BHB maternity guidelines during the current surge of COVID-19 cases

Friday 11 December 2020: Bermuda Hospitals Board (BHB) today confirmed that the guidelines for designated support people attending births and visiting mothers in Maternity are not currently changing. However, in order to minimise the number of people from the community in the Maternity department, BHB is returning to the guidance earlier this year relating to doulas not attending births until the risks of transmission have once more declined.

Current guidelines allow for one designated support person to attend the birth and stay for up to eight hours afterwards. For mothers who have to stay in Maternity for more than 24 hours, that designated support person can visit up to four hours a day between 10 and 6pm.

Granville Russell, Director of Maternal Child, comments: “A birth is such a precious experience and as much as possible we want to allow the mother and her designated support person to be together throughout and after the birth. However, we also have to recognise that the rising numbers of people testing positive for COVID-19 means everyone entering Maternity brings an additional risk to mothers, babies and staff. We will continue to closely monitor the prevalence of COVID-19, and when the risks decline again, we look forward to welcoming doulas back for mothers who want their support.”

Expectant mothers are reminded that the free wifi at BHB will allow them to video chat, message and email friends and family without incurring mobile data costs while they are in the Maternity department.

Mr Russell adds: “We will do all we can to support and care for mother and newborns in the Maternity department. We recognise these are stressful times. Our guidelines will likely change in the coming months based on the risks of exposure rising or declining in the community. Expectant mothers or their designated support person can call the Maternity department at any time if they have any questions, or they can visit bdahospitaldev.wpengine.com and view the latest maternity guidelines.”

As tours of the Maternity department have been suspended due to the pandemic, BHB developed a virtual tour earlier this year so expectant mothers and their support person know what it is like before they arrive for the birth. The tour is on the Maternity Page of our website and the BHB Youtube Channel (see below).

Click here to read the full guidelines on the Maternity Department page of this website.

BHB returns to restricted visitation following rise in COVID-19 cases

Wednesday 9 December 2020: Bermuda Hospitals Board (BHB) today announces that it is returning to restricted visitation from Thursday 10 December 2020 in its acute care units following the rising numbers of COVID-19 cases in the community. This will return BHB to the level of visitation implemented in June of this year.

Norma Smith, Vice President of Acute and Ambulatory, comments: “It has really been a tough call to reintroduce some of our earlier visitation restrictions once more at BHB. We are trying to balance the vital emotional support visitors bring patients with the risks that they bring in from the community to our vulnerable patient population. We ask family members and loved ones to please understand that we are trying to do our very best to ensure those in our care are protected from the risks in the community right now.”

While there will be limited visitation for acute care patient, 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.

Requirements for visiting:

• 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.
• 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 at this time.

People who cannot visit:

• People who are feeling unwell will not be allowed to visit.
• People who have been in contact with a positive COVID-19 case or someone in quarantine should not visit.
• People who have travelled overseas cannot visit until they have had a negative COVID-19 test result from their 14^th day test.

If you have any questions about the visitation for the unit your loved one is on, please call the unit directly before you visit.

KEMH Acute Care Visitation

Acute Inpatient Care Units (Acute Care and General Wing):

• 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. (*ACE Barber, Ascendant Partner Re, Catlin Lindo Units)
• 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.

Intensive Care Unit:

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

MWI Acute Care Visitation

Acute Care Inpatient Units (Somers Ward, Somers Annex, Child & Adolescent Inpatient Unit):

• Visitation will only take place at the discretion of the Manager. Please call in advance if you intend to visit a loved one at 236-3770
• Check into the front desk.
• If allowed by the manager, one visitor will be allowed with visitation occurring in a public space (eg family conference room).

Dr Christopher Fosker Appointed Director of Oncology at BHB

Wednesday 28 October 2020: Bermuda Hospitals Board (BHB) today announces that Dr Christopher Fosker has been appointed to the position of Director of Oncology at BHB, taking over from Dr Sein Aung. Dr Aung will continue at BHB as a Consultant Oncologist.

As Director of Oncology, Dr Fosker will be the medical lead for cancer services at BHB. His responsibilities will include consulting with cancer patients in Bermuda and managing their care, working with healthcare partners here and overseas and developing cancer services on-island. He reports to the Chief of Medicine, Dr Michael Ashton.

