Bermuda Hospitals Board Launches Six Week Consultation on Clinical Structure

Bermuda Hospitals Board today announced the launch of a six week consultation process as the first step towards a reorganisation of its clinical structure. The restructure aims to improve clinical quality and care at the hospitals and is a key goal for BHB’s 2008/09 strategy approved by the Board earlier this year.

In January 2007 the Senior Management team was restructured and over the last year new physician leadership and management has been established. Reviewing the structure of clinical leadership (ie in nursing and allied health) at BHB is the logical next step in ensuring BHB can keep pace with international best practices and provide a consistently high quality patient experience.

The consultation paper proposes a structure for King Edward VII Memorial Hospital and Mid-Atlantic Wellness Institute that is in line with those found in successful healthcare organisations in the US and UK. It moves away from “Programme Management”, which was introduced in 1998. Programme Management tried to build multidisciplinary ‘programmes’ around patient groups. At MWI the structure has seen some success. However, at KEMH the size of scope that clinical leadership had to manage has over time shown to reduce effective communication and co-ordination around patient care.

“Our consultation paper clearly shows us putting patient care back at the heart of our hospitals and bringing clinical leadership closer to the bedside,” comments David Hill, CEO. “It is closer to BHB’s structure before Programme Management, but it has been updated in line with current best practices. It essentially tightens the focus of senior clinical leadership and proposes four new senior nursing positions to support bedside care and quality. We are also reviewing job descriptions to make all leadership positions clear and accountable, while better supporting the development of staff in leadership roles.”

As part of the proposed restructure, BHB is clearly defining the roles and responsibilities of the clinical management team to improve accountability, provide improved development opportunities for leadership to support their success, and focus leadership on ensuring a consistently high day-to-day quality of care for patients throughout our hospitals.

The consultation paper has been sent to the BIU, BPSU, physician leadership, employees whose positions are included in the document, relevant Government stakeholders and the Bermuda Hospitals Charitable Trust and Hospitals Auxiliary of Bermuda. It can also be reviewed by any member of the public at the BHB Library at KEMH and MWI or on our website at The consultation ends on Friday 19 September, after which feedback and BHB responses will be collated and sent to the Board for consideration and decision.

“We want to make this an inclusive process as it is a critical step in our journey if we are to achieve our long term vision of becoming the first choice for health and wellness,” adds Mr Hill. “There is no doubt that we need to make some changes in order to keep pace with international best practices and we look forward to comments and feedback as we move forward. The most significant proposed change is for our most senior clinical leaders, who’ll go through a placement process to ensure skills and strengths are matched to new Director positions. This will also help us ensure appropriate developmental support is put in place to help them succeed in their new roles. Over time we expect this restructure to achieve a sustained and constant improvement in the quality of care our community receives.”

Attachment 1: Clinical Consultation Paper – Main Section

Attachment 2: Clinical Consultation Paper – Appendix 1

Attachment 3: Clinical Consultation Paper – Appendix 2 & 3

Attachment 4: Clinical Consultation Paper – Appendix 4 & 5


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