HSBC brings Cup Match magic to BHB

Tuesday 27 July 2021: HSBC brought some Cup Match magic to Bermuda Hospitals Board this week. The HSBC Cup Match Motorcade was rerouted to pass King Edward VII Memorial Hospital (KEMH) on Point Finger Road on Monday, and special treat tables were arranged at KEMH on Monday and at Mid-Atlantic Wellness Institute (MWI) on Tuesday as many staff had to stay onsite to work.

In addition, 10 cricket sets were donated to the residents and clients who have intellectual disabilities or seniors with mental health issues, who live on site at MWI or in one of their group homes in the community.

BHB CEO & President Michael Richmond said: “Thank you, HSBC, for including our staff, who often miss out on Cup Match festivities as they have to work, and who have been under particular strain over the last 18 months due to the pandemic. We appreciate the love and support and wish everyone a wonderful Cup Match holiday.”

Tanya Bule, HSBC Bermuda’s Head of Wealth and Personal Banking & Marketing, shared: “Given everything that BHB has done and continues to do, in caring for our community during the pandemic, we felt it was important to show our appreciation while bringing some Cup Match cheer to them. Thank you from all of us at HSBC.”

 

27 July 2021 News

BHB trans-oceanic telestroke service with Johns Hopkins

Thursday 22 July 2021: The Bermuda Hospitals Board (BHB) Primary Stroke Centre is one of the first facilities in the world to offer a trans-oceanic telestroke service. The service is provided through a collaboration with Johns Hopkins Medicine International (JHMI).

Telestroke allows experts anywhere in the world to quickly examine a suspected stroke patient and make the time-sensitive treatment recommendation that can mean the difference between full recovery and permanent disability or death.

Dr Victor Urrutia, director of the Johns Hopkins Hospital’s Comprehensive Stroke Center, and Dr Francene Gayle, BHB consultant neurologist and Primary Stroke Centre medical director at the launch of the stroke programme at BHB

“BHB started a local telestroke service internally between Emergency Department physicians, hospitalists and local neurologists,” explained Dr Francene Gayle, BHB consultant neurologist and Primary Stroke Centre medical director. “Then in December 2020, the telestroke service became trans-oceanic, connecting with Johns Hopkins.

“Not even a pandemic stopped our teams from moving ahead with plans to advance the service. We have up to five patients a week who come to the hospital having suffered a stroke whether there is a pandemic or not, so continuing to develop our services in the Primary Stroke Centre has been so important to the whole team working on this initiative at BHB.”

“This innovate way of managing stroke patients helps us collaborate in real time to care for our patients, despite being over 800 hundred miles apart,” said Dr Victor Urrutia, director of the Johns Hopkins Hospital’s Comprehensive Stroke Center. “Time is one of the most important factors in stroke treatment, so being able to collaborate remotely and make critical decisions about care makes a huge difference in outcomes for the individual patients.”

When the local telestroke service began in June 2020, about 8% of ischemic stroke patients received IV thrombolysis treatment – a significant improvement on the numbers given the drug before the Centre launched. After JHMI neurologists joined the local telestroke team in December 2020, the proportion of stroke patients who were administered the drug continued to rise to 13%. The average for primary stroke centres in the US is 7%.

The benefit is not just for those treated on island, however, but also for those who would benefit from treatment overseas.
“Most recently, we had our first trans-oceanic transfer from BHB to a comprehensive stroke centre in the US for the removal of a large clot that had blocked a major blood vessel in the brain, a procedure called mechanical thrombectomy,” Dr Gayle explained.

“Timing is critical in these cases, as the patient needs to be at the overseas hospital within 16 hours of the start of symptoms. BHB is engaging with the insurance companies to ensure that our airvac turnaround times are efficient in order for us to meet the transfer process within 16 hours,” said Dr Gayle. “We are quite thrilled about this.