Dr Chris Fosker joined Bermuda Hospitals Board as an Oncologist in May 2015, tasked with treating cancer patients with radiation therapy, chemotherapy and molecular therapy. Dr Fosker works also with Bermuda Cancer and Health Centre as their medical director overseeing the radiation programme. He is an affiliate medical staff member at Dana-Farber Cancer Institute and a consultant at Brigham and Women’s hospital in Boston. Prior to his arrival in Bermuda, Dr Fosker worked at St James’ Institute of Oncology in Leeds, UK. Dr Fosker has a Bachelor of Science in Genetics and graduated from Leeds Medical School in 2003. He completed a Fellowship at Princess Margaret Hospital in Toronto, where he received the RS Bush Award for academic excellence. He was also this year awarded a fellowship by the Royal College of Physicians in the UK in recognition of his excellence and commitment in the field of oncology care.

Dr Ashton comments: “I would like to congratulate Dr Fosker on his appointment. Oncology services at BHB provide a critical service to patients with cancer in Bermuda, and it is a busy department. Chemotherapy treatments increased from 3,260 in fiscal year 2016-17 to 3, 943 in 2019-20 and the service is very highly rated in our regular patient satisfaction surveys. Dr Fosker’s relationships with patients and providers in Bermuda and overseas will be of great benefit in leading this ever-evolving department. A special thank you must go to Dr Aung who has led the department for the last six years, and we are very fortunate that he is continuing with us.”

Dr Fosker adds: “I am looking forward to building on the great work in Oncology in this role. We have a great team at KEMH and we remain committed to providing the best service possible for people in our community with cancer. Although this is a new role for me, I would like to reassure my patients that I will continue to be there for them.”

Agape House maintenance In August

Wednesday 5 August 2020: BHB today announces that Agape House patients have been temporarily relocated to Curtis Ward in the KEMH General Wing for about a month, while work is undertaken at the Agape House facility. Work will include some basic maintenance and the building will be tented for fumigation nearer the end of August. During this time the service will be closed to new inpatient admissions, but Dr Debbie Benson, BHB’s Palliative Care lead physician, will continue to offer palliative care consults by referral.

Granville Russell, Director for the service, comments: “This is essential work for us to maintain services over the longer term. We apologise for any inconvenience to our patients, but the relocation is essential for the work to be completed.”

During this time, the fax for referrals has changed to 239-2208, but emails and phone numbers for staff remain the same.

Increased visitation for KEMH acute care patients from 4 August

Monday 3 August 2020: Bermuda Hospitals Board (BHB) today announces that, given the sustained low prevalence of COVID-19 in Bermuda, that it will allow more visitation over increased hours for acute care patients at KEMH from Tuesday 4 August 2020.

Acute care patients in the Acute Care Wing units (Ace Barber, Ascendent 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 6pm.

Acute care patients in the General Wing (Curtis Ward): as these rooms are smaller and have other patients in, acute care patients in the General Wing (Curtis Ward) can have one visitor in their room at any one time between noon and 6pm.

Isolation patients: For patients on isolation due to a known infection of any kind, or in the first 24 hours of admission while waiting for results of the required COVID-19 test, two designated support people pre-identified by the patient will be able to visit for up to two hours per day.

The following requirements must be followed when visiting any BHB services:

• Visitors must be masked at all times, including in patient rooms
• Visitors must maintain physical distancing at all times, including in patient rooms
• People who have symptoms of COVID-19 or any other infection 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 at this time, other than in exceptional circumstances

Norma Smith, Vice President, Clinical Operations (Acute and Ambulatory) comments: “We are encouraged by the sustained low prevalence of COVID-19 in Bermuda at this time and feel it is currently safe to allow visitation so our patients benefit from the love and support of their families and close friends. As front line carers, we see the difference it makes. We remain on alert, however. Our ability to increase visitation may change if there is evidence of second wave of infections in Bermuda. However, while it is safe to do so, we look forward to welcoming more visitors.

