Nearly half of acute care beds filled with patients medically fit for discharge

Thursday 19 December 2024: Bermuda Hospitals Board today revealed that analysis undertaken on Wednesday 18 December showed that 42 of its 90 beds on the acute care inpatient units were filled with people who were medically fit for discharge. That is 46% of all inpatient beds in the Acute Care Wing (ACW). The average length of stay of these patients was 70 days (over two months) with longest stay patient being over nine months.

Medically fit for discharge refers to patients who no longer require acute medical care but remain in the hospital due to barriers to safe and appropriate discharge.

In the General Wing, where beds are used as acute care overflow, there are an additional 24 patients medically fit for discharge, with the longest stay being almost 2 years (23 months).

Minister of Health, the Hon. Kim Wilson JP MP, comments: “These figures will understandably concern the community, as behind each patient is an individual in need of assistance. We continue to support BHB’s efforts to enhance hospital capacity and remain committed to developing long-term solutions to improve care availability in the community.

“While healthcare systems must invest in these long-term solutions to address patients who are medically fit for discharge, families play a crucial role in the immediate response. By recognising the challenges faced by hospitals and the needs of their loved ones, families can make a significant difference by stepping up to assist in the discharge and care process.

“Ultimately, addressing this issue requires a collaborative effort among families, healthcare providers, and policymakers. By working together, we can ensure hospital resources are used effectively and patients receive the appropriate care in the most suitable setting.”

CEO & President Scott Perman noted that the number of patients medically fit for discharge in the acute care wing had increased over 50% since figures were last publicly shared in June 2023, when there were 25 patients in acute care inpatient beds.

“This is something we have been experiencing over the last few months,” he says. “Its biggest impact has seen rising waits for emergency patients needing an inpatient bed.”

The issue is mostly caused by patients who need either a nursing home or more care support at home in order to be safely discharged.

Mr Pearman noted, “We obviously implore families to take their loved ones home as soon as they are ready to be discharged, when possible. We know Bermuda needs more affordable nursing home placements and affordable care support for people at home, but the impact on hospital services of these delayed discharges is detrimental to others needing acute, surgical* and emergency services**, and those patients trying to return from medical institutions overseas. It also increases hospital costs that the healthcare system overall has to bear.”

Data from 18 December shows:

Acute Care Inpatient Units (ACW)
• 42 of the 90 acute care inpatient beds had people medically fit for discharge in them (46%)
• The average age of the patients whose discharge is delayed is 76 years
• The average length of stay for these patients is over 2 months (70 days)
• Of the 42 patients, 24 % have been in hospital 3 months or more and 12% have been in hospital 6 months or more
• The longest stay patient has been in an acute care bed for over 9 months.

Acute Care Overflow Beds in the General Wing
• 24 medically fit for discharge patients are staying on units in the General Wing
• The average age of patients is 78 years
• The average length of stay of these patients is over 9 months (262 days)
• 88% of these patients have been in hospital over 3 months and 58% of these patients have been in hospital over 6 months
• The longest stay patient has been in hospital for nearly two years (23 months)

“Our longest stay patients whose discharge is delayed will find themselves eventually on a bed on the General Wing side. These patients do not need BHB’s long term care service, which is for seniors with higher care needs than a community nursing home can offer. This means they are still using beds that others need. Most importantly, they are not in the environment best suited for their needs, impacting their quality of life and putting them at risk of unnecessary physical deterioration.”

A 100-day challenge undertaken at the beginning of 2024 had helped identify internal efficiency improvements relating to bed flow and some solutions were implemented. A task force was recently established to follow up on the improvements and work on some of the more complex solutions highlighted from this effort. But the increasing number of medically fit for discharge patients in hospital is something BHB cannot control.

Mr Pearman urged the community to use emergency services wisely and ensure relatives ready for discharge are supported to go home as soon as possible. These actions will help relieve some of the pressure.

He added, “While we are focusing on the impact of delayed discharges, we should also be wise about our own health and care. We have had as many as 30 people waiting for admission in our Emergency Departments and this impacts everyone coming in. So please use your GP in the weekday or go to the Lamb Foggo Urgent Care service between 9am and 9pm on Saturday and Sunday if it is not a true emergency. Avoid the need of emergency services by taking any medications for chronic conditions, getting available vaccines that safely prevent flu, measles and other diseases, and don’t drink or do drugs and drive. Make sure the emergency services can focus on the true emergencies, such as strokes, heart attacks and other life-threatening conditions.”

