BHB updates COVID guidelines

Monday 5 December 2022: Following the end of the public health emergency laws, BHB updated its COVID-19 guidance for patients and visitors from 1 December. BHB has also returned to alert level 1 (the lowest level), for the first time since 2020.

Chief of Staff Dr Wesley Miller comments: “Although public health emergency laws ended on 30 November, COVID-19 and other respiratory diseases, such as flu and respiratory syncytial virus (RSV), are still dangerous, especially to vulnerable people who are older, immunocompromised or unwell.

“The winter months have long been challenging for BHB, even prior to the pandemic, with increased emergency visits and admissions. This means, while we have returned to alert level 1, we remain cautious. We are, for example, maintaining precautions for staff during patient interactions, so people will find that BHB staff are masked when they have their treatments or tests, or if someone enters their inpatient room.

“There is certainly a balance between protecting our vulnerable patients, while accepting that the community is returning to normal practices throughout Bermuda. The public health emergency is over, but if you are visiting a loved one in hospital they may be more vulnerable to an infection due to age or illness. We are asking you to help protect them by wearing a mask in their room as you are in close contact for longer periods of time.

“People should also feel comfortable remaining masked throughout any other areas as a precaution. Masking in communal areas is recommended, though not mandatory, and we will continue testing patients before admissions and surgery, and regular surveillance testing in long-term care areas.”

Overview of precautions for visitors and patients from 1 December:

General masking at BHB:

  • Masking is recommended but not mandatory in most communal areas of the hospital outside of patient rooms.
    There will no longer be mask and temperature checks at the door.

When masks should be worn:

  • BHB staff will continue to mask for patient interactions, including outpatient consults, testing and in inpatient/resident rooms.
  • Patients and visitors who are vulnerable themselves should wear a mask in all areas of BHB.
  • For parents and visitors, masks must be worn in the Special Baby Care Unit (SCBU), and masking is strongly recommended in all of Maternity.
  • Patients who have cold- or flu-like symptoms must wear masks if they need a service that cannot be rescheduled, for example, a dialysis treatment or emergency visit.
  • People visiting patients or long-term care residents who are on isolation must wear the appropriate protection as advised by BHB staff before entering an isolation room.
  • People visiting patients or long-term care residents are strongly recommended to wear a mask while in patient rooms as patients and residents are more vulnerable to serious complications of a respiratory infection.

Other protections that will remain:

  • Symptom checking surveys will continue for people attending BHB outpatient services.
  • Patients who have symptoms or have tested positive for COVID-19 should reschedule hospital appointments if possible. If it is urgent for someone with symptoms to attend BHB (eg a dialysis treatment or emergency visit), they should advise staff and wear a mask.
  • All patients admitted to BHB inpatient units and people undergoing a surgical procedure will be tested for COVID-19.
  • Surveillance testing for residents in long-term care units across BHB will continue every two weeks.
  • Staff, patients and residents in any area of BHB who exhibit symptoms will be tested for COVID-19.

BHB visiting guidelines remain as follows:

Emergency Department and Lamb Foggo Urgent Care Centre:

  • Patients will be allowed one support person while in the Emergency Department or Lamb Foggo Urgent Care Centre.
  • Vulnerable adults and all children will be allowed up to two support people.
  • For patients near the end of life, up to two support people can attend.
  • If someone dies in Emergency or is brought to the hospital after passing away, only one person and one support person for that individual can attend. Up to three people can be in the family room. Other family and friends should not attend, as there is not adequate space to gather safely and the ability to offer viewings is very limited.

Acute care patients in the Acute Care Wing units (Ace Barber, Ascendant 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 8pm.

Mid-Atlantic Wellness Institute acute inpatient care units (adult, child and adolescent services):

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

Long-term care units (KEMH and MWI, including group homes):

  • Up to two people (one at a time) can visit each resident for two hours each day between noon and 7pm.
  • No more than two visitors are allowed in rooms with more than one resident at any given time.

Isolation patients in all areas of BHB:

  • Two designated support people pre-identified by the patient can visit for up to two hours per day, wearing required protection as advised by BHB staff.