“While this overseas relationship has clear clinical benefits, we have to stress the importance of recognising the need to get to hospital immediately if an individual thinks they have had a stroke. We have the clinical processes in place to act quickly, but this can only happen if people get to the hospital in time, so remember the BEFAST acronym – balance, eyes, face, arms, speech and time – to quickly identify and act on the early warning signs of a stroke.”

“We are honoured to collaborate with BHB to improve the care of stroke patients in Bermuda,” concluded Dr Urrutia. “The telestroke work we have done not only benefits people in Bermuda, but has far reaching implications for other remote area facilities. The experiences we gain through this collaboration can be shared globally.”

Editor’s note:

  • About the BHB Primary Stroke Centre: Established in July 2019 as part of a clinical affiliation with Johns Hopkins Medicine International, the BHB Primary Stroke Centre focuses on improving treatments and processes within the hospital, as well as providing education to help the community identify stroke symptoms to ensure timely treatment, and know the risk factors that can help reduce the incidence of stroke altogether.
  • About strokes: Ischemic stroke patients with smaller blockages are also experiencing better outcomes since the telestroke service began. IV thrombolysis is the procedure by which stroke patients receive a drug to dissolve or breakup the clot or blockage in the blood vessel that is restricting the flow of blood and oxygen to the brain. Administering the drug quickly increases the chance of the patient recovering from the stroke with little or no disability at all.
  • Strokes in Bermuda: There are up to five strokes every week in Bermuda, and 25% of strokes in 2020 were in people under 60. Seventy-three percent of strokes are in Black people, 24% are in white people and 2% are in ethnicities classified as ‘other’.
22 July 2021 Home Page, News

BHB cautiously opens up to more visitors

Thursday 22 July 2021: Bermuda Hospitals Board today announces that it is updating visiting restrictions, effective immediately, in light of the low prevalence of COVID-19 in the community at this time.

Dr Wesley Miller, Chief of Staff, comments: “We are pleased it is safe enough to allow more visitation at this time. We remain prepared, however. The last surge of cases was so large and fast, it was extremely challenging for us. At its peak we had 45 cases in the hospital, and about 120 COVID-19 patients over two months. Thankfully we purchased an additional oxidiser last year, otherwise we would have run out of oxygen this year. This is a sobering reminder of how quickly things can escalate, especially with the Delta variant which is 60% more infectious than the variant that caused our last dramatic surge. So we look forward to welcoming more visitors, but remain cautious.”

Judy Richardson, Chief of Nursing, comments: “We are really happy that patients, residents and clients can see more of their loved ones, but we are keeping a close eye on the number of cases and hospitalisations. While prevalence is low, we can maintain a more open visiting policy, though all visitors will still have a temperature and mask check before being able to enter our facilities. Our position will be reviewed if COVID-19 cases rise.”

Vice President of Acute and Ambulatory, Norma Smith, comments: “Opening up to more visitors for our patients and residents is heart-warming for all of us working in the hospitals. We know what it means for someone in hospital to see their loved ones, and have been through what it is like when they can’t. Given the risks of the Delta variant, we just remind visitors to stay masked at all times, even when in patient rooms and be mindful of physical distance; this vigilance will help us maintain a more open visiting policy.”

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

  • Visitors must pass a temperature and mask check at our entry screens before coming into a BHB facility
  • 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
  • If someone has travelled, they should only visit after they have completed their post-travel testing requirements with all negative tests
  • 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 allowed only in exceptional circumstances.

All current visiting requirements are listed below:

Acute care patients in the Acute Care Wing (Ace Barber, Ascendant Partner Re, Catlin Lindo), including those on isolation: visitors allowed between noon and 8pm. Masking and physical distance precautions must be followed in the room.

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 at any one time between noon and 8pm.

Intensive Care Unit: Two designated support people 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
  • The same designated support person can visit between noon and 8pm after the birth, but will be restricted to the patient’s room
  • Doulas can attend the birth, and afterwards once a day between noon and 8pm

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 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)/Agape House:

  • MWI Long Term Care (Devon Lodge and Reid Ward): visiting between noon and 6pm. Visitors must stay masked and physically distant.
  • KEMH Long Term Care (Cooper, Gordon, Perry Units)/Agape House: one visitor per patient for up to one hour between noon and 8pm, and no more than two visitors in a room at any given time. If a resident is isolated due to COVID-19 they cannot have visitors, but if isolated for any other reason they can.

Emergency Department and Lamb Foggo Urgent Care Centre:

  • Patients can come with one companion to the Emergency Department or Lamb Foggo UCC – patients and visitors must remain masked and physically distant from other people waiting.
  • Up to two companions may be allowed for:
    • Minors (under 18)
    • End of life cases
    • Combative individuals
  • Please note if someone dies in the ED or is brought to the hospital after passing away, only two people can visit at a time from the immediate family. There is not enough space to safely accommodate large viewings so we discourage mass attendance in the waiting room. Only three (3) family members will be accommodated in the family room at a  time .
22 July 2021 News

BHB announces breast ultrasound service

Wednesday 21 July 2021: Bermuda Hospitals Board (BHB) is on the forefront of breast care with plans to offer breast ultrasound for people with dense breast tissue.

BHB provided the service to its first patients last week. The automated breast ultrasound system (ABUS) is a new piece of equipment that is FDA approved for breast cancer screening as an adjunct to mammography for persons with dense breast tissue.

“We are excited to add the automated breast ultrasound system from GE Healthcare to our comprehensive breast cancer screening programme,” said BHB Chief of Radiology Daniel Stovell. “By offering ABUS in addition to mammography for our patients with dense breast tissue, we anticipate improving detection for small cancers that cannot be seen on a mammogram alone.”

Dense breast tissue has been found to be the most common risk factor for the development of cancer and also makes cancer more difficult to detect using mammography alone, according to multiple large studies. As breast density goes up, the accuracy of mammograms goes down. The difficulty radiologists experience when reading mammograms is that both dense tissue and cancer appear white on a mammogram. With ABUS, suspicious masses appear black against the white of the dense tissue.

“Mammography is the gold standard for the detection of breast cancer. However, it doesn’t work equally well in everyone, particularly those with dense breast tissue,” said Dr Stovell. “Designed and built specifically for screening, research shows that ABUS technology as an adjunct to mammography has the potential to find 35.7 percent additional cancers that would not have been found with mammography alone.”

Dr Stovell recommends women get regular mammograms as suggested by their doctor, and if they have been informed that they have dense breast tissue, that they talk to their doctor or radiologist about specific risks and additional screening tests that might be appropriate.

ABUS scanning is part of the comprehensive service offered in the Mammography Department of BHB’s Imaging Services. Services include:

  • annual mammograms (3D)
  • stereotactic breast biopsies (3D)
  • automated breast ultrasound (ABUS)
  • breast MRI
  • bone density with body composition

Pictured from left: BHB imaging technologists Terricca Smith, Terri Farnan and Carla Cann complete their training on the new automated breast ultrasound (ABUS) system with a volunteer patient

21 July 2021 Home Page, News

Stroke patients benefit from improved treatments at BHB

Monday 19 July 2021: Stroke care in Bermuda has dramatically improved since the establishment of Bermuda Hospitals Board’s (BHB) Primary Stroke Centre in July 2019, part of a clinical affiliation with Johns Hopkins Medicine International.

Establishing a Primary Stroke Centre has led to improvements to processes and treatments within the hospital. These clinical improvements, alongside a public awareness campaign about the importance of seeking immediate emergency care at the first signs of stroke, have meant more people get the critical care they need in time to improve their outcome.

About 13% percent of those who experience a stroke now receive a clot-busting drug that increases their chances of making full recoveries, a benchmark that puts BHB’s Stroke Centre in line with outcomes at leading hospitals and stroke facilities around the world. This compares to an average of 7% for primary stroke centres in the USA, with an accepted minimum being 5%.

“This has immediate human impact,” said Medical Director of the BHB Primary Stroke Centre, Dr Francene Gayle. “It means more of our stroke patients than ever before are able to make full recoveries. Three months after having a stroke they are able to return to their pre-stroke functioning levels. This is so important for quality of life, and as 25% of those who had a stroke in 2020 in Bermuda were under the age of 60, these are often people with many years ahead of them.”

Recognising that stroke had become an epidemic on the island, in 2018 BHB took action to turn the tide. Stroke can be debilitating, leaving individuals paralysed and/or significantly impaired. It is also leading cause of death globally.

“Major disability and death are the common consequences of those with a diagnosis of a stroke globally and Bermuda was no exception” said Dr Gayle. “Those who survive are often unable to return to work or their routine way of living. These individuals were oftentimes the bread winners of their households, and required 24-hour care. The financial impact on the families involved and on the local economy was significant,” Dr Gayle continued.

“We needed to change the trajectory of the trend,” she added. “We wanted to create a Primary Stroke Centre to increase and improve the access of all Bermudians to high-level acute stroke care that’s based on the latest research.

There are two types of strokes: ischemic and haemorrhagic. The most common are ischemic and involve a restriction in blood supply and therefore oxygen, to the brain. This can be caused by a blood clot or plaque build-up in the arteries.

In an ischemic stroke, patients who access medical treatment within 4.5 hours of the start of symptoms may be suitable to get a clot-busting medication – called IV thrombolysis tPA (IV tPA). In cases where this medication is given in time and bursts the clot, the patient avoids the major damaging effects of having a stroke and increases their chance of recovering with little or no disability.

“This clot-busting drug is integral to the process of full stroke recovery,” said Dr Gayle. “But I can’t stress enough the importance of recognising the signs and getting to the hospital immediately. We have to work together to get IV tPA going within that 4.5 hour window. Remember BEFAST—Balance, Eyes, Face, Arm, Speech, Time. If you think you’ve had a stroke, get to hospital immediately, or call 911.”

“We are thrilled to see the improvement in stroke outcomes take place so quickly,” said Victor Urrutia, MD, Director of Johns Hopkins Hospital’s Comprehensive Stroke Center. “It is a clear indication that collaborations like ours can have a significant impact on the health and stability of individuals, families and communities around the world. We will continue to work closely with BHB to assist in their efforts to reduce the incidence and improve stroke outcomes for Bermudians.”

“We have surpassed our goal and we’re now meeting the benchmark of leading hospitals around the world,” said BHB CEO & President Michael Richmond, MD. “But most importantly, we’re improving quality care and changing lives.”

19 July 2021 Home Page, News

Team established to support adults with intellectual disabilities at home

Monday 19 July 2021: Bermuda Hospitals Board today announced the establishment of a community team that will help and support adult (over 18) intellectual disability clients and their families at home.

The team is part of the Intellectual Disability Directorate, which is based at the Mid-Atlantic Wellness Institute with residential care offered in 14 group homes across Bermuda.

Community Intellectual Disabilities Team (CIDT) clinical manager, Christopher Cunningham, explains: “There is a pressing need for better support for adults with intellectual disability who live at home with their families. People who have intellectual disabilities can live full and wonderful lives at home with their families, and we can help this happen with a strong support service for them. We don’t want families to struggle on their own, or see their loved ones deteriorate because they can’t access the support they need.”

“By providing a support service for clients who live with their families, we want to improve access to safe and equitable care, empower clients and their families to be actively involved in their health care, increase levels of independence, and help clients develop new skills so they can thrive in their community.”

The team is multi-disciplinary, which means that individuals from a number of different professions work together to meet the needs of the clients and their families. The team includes a nurse, rehabilitation therapist, rehab aides, psychology assistant, case manager clinical assistant and is the process of recruiting for an occupational therapist, speech and language pathologist and physiotherapist to complete the group.

Intellectual Disability Director, Morrisa Rogers, adds: “We are thrilled to see the Community Intellectual Disability team established – this has been a long plan in the making. The need is there, and we believe there are many families who could benefit from our support, but who are currently struggling on their own. We want to better support families and their loved ones with intellectual disabilities so they can flourish in their homes. They may have additional needs, but intellectual disabilities should not stop anyone from being able to live a full and loving life on their own terms.”

The service is available via referral from physicians or other agencies, and individuals can contact the service directly if they believe they need it. They should call 249-3807 or 239-3803.

To be eligible, to access the community intellectual disability team service, an individual must be over 18 and have an intellectual disability as defined by the World Health Organisation means an individual has a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence) and a reduced ability to cope independently (impaired social function) which started before adulthood with a lasting effect on development (life-long condition). The individual also needs to have a presenting health need that requires intervention from the CIDT, and the person’s intellectual disability is directly impacting their ability to have this health need met through mainstream service.

19 July 2021 Home Page, News

BHB Pathology Department maintains accreditation

Monday 12 July 2021: The Pathology Department at King Edward VII Memorial Hospital has once more maintained specialised laboratory accreditation with the Joint Commission International (JCI). Accreditation is assessment of patient safety and quality standards. This is Pathology’s sixth JCI survey, which it has successfully achieved each time since 2006.

The Pathology Department at KEMH includes the laboratory areas that do diagnostic testing, from blood and urine to biopsies, the morgue, transfusion services, including the Bermuda Blood Donor Centre, and the phlebotomy staff who draw blood.

This is the first time the accreditation process has been completed remotely for Pathology, due to the pandemic, but this did not diminish its rigor. The survey was carried out in mid-May.

Danee Swan, Quality Manager in Pathology, comments: “The survey was carried out remotely, but was still intense and rigorous. We had to give two detailed presentations to our surveyor and sent a lot of advance documentation. During the survey week, surveyor requested specific tests from specific dates and trace processes, staff competencies and patient results. This was an extremely demanding process that traced tests from the patient – whether in an inpatient bed or outpatient lab – to the delivery of results. We are very pleased to have been awarded accreditation status.”

Kathy Stephens, Pathology Manager, comments: “We are accredited by Accreditation Canada as part of the hospital-wide process, but Pathology has also sought specialised laboratory accreditation with JCI since 2006, and we have successfully achieved it every three years since then. It is a testament to Pathology’s ongoing pursuit of excellence, ensuring we follow the highest patient safety and quality standards.”

Dr Clyde Wilson, Chief of Pathology, comments: “I would like to thank and congratulate the Pathology staff who work tirelessly every day to meet the highest standards to ensure our tests are accurate and timely. Through the year we have had to adapt constantly to the changing restrictions of the pandemic as the surges have come and gone and included new testing for COVID-19. We undertake about 3.5 million tests a year in the lab, but every one is significant to the individual patient, and at the heart of accreditation is our focus on patient care, doing the best we can for the people who need answers about their health.”

12 July 2021 Home Page, News

Blood donor winners announced

Friday 9 July 2021: The Bermuda Blood Donor Centre today was pleased to present blood donors Jason Kyme and Lorraine King with a prize each, donated by Hamilton Princess & Beach Club. The two prizes were a weekend stay at the hotel, and a champagne brunch.

Included in one draw were the most active regular blood donors, and in the other all new donors, based on donations made over the last twelve months.

Dr Eyitayo Fakunle, Consultant Haematolgoist, who oversees the Blood Donor Centre comments: “We would very much like to thank all our new and regular donors who week in and week out help us save lives throughout the year. This raffle was a way for us to recognise the tireless giving of our donors. Thank you to Hamilton Princess for helping us celebrate their generosity.”

From left to right in the photo: Alma Lou Polinar-Swainson (Phlebotomy Nurse), Susan Deverteuil (Phlebotomy Nurse), Lorraine King (blood donor), Dr Clyde Wilson (Chief of Pathology), Tim Morrison (General Manager, Hamilton Princess), Dr Eyitayo Fakunle (Consultant Haematologist), Jason Kyme (blood donor), Dawnette Been (Senior Technologist, Blood Donor Centre and Transfusion Services) and Kathy Stephens (Manager, Pathology)

9 July 2021 Home Page, News

Bermuda Hospitals Board Primary Stroke Centre screens all its patients for depression

Tuesday 6 July 2021: Bermuda Hospitals Board (BHB) will now routinely screen all its stroke patients for depression.

“Experiencing a stroke can dramatically affect a person’s life,” said BHB Primary Stroke Centre Medical Director Dr Francene Gayle. “Strokes can be debilitating, moving a normally functioning person to one with significant function impairment. This can happen suddenly.

“Such a drastic change in a person’s mental and physical condition is understandably often traumatic, not only for the person but also for their family. It’s the reason many stroke patients become depressed in the days, weeks and months following their diagnosis.”

“Depression after a stroke is common,” said BHB Chief of Psychiatry Dr Chantelle Simmons. “In addition to the direct emotional impact, post-stroke depression is also associated with poorer functional outcomes. The good news is that treatment is available and we will provide it.”

“Early identification and treatment of post-stroke depression is critical in optimising patient outcomes,” added Dr Gayle.

The Primary Stroke Centre has implemented a post-stroke depression policy that clearly details how patients will be assessed for depression, when they will be assessed and, based on the assessment, the treatment that will be used. Inpatient and outpatient treatments are available.

The new process involves various hospital departments and disciplines, including allied health professionals (occupational, physical and speech therapists), nurses, physicians, psychiatrists and clinical psychologists.

“Implementation of this policy is another example of how we at BHB continuously strive to give the highest quality and safest care to our patients,” said BHB Chief of Staff Dr Wesley Miller. “We have a vision to pursue excellence through improvement wherever we can. Recognising and attending to the mental health needs of our stroke patients is not only good for our individual stroke patients, but by extension for their families and friends. It’s beneficial to our Bermuda community.”

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6 July 2021 Home Page, News

BHB and BIU sign three-year agreement

Thursday 1 July 2021: Bermuda Hospitals Board and Bermuda Industrial Union today announce the completion of negotiations and signing of the three-year collective bargaining agreement on behalf of all BIU staff at KEMH and MWI. The agreement will last up to October 2021.

To officially complete the process, a signing was held at the BIU headquarters in Hamilton for members of the two negotiating teams.

R Scott Pearman, BHB Deputy CEO, comments: “Although negotiations have taken some time, I’d like to recognise the hard work of both BHB and BIU negotiating teams in reaching an amicable agreement.  COVID-19 has been a disruptive force to the process, but we have all adjusted and kept going. I must give a sincere appreciation for the BIU leadership and BIU hospital membership during what has been an incredibly challenging time for people working in healthcare. BIU staff include aides, emergency medical technicians (EMTs), environmental services staff, community care workers, laundry operators, maintenance personnel, orderlies, sterile processing technicians and food services employees. They are very much involved directly or in support of frontline care. Not only have they worked tirelessly to keep services running during the pandemic, but they have also stepped up to the plate in helping the hospital manage costs.  They supported the pension and social insurance holidays, and while base pay remained stable, BIU members agreed last year to a temporary reduction in overtime rates. This has made a huge difference to BHB’s ability to meet its financial obligations to all its staff and keep services running throughout. Truly the BIU and its members have shown strength and compassion, and have played a major role in seeing our community and hospitals through this difficult time.

Chris Furbert, BIU President, agreed: “We are very pleased to be completing the current negotiations, which have reflected the good relationship between the BIU and BHB. We appreciate the good faith with which both parties came to the table. It has been a very difficult 18 months for BHB and Bermuda as well as our membership, but we have stayed at the course and ensured employee rights are supported and fair agreements made. We recognise the financial pressures the hospitals are under because of the pandemic as well as the additional burden BHB and its staff have shouldered. I am very proud of the BIU members’ efforts and commitment in their work, and we all recognised the crisis being faced and so were willing to help out where we could to ease the financial burden. We will all be rolling up our sleeves for the start of the next two year agreement negotiations in a few months, but we have built trusted relationships through this process and this will help us as we move on.”

1 July 2021 Home Page, News