Related data:
*Below is a year’s data on surgical cancellations. Highlighted in the table is the number of surgeries rescheduled due to no beds being available. The highest cause of surgical cancellation, however, remains patients themselves not turning up or cancelling.

 

 

 

 

 

 

 

 

 

** Emergency wait times are posted monthly to the BHB Statistics page, and real-time wait times are available on a screen in the Emergency Department.

19 December 2024 Home Page, News

Bermuda Hospitals Board joins Bermuda is Love’s EmpathyInAction Campaign

Tuesday 17 December 2024: Bermuda Hospitals Board has joined Bermuda is Love in urging the public to cultivate and practice empathy.

This December is the third year BHB has erected green exterior lighting over the Point Finger Road main entrance of King Edward VII Memorial Hospital to remind the public to take care of their mental health.

“Green is the international colour for mental health, and this year we invite the public to consciously practice empathy,” said BHB Acting Chief of Staff Dr Anna Neilson-Williams. “Empathy is more than simply helping someone. It involves seeing a situation from the perspective of another, understanding and, if possible, feeling how that other person feels.

“Compassion is a form of empathy that can have a beneficial impact on the mental wellbeing of the giver as well as the recipient.

“We understand and applaud the strong activism Bermuda is Love is undertaking, supporting both individuals and families in our community. We are pleased to echo their call inviting the public to join the #EmpathyInAction campaign this December.”

A Bermuda is Love spokesperson explained: “Through #EmpathyInAction, we aim to empower individuals to view Bermuda and the world through a new lens, fostering understanding of the challenges others face, such as poverty and socio-economic inequality. With this understanding, we encourage everyone to act with kindness and contribute to tangible solutions.

“When we help others – whether by offering our time, skills or resources – we not only address immediate needs but also gain insights into their lives and challenges. Participating in acts of service nurtures a deep sense of our shared humanity, of our connectedness to one another, reminding us of the strength in unity and collective effort.

“At its core, empathy is a bridge – a powerful tool for reducing division, resolving conflicts and creating spaces where all individuals feel valued and seen. By actively listening, volunteering and acting, we can strengthen our communities and deepen our connections to one another.”

Dr Neilson-Williams advised: “As you take a drive to enjoy the holiday lights this month, do pass along Point Finger Road and see our green holiday lighting. Use it to remember to pause to enjoy your life and know that that is good for your mental health.”

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17 December 2024 Home Page, News

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.

16 December 2024 Home Page, News

Stroke and the holidays

Monday 16 December 2024: The Christmas holiday season, as joyful as it is, can also be stressful for many adults. Amid the increased pressures and demands, Bermuda Hospitals Board’s Primary Stroke Centre and Mid-Atlantic Wellness Institute urge everyone to be mindful of their mental and physical health.

Psychosocial stress, excessive alcohol intake, overeating, physical inactivity and sleep deprivation are common during this period and can increase the risk for certain health conditions, including stroke.

“In the US, more strokes are reported from November to February,” said BHB Primary Stroke Centre Director Dr Srinath Meadipudi. “That’s why we are encouraging the public again to get to the hospital as fast as possible at the earliest indication that someone may be experiencing a stroke.”

BE FAST is the acronym to help remember the signs and symptoms of stroke. If you or someone you know suddenly loses Balance, experiences a change in Eyesight, suffers Facial drooping, weakness in an Arm or leg, changes in Speech where it may become slurred or not accessible, then it’s Time to call 911 and report to the hospital immediately.

“When people seek emergency care quickly, our physicians can administer tenecteplase, a blood-clot-busting drug, within the crucial time window,” said Dr Meadipudi. “This treatment greatly improves stroke outcomes and helps stroke patients achieve better recovery.

“Since BE FAST was launched as part of our public education on stroke, we have seen a significant increase in the number of people attending the hospital at the first signs of stroke. Every minute matters, and presenting to the Emergency Department as soon as possible allows us to deliver the best possible care to those in need.”

BHB thanks everyone who has listened, learned and taken action by recognising stroke symptoms and seeking immediate medical attention.

“Together, we are improving stroke care and saving lives,” said Dr Meadipudi.

For information leaflets on stroke symptoms, what to do in an emergency and what you can do to minimise your stroke risk, please visit the Primary Stroke Centre online at bermudahospitals.bm.

16 December 2024 Home Page, News

BHB Public Advisory: No through traffic at KEMH between Point Finger and Berry Hill roads on Saturday 14 December 2024

Wednesday 11 December 2024: Bermuda Hospitals Board advises the public that there will be no through traffic on the campus of King Edward VII Memorial Hospital (KEMH) between Point Finger Road and Berry Hill Road on Saturday 14 December from 7am – 9am.

People will be able to access the Emergency Department, the main Acute Care Wing (ACW) entrance and the ACW visitor parking lot from Point Finger Road.

Access from Berry Hill Road will stop at the Berry Hill visitor parking lot for both vehicular and pedestrian traffic.

To ensure safety, please adhere to all signage, barricades and directions of personnel at the site.

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11 December 2024 News

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.”

11 December 2024 Home Page, News

BHB urges online bill payment

Tuesday 10 December 2024: Bermuda Hospitals Board (BHB) will no longer accept payments at its Hamilton location in Craig Appin House on Wesley Street. Patients are encouraged to make payments online where possible.

The change takes effect on 1 January 2025.

Butterfield and HSBC Banks have included BHB in their list of payees for online payments. Clarien Bank clients can do an online transfer using BHB account #6000247519. Payees should include their statement number followed by their full name with any online payment.

Payments can be made with cash, credit card or personal cheque at King Edward VII Memorial Hospitals cashier’s window, Ground Floor Acute Care Wing from 9am-3pm, the Emergency Department Admitting window from 3pm-9am on weekdays and all day on weekends, and the Lamb Foggo Urgent Care Centre during its opening hours – 9am-9pm Saturdays and Sundays.

“I also remind the public to speak with our accounts department if they are having difficulty settling their bill,” said BHB Chief Financial Officer Arthur Ebbin. “We will work on a payment plan with you.”

 

10 December 2024 Home Page, News

BHB Public Advisory: Lamb Foggo Urgent Care Centre closed on Sunday

Tuesday 10 December 2024: Bermuda Hospitals Board advises the public that due to a shortage of staff, the Lamb Foggo Urgent Care Centre (UCC) will be closed on Sunday 15 December 2024.

The UCC will be open its regular hours of 9am to 9pm on Saturday 14 December 2024.

This temporary UCC closure is to ensure adequate staffing levels to safely manage demand for all patients who require urgent or emergency care. BHB apologises for the inconvenience.

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10 December 2024 Home Page, News

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.”

 

25 November 2024 Home Page, News

Joint Statement from BHB, PALS, Bermuda Cancer and Health Centre (BCHC) and Ministry of Health on oncology referral navigation

Friday 15 November 2024: Cancer care service providers are working together around the clinical care of all patients with cancer and wanted to provide an overview of how new cancers will be managed while Bermuda Hospitals Board’s (BHB’s) two newly appointed oncologists go through the final stages of moving to the island.

Bermuda Hospitals Board (BHB) announced last week that two new full-time oncologists had been hired.  Their immigration applications have now been approved and BHB is in the process of confirming start dates of the new oncologists.

Although BHB’s medical oncology capacity has been reduced, the clinical teams are all here to help and will remain involved for all those with cancer. Moving forward, all referrals for oncology patients should be sent via email to the BCHC Cancer Navigator at referrals@chc.bm. Any referrals received directly to medical oncology via the current route will be forwarded on.

This includes new consults, previously seen patients with new issues and any returning overseas patients.

As standard, referrals should include a referral letter, pathology report, imaging reports, lab work and any overseas notes.

Each patient will be triaged and reviewed through an additional oncology tumour board dedicated to triaging patient care. This will occur weekly or as needed for urgent patients.  Recommendations will be documented in a tumour board note, and the patient will be followed to the next steps of their pathway.

Patients requiring further discussion with the wider multidisciplinary team will be presented at the General tumour board, which occurs each Friday.

Patients requiring referral overseas for treatment will have their HIAB form completed by the navigation team. However, the GP or referring physician will remain the point of contact for those patients and will be required to contact the patient to advise them of the tumour board recommendation.

The cancer navigator will then follow up with the patient regarding overseas referral information/process.  Patients will be advised to liaise with their insurance company regarding which facility they should be referred to.

Patients who can receive treatment on the island will be referred to the appropriate physicians and monitored by the navigation team for any status updates/changes.

The Navigation team can be contacted with any other questions or concerns:

Michele Hypolite & Harriet Stuckes

referrals@chc.bm

441-621-1003

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15 November 2024 Home Page, News