KEMH acute care visiting guidelines available on website

Friday 5 June 2020: Bermuda Hospitals Board has today posted a factsheet with details about the current visiting limitations for acute care units at King Edward VII Memorial Hospital (BHB COVID-19 Phase One Visiting Factsheet.) A short animation has also been posted to help inform people about the current guidelines.

Norma Smith, Vice President Acute and Ambulatory, comments: “We have fielded a lot of calls about the new visiting policy, so we want to make the information as freely available as possible. We are aware that many people want to visit their loved ones in hospital, but we have to remain cautious while the threat of COVID-19 remains. The acute care units care for our biggest patient group and with new admissions every day, we hope these additional resources are useful.”

There are four KEMH acute care units. Three are in the Acute Care Wing (Ace Barber, Ascendant Partner Re and Catlin Lindo), and one in the General Wing (Curtis Ward).

The only exception for the following requirements are patients in isolation (including those with non-COVID-19 infectious diseases), and patients awaiting the results of COVID-19 tests.

Visiting Requirements for KEMH Acute Care Wards:
• Patients in all the acute care wards can designate two support people to visit.
• Visitors are required to check in first at the front desk in the ACW, where the names of all support people are listed.
• They can visit up to two hours between 12 noon and 6pm every day.
• Only one person can visit at a time in Curtis Ward, where there are public and semi-public rooms.
• Two people can visit in the ACW units as rooms are larger and private, so physical distancing can be maintained.
• Visitors must remain masked and maintain physical distancing at all times (even with patients).
• Visitors should also wash hands regularly and well on entry and exit to the hospital, ward and patient room and in between if necessary.
• Visitors should also only use public restrooms, and not use patient bathrooms.

BHB moves to limited visitation

Wednesday 3 June 2020: Bermuda Hospitals Board (BHB) today announces that it will allow limited visiting for its acute care patients in King Edward VII Memorial Hospital (KEMH) and Mid-Atlantic Wellness Institute (MWI) from Wednesday 3 June 2020.  This is a phase one relaxation of visiting restrictions.

To safeguard patients and staff, visiting was stopped in April, except for end of life, births and unwell children. This was due to the increasing number of COVID-19 infections in the community and the risks they posed to patients who were already unwell.

Judy Richardson, Chief of Nursing, comments: “We are not out of the woods yet and COVID-19 remains a threat. However, we understand the huge difference it will make to those in our care to see their loved ones. We are moving cautiously and monitoring the COVID-19 presence in Bermuda closely, but hope that continued low infection rates will allow us to gradually relax further in the coming weeks and months ahead.”

Norma Smith, Vice President of Acute and Ambulatory, comments: “Visitors are a vital support for patients, bringing love and connection to those in our care. It was such a hard decision to stop visitation, and as long as infection rates remain low and all government rules on wearing masks, physical distancing and hand hygiene are followed, we will allow limited visitation from 3 June.”

The one exception to the change is that patients on isolation will not be able to receive visitors. This includes all patients who are confirmed as having COVID-19, or who are awaiting COVID-19 test results. All patients admitted to a BHB acute care unit are tested for COVID-19. The results take at least 48 hours, and there will be no visitation during this period.

Requirements of visiting in phase one:

• Visitors will need to adhere to physical distancing, good hand hygiene and wear masks at all times during their visit (including in private patient rooms). Visiting may be suspended for breaches to social distancing, visiting policy or infection control requirements.
• Patients must identify visitors as a support person prior to them arriving. Names will be held at the front desks of KEMH and MWI and nurses stations.
• People who are feeling unwell will not be allowed to visit.
• For infection control purposes, visitors will not be allowed to use patient bathrooms and will need to use public restrooms on each floor.
• Overnight stays are not allowed in this phase.

Limited visitation by BHB in acute care areas:

Acute Inpatient Care (KEMH)

• Designated support people can visit for two hours each day between 12 noon and 6pm.
• Check into the front desk in the Acute Care Wing lobby for KEMH.
• In the three Acute Care Ward Units at KEMH where patients are in large private rooms, two visitors can attend at any one time.
• In Curtis Ward in the General Wing of KEMH, due to space and the use of public and semi-public rooms, one visitor will be allowed at any one time.