Intensive Care Unit:

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

Maternity Unit:

  • Symptom screening is required for support people and visitors. If they have symptoms, they will not be allowed to attend.
  • One designated support person may stay as long as needed after the birth.
  • If the mother is not discharged within 24 hours, visitors will be allowed to visit between noon and 8pm.

Gosling Unit:

  • Up to two parents may visit minor patients.
  • Adult patients can have up to two designated visitors (one at a time), between noon and 8pm.
5 December 2022 Home Page, News

O positive blood donors urgently needed

Thursday 1 December 2022: Bermuda Hospitals Board (BHB) is asking people with O positive blood to donate as stocks of this blood type are running low. Donors and potential donors are asked to call 236-5067 to make an appointment.

If you are unsure about your blood type but are willing to donate, please contact the Bermuda Blood Donor Centre at (441) 236-5067 or blood.donor@bhb.bm, or by WhatsApp at (441) 533-9553.

Appointments are preferred, although walk-ins are accepted.

The Bermuda Blood Donor Centre is located at King Edward VII Memorial Hospital and is open Monday through Thursday from 8:30am to 2:30pm, and on Friday from 8:30am to 1pm. It is closed on weekends and public holidays.

The Bermuda Blood Donor Centre team thanks the community for their kind assistance in ensuring they can continue to save lives.

More information about blood donation is available online at bermudahospitals.bm/be-a-donor/.

1 December 2022 Home Page, News

BHB shines green light for mental health awareness

Wednesday 30 November 2022: Mid-Atlantic Wellness Institute (MWI) encourages the public to be joyous and celebratory this holiday season.

“Positive thoughts engender positive feelings, which promote good mental health,” said Preston Swan, vice president of MWI clinical operations and acting chief operating officer for Bermuda Hospitals Board. “This December, we will again light the outside of our sister facility, King Edward VII Memorial Hospital’s Acute Care Wing, in green.”

This year’s theme for mental health awareness is Make Mental Health and Wellbeing for All a Bermuda Priority.

“Making mental health and mental wellbeing a Bermuda priority is not only a matter for the island’s mental health professionals,” said Chief of Psychiatry Dr Anna Neilson-Williams. “We can all reflect and recognise where we may be feeling stressed or pressured, and take small steps to address our mental health, particularly considering the challenges of recent years.”

Here are a few measures you can take, particularly during this season, to support your mental wellness.

  • Go outside and be with nature. Disconnect from devices.
  • Don’t get caught up trying to create a perfect holiday setting or experience. Set small, meaningful goals with family or friends and connect where you can.
  • If you are feeling overwhelmed, reach out to a professional who can help. Seeking support is not a sign of weakness.

“We encourage you to contact MWI, your GP or one of the many mental health professionals available within our community if you need support,” said Dr Neilson-Williams. “You are not alone.”

The green light for mental health awareness will start at dusk tomorrow, Thursday 1 December 2022.

If you need assistance, please call the MWI Acute Community Mental Health Service at 249-3432. For serious mental health crises at any time of the day or night, call 239-1111.

 

30 November 2022 Home Page, News

BHB Traffic Advisory for Monday 21 November 2022

No through traffic at King Edward VII Memorial Hospital on Monday 21 November

Thursday 17 November 2022: There will be no through traffic at King Edward VII Memorial Hospital from Point Finger Road to Berry Hill Road all day on Monday 21 November 2022.

All people needing to access services in the Acute Care Wing (ACW) should enter the hospital campus from Point Finger Road and use the visitor parking there.

All people needing to access services in General Wing should enter the hospital campus via Berry Hill Road and use the visitor parking there. Pedestrian access to the General Wing will be at the ambulance bay at the former Emergency Department or via the ACW main entrance.

The access restrictions are due to two separate crane lifts of heavy equipment on the campus.

For your safety and the safety of others, please comply with directions of personnel at each site.

17 November 2022 Home Page, News

PEARL Implementation Update

Sunday 13 November 2022: Bermuda Hospitals Board today provided an update on its progress with the implementation of its first BHB-wide electronic medical record system, called PEARL (Patient Electronic & Administrative Records Log).

Chief Executive Officer & President Dr Michael Richmond noted that the first two weeks had not been without their challenges, but that activity was beginning to return to normal.