The following departments have also increased visiting hours:

Intensive Care Unit

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

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 now be allowed to visit up to 4 hours a day between 10am and 6pm
• If the support person leaves the hospital during visiting hours they will not be permitted back on the unit

Visitation in other BHB areas remains unchanged at this time during the pandemic:

Acute Inpatient Care for Mid-Atlantic Wellness Institute services (adult, child and adolescent services):

• Pre-identified support people can visit for 30 minutes each day between 12 noon and 6pm
• Support people should check in at the front desk
• One person can visit at any one time and visitation will be in a public space, such as a family conference room

Long Term Care (KEMH and MWI), including Group Homes

• One designated support person can visit for one hour each day between 12 noon and 6pm

Emergency Department and Lamb Foggo Urgent Care Centre

• 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)

Consultation on draft Mental Health Act Code of Practice launched

Tuesday 28 July 2020: Bermuda Hospitals Board (BHB) today announces that a consultation has been launched on a draft Code of Practice (the Code) relating to the Mental Health Act 1968 and subsequent amendments. As allowed by the Act, the Minister of Health has delegated the responsibility of completing the consultation on the draft Code to BHB on her behalf. The consultation opens today and will run until 4 September 2020.

The Code can be downloaded from here: Mental Health Act Code of Conduct_CONSULTATION DRAFT-July2020

Feedback should be provided by clicking on the following link: https://www.surveymonkey.com/r/Code-of-Conduct

The Code provides guidance to medical practitioners, BHB staff and approved mental health professionals on how they should carry out their responsibilities under the Mental Health Act when providing psychiatric treatment and care for persons suffering from mental disorder. The Code will also help patients and their families to understand what they can expect from health professionals who are assisting with their loved ones’ treatment.

This is the first time in Bermuda that a Code of Practice will be available to support the implementation of the Mental Health Act, and it will come into effect on 31 October 2020. It is intended that the Code will:

• Ensure that all patients receive high-quality, safe care
• Provide straightforward and accessible information about how the Mental Health Act is to be used
• Clarify how decisions should be made about people’s treatment and support when it is suspected they may not have the capacity to make such decisions
• Set out the over-arching principles that should guide the care of people who have mental health needs
• Ensure compliance with the law
• Protect patient rights

The Minister of Health, Hon. Kim Wilson, JP MP, comments: “I am pleased that BHB, on behalf of the Ministry, is sharing a draft of Bermuda’s first Code of Practice for all practitioners in the mental health field for feedback. We are looking for input from as wide a range of individuals and organisations as possible. We are particularly keen to have comments about the clarity and detail of the Code. We will review all feedback before finalising the drafting of the Code.”

If people who would like to participate in the consultation have any questions, please email Alick Bush at alick.bush@bhb.bm.

Hyperbaric chamber service to resume from 1 July 2020

Friday 26 June 2020: Bermuda Hospital Board is pleased to inform referring physicians and the diving community that its hyperbaric chamber services will resume on 1 July 2020 for elective and emergency service.

The hyperbaric chamber is a treatment chamber used for certain medical (specific types of ulcers) and certain surgical conditions likely to benefit from hyperbaric oxygen treatment. It is also used for diving accidents such as arterial gas embolism, and decompression sickness (‘the bends’). The chamber was closed earlier this year in response to the pandemic and increasing COVID-19 infections in Bermuda. The chamber oxygen was diverted in anticipation of a surge of seriously ill COVID-19 patients who would need all available oxygen in the hospital. Additionally, staff members from the department were seconded to and supported the critical care units in the management of the COVID-19 patients.

Dr Chikezie Dean Okereke, Chief of Emergency & Hyperbaric Services, comments: “BHB prepared early in case Bermuda experienced a surge of seriously unwell patients. To support a threefold increase in critical care beds and ventilator capacity, we had to preserve oxygen and redeploy some of the hyperbaric and wound care staff. We have been closely monitoring the COVID-19 infections, and the continued low prevalence in Bermuda suggests it is safe to resume the service.”

Dr Okereke adds: “Recognising that COVID-19 remains a threat and to ensure the safety of the patients and the staff, all the necessary infection control precautions will be followed for all patients and staff. We will continue to monitor the situation closely in case the situation changes. We would like to thank the community for their patience and for understanding of the need to temporarily suspend this service.”