Acute Inpatient Care – Adults, and Child & Adolescents (MWI)

• Designated support people can visit for up to 30 minutes each day between 12 noon and 6pm.
• Check into the front desk.
• One visitor will be allowed with visitation occurring in a public space (eg family conference room).

Intensive Care Unit

• One designated support person per patient allowed to visit for two hours between 10am and noon, or 4pm and 6pm.

Emergency Department

• Patients should come to emergency on their own, to minimise numbers in the ED waiting room and ensure physical distancing is possible.
• Exceptions for one visitor will be made in the following circumstances:
  • Vulnerable individuals and children (1 parent/support person)
  • Combative individuals
  • End of life cases
  • Deaths (prior to or within the ED)

Maternity

• One designated support person may stay up to 8 hours after the birth.
• If the mother is not discharged within 24 hours, the support person will be allowed to visit up to 2 hours a day between 10am and noon.
• The support person will need to stay in the mother’s room.

KEMH acute care visiting guidelines available on website (Friday 5 June 2020)

BHB maximises space to cope with potential COVID-19 surge

Thursday 23 April 2020: Bermuda Hospitals Board is continuing to increase clinical space in case there is a potential surge in COVID-19 cases.

Along with the additional negative pressure rooms in the Acute Care Wing (ACW), and an overflow Intensive Care Unit being opened in the surgical area of the ACW, this week, additional acute space has been completed in the old surgical area of the General Wing, and BHB is maximising all the buildings on its campus as potential swing space The goal is to increase the total acute care bed stock to about 200, up from the usual figure of 120.

To prepare the swing space, construction work was approved to continue by the Minister of National Security, in line with Shelter in Place Regulations, at Montrose Cottage at KEMH, and Hibiscus Cottage and Fairview Court at MWI, to ensure the additional space was ready for people to work in if needed.

Chief Operating Officer R. Scott Pearman comments: “A big thanks goes to our Facilities and Estates Department and our contractors, who have worked extremely hard to prepare additional clinical space in the hospital and swing space options outside the hospital building where non-acute, support or administrative services can temporarily relocate if needed. We will do everything we can to make sure we have the capacity to care for people with serious complications of covid-19, although our hope is that people abide by the shelter in place restrictions, and keep washing their hands, not touching their faces, and wearing masks when outside, as this will give us the best chance at being able to cope with all those who may need hospital care during this time.”

Over $1 million raised by businesses for COVID-19 medical supplies

Wednesday 15 April 2020: Bermuda Hospitals Board today thanks international and local businesses in Bermuda who have collectively raised $1,044,000 to date for essential medical supplies and equipment, including personal protective equipment and ventilators.

CEO of Hiscox Bermuda, Mike Krefta, helped coordinate the industry’s fundraising efforts, which included contributions from Allied World, AmTrust Group, Aon, Ascot Bermuda, Aspen, Assured Guaranty, Australia-Japan Cable Limited, AXA XL, Axis, Bermuda Chiropractic Association, Bermuda Dental Association, Bermuda International Long Term Insurers and Reinsurers, Bermuda Medical Doctors Association, BF&M, Catalina Holdings, Chubb, Colonial, CPGB Insurance Management, Enstar, Fidelis, Fidelity International, Guy Carpenter, Hannover Re, Hiscox, Jardine Matheson, KPMG, Lancashire, Liberty Specialty Markets, Markel, MS Amlin, OIL & OCIL, Orbis Management, Par-La Ville Dental, QIC Global, Sompo International, Third Point Re, Transatlantic Re and Willis Re.

BHB CEO & President Venetta Symonds comments: “We are extremely grateful for this donation, which helps the hospitals, staff, patients and country by purchasing vital medical supplies at a time of great financial and social uncertainty. Thank you to our Chief of Nursing, Judy Richardson, who made the initial contact with Hiscox and detailed our needs. Our appreciation goes to the donors who are helping us care for those most seriously sick with COVID-19. We have prepared to the best of our ability to meet the potential challenges ahead and this donation means so much to us as we seek to protect and equip our staff and provide the critical care services people may need to save their lives. We thank you for your caring and support.”

Mr Krefta says: “Coronavirus is affecting all of us in some way, and so all of us must contribute to the response. I’d like to thank ABIR, ABIC, Richard Winchell Executive Director of ABIC, Myra Dill BMDA Communications Director and Bill Shields Chief Financial Officer of BHB for all their significant efforts in helping with this appeal.  I’m really proud of how Bermuda’s insurers, reinsurers, brokers, investment managers, local insurance companies, financial service companies and medical associations  have come together to support the hospital at this time, but like everyone I’m even prouder of the work that those on the frontline are doing, so I hope our collective contribution makes a real difference for them.”

UCC temporarily closed due to COVID-19 pandemic

Saturday 4 April 2020: Following the announcement that Bermuda has entered a state of emergency, BHB is suspending services at the Lamb Foggo Urgent Care Centre from Saturday 4 April 2020. This is being done in order to focus much needed resources on the KEMH Emergency Department.

Dr Chikezie Dean Okereke, Chief of Emergency, comments: “We have seen in other countries the strain that Emergency Departments have experienced due to an influx of COVID-19 patients, and the strain is compounded because staff themselves can also become sick or need to be quarantined, reducing overall resources. We have looked at how best to keep our emergency services open and running for Bermuda at this time of great challenge and anxiety for the community. We believe that we now need all of our available staff in the Emergency Department. We apologise for any inconvenience and remind people that they can travel during the 14 days of sheltering at home for emergency care.”

Dr Okereke adds: “If people start experiencing COVID-19 symptoms or are worried they have been exposed, they do not need to panic. For many people this is a mild enough disease they can manage at home, with plenty of fluids and Tylenol, if needed. Please be aware of the risks of age and existing medical issues, or if symptoms get worse, call your doctor, the COVID-19 Hotline at 444-2498, or the Emergency Department Telephone Triage at 239-2009. There is a COVID-19 symptom checklist assessment that can be found on both the BHB and Government websites to help you determine your course of action, but don’t just turn up if you think you need care. Always call first.”

COVID-19 pandemic telephone support line for children

Tuesday 31 March 2020: Bermuda Hospitals Board’s Child & Adolescent Services (CAS) team is offering telephone support for families with children who are worried or fearful about the COVID-19 pandemic.

CAS offers mental health services for children up to 18 years old. Usually delivering services from the Mid-Atlantic Wellness Institute (MWI), the CAS team offering telephone support for any children who may feel heightened fears or worries due to the pandemic. Parents of the children themselves can call 249-3370 between 9am and 5pm, Monday to Friday.

Jayne Isaacs, Manager of Child & Adolescent Services, comments: “This special COVID-19 pandemic telephone support service is for parents and children who may be struggling with fears and worries about illness, being isolated or about coping with all the changes. During these challenging times, we are here to support families with children who need help. Being stuck at home with schools closed, public transport suspended and without normal supports from family and friends, can be incredibly challenging for families. We are not used to these restrictions and families who need help with the stress and anxiety caused by our situation, can call to speak to our mental health experts.”

Only essential visiting now allowed at BHB

Friday 20 March 2020: Bermuda Hospitals Board today announces that it will be further restricting visitors to its facilities, following the confirmation of two COVID-19 cases in the community. People are being advised not to visit patients or residents, other than in exceptional circumstances, such as newborns (the mother’s partner, or one close relative of friend if there is no partner), unwell children (parents only), or people near the end of life.

Additionally, outpatient activity is being critically reviewed, with the aim of only seeing people in person by exception. All other patients will either have appointments postponed if they are stable, or offered a remote consultation (for example, by phone). People with outpatient appointments will be each contacted directly. Elective hyperbaric treatments sometimes used for wound care, have been suspended, and BHB is reviewing closing down even to emergency treatments. These are mostly diving accidents, but the oxygen from the hyperbaric chamber will be needed if multiple people with COVID-19 need ventilator and/or oxygen support in the hospital.

As previously announced, diagnostic and lab tests are now by appointment only (no walk ins), and the focus is now on urgent tests, rather than routine activity. The Emergency Department is also asking people to come alone if possible, or just one companion if essential. This is to reduce the number of people in the waiting room and help Emergency patients, who are more likely to be in an at risk group, to maintain a physical distance from each other while they wait. Parents who are seeking treatment for themselves are advised not to bring their children with them.

Michael Richmond, Chief of Staff, comments: “BHB is finding ways to reduce opportunities for the virus to spread by temporarily reducing the foot traffic in its hospitals, and minimising numbers of people in waiting rooms together. This supports physical distancing that, along with hand washing and not touching your eyes, nose or mouth, are key ways people can protect themselves and their families from COVID-19. Government has taken decisive action to minimise the potential spread of COVID-19 and BHB is in complete support. The community must adhere to these restrictions, abide by quarantine and isolation rules, or else the healthcare system could be overwhelmed as has happened in countries such as Italy. BHB is doing everything in its power to prepare for increased demand, but we have limits. If we as a community do not control the spread of COVID-19, the numbers of critically ill patients could rise precipitously and the ability for the healthcare system to support those who are most critically ill will be put at risk.”

COVID-19 protections for KEMH diagnostic services

Wednesday 18 March 2020: Bermuda Hospitals Board is today moving to an appointment-only system for routine Imaging Services and Lab tests. This doesn’t affect diagnostics for patients referred through KEMH or MWI inpatient or Emergency care.

“People will no longer be able to walk in for appointments in Lab and Imaging Services, and will need to call to make an appointment,” explains Anthony Fitzgerald, Vice President, Clinical Operations (KEMH).  “This is a precautionary measure so we can do a quick telephone triage before they come in. It will also reduce the number of individuals waiting together and the volume of foot traffic through the hospital.  This encourages the physical distancing that is needed to minimise the transmission of COVID-19. While there are no COVID-19 cases confirmed in Bermuda at this time, this process change will help protect staff and patients in the hospital at a time we are on heightened alert.”

To make an appointment, please call 239-2032 for Laboratory appointments (blood and urine tests), 239-1144 for Imaging Services X-ray, CT, MRI; 239-1223 for Ultrasound, Mammography and Nuclear Medicine; and 239-1416 for the Cardiac Diagnostic Unit. For appointments made days or weeks in advance, patients are asked to call before turning up if they have any symptoms such as fever, dry cough or difficulty breathing.

“These diagnostic services need to continue to support the health needs of Bermuda,” says Mr Fitzgerald. “By moving to appointments only, we can have a level of protection in place.”

BHB restricts visitation to protect patients, staff and supplies

Sunday 15 March 2020: Bermuda Hospitals Board today announces the introduction of visitor restrictions to all BHB facilities, KEMH, MWI and group homes, in an effort to safeguard patients against potential COVID-19 infections in the community, and preserve personal protective equipment (PPE) such as masks, gloves and gowns for frontline staff at a time of global shortage.

Judy Richardson, Chief of Nursing, comments: “We do not take this step lightly, as we recognize the power of family in visiting people when they are unwell, or vulnerable. But we also have to acknowledge that a COVID-19 infection can be much more serious and deadly for seniors and people with existing medical conditions – and these are the people we care for.”

The restrictions across all facilities are effective immediately and are as follows:

• For general acute care patients, long term care and residential units, only immediate family/carers will be allowed to visit.
• For patients on isolation (wherever they are), only one visitor will be allowed, once per day.

BHB offers free wi-fi for patients and visitors, so strongly recommends that anyone in hospital brings or is given a smart phone or mobile device by their loved ones with video messaging apps, such as WhatsApp, Skype, etc.

Dr Michael Richmond, Chief of Staff, explains: “We apologise to people who want to visit their loved ones, but hope they understand we must put our patients and staff first.  Many people do not get seriously ill from COVID-19 or have no symptoms at all, so we anticipate someone could inadvertently visit their loved one and infect them. Additionally, we need to preserve personal protective equipment in the face of global shortages. We are preparing in case COVID-19 is an issue for many months, or longer. Our expectation is that we may have to close visiting at some point if COVID-19 spreads locally, but this balance gives patients and residents some access to the love and support of their families, while reducing the risks of exposure and preserving personal protective equipment.”

People are reminded not to visit their loved ones if they feel unwell with fever, dry cough, trouble breathing or any other symptoms. They should also not visit if they have returned from overseas, or been in contact with someone with the above symptoms, in the last 14 days.