He said: “The success of the implementation has been carried by our staff, external physicians and our partners, who prepared all they could, then have worked through the early expected issues that a major system implementation experiences. It has been a true team effort, as PEARL connects all parts of the hospital from pharmacy, diagnostics, finance and support areas to emergency, acute and critical care at all campuses.

“The good news is that we are on track and, after two weeks of having a slow down in our planned and outpatient activity, services will be running at normal capacity from Monday, including the number of elective surgeries. These are still early days, but issues have been managed, staff are mastering the new system, and we wanted the community to be fully informed about our progress.”

Despite a planned slow down in planned and outpatient activity, over the first two weeks after go-live there were still 3,267 encounters in ambulatory care (outpatient clinics and diagnostics), 150 surgeries (elective and emergency) and 20 babies born. In areas where activity could not be controlled, the normal activity levels were experienced. There were 1,011 people who attended the Emergency Department and Lamb Foggo Urgent Care Centre, and 142 admissions to an inpatient ward. This reflects KEMH and MWI wards.

In the Emergency Department, the average length of time between arrival and discharge did increase in line with expectations in the first week, but has gradually decreased since then (see data below).

Dr Richmond added: “I would like to extend my appreciation to the community for their understanding. We know it has been a challenge at times for patients in Emergency with longer average stays than normal, and elective procedures were reduced in the first two weeks. But the great promise of PEARL is to that as we work through this period we will be able to improve our care, smooth transitions, and use the system to help us deliver a better, safer care experience.”

PEARL went live in the early hours of Saturday 29 October, when information was transferred and then validated. Staff in different departments started using the system from the early afternoon.

The following is the ED length of stay (from arrival to discharge) for each day following go-live. The average length of stay up to 29 October in ED was 198 minutes (3 hours and 18 minutes).

Emergency average length of stay per day (midnight to midnight) in minutes

  • Saturday 29 October (partial day): 294
  • Sunday 30 October: 405
  • Monday 31 October: 442
  • Tuesday 1 November: 358
  • Wednesday 2 November: 485
  • Thursday 3 November: 366
  • Friday 4 November: 285
  • Saturday 5 November: 289
  • Sunday 6 November: 239
  • Monday 7 November: 289
  • Tuesday 8 November: 190
  • Wednesday 9 November: 160

 

13 November 2022 Home Page, News

O positive blood donors needed

Wednesday 9 November 2022: Bermuda Hospitals Board (BHB) is asking people with O positive blood to donate. Donors and potential donors are asked to call 236-5067 to make an appointment.

BHB Consultant Haematologist Dr Eyitayo Fakunle said: “We are in need of O positive blood due to a recent emergency that made our stock lower than we would have anticipated.”

If you are unsure about your blood type but are willing to donate, please contact the Bermuda Blood Donor Centre at (441) 236-5067 or blood.donor@bhb.bm, by WhatsApp at (441) 533-9553.

Appointments are preferred, although walk-ins are accepted.

The Bermuda Blood Donor Centre is located at King Edward VII Memorial Hospital and is open Monday through Thursday from 8:30am to 2:30pm, and on Friday from 8:30am to 1pm. It is closed on weekends and public holidays, including this Friday 11 November.

The Bermuda Blood Donor Centre team thanks the community for their kind assistance in ensuring they can continue to save lives.

More information about blood donation is available online at bermudahospitals.bm/be-a-donor/.

9 November 2022 Home Page, News

Local newborn makes BHB history

Thursday 3 November 2022: Bermuda Hospitals Board (BHB) is happy to announce the birth of the first Bermudian since the implementation of its electronic medical record. The Patient Electronic & Administrative Records Log (PEARL) is the name of the system which went live at both the King Edward VII Memorial Hospital (KEMH) and the Mid-Atlantic Wellness Institute (MWI) over the weekend.

Frances Ivy Edwards was born at 5:35 on Monday morning to parents Thomas and Kaitlin Edwards. Her birth represents the first Bermudian on the island who will never have had a paper BHB medical record. Her entire record will be digital.

“There was hospital-wide excitement at Frances’ birth,” