-Lynn Santucci is attending the University of Salford Manchester and is obtaining her Bachelor’s in Nursing. She received the BHB General Scholarship for $10,000 for one year.

Taniece Wilson – Edmead is attending Keiser University and is obtaining her Certification in Nuclear Medicine. She received the BHB General Scholarship for $10,000 for one year.

GlaxoSmithKline Scholarship:

Jay-Quan Dill attends the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and is obtaining his Doctor of Pharmacy. He was awarded the GlaxoSmithKline (GSK) scholarship for $20,000 for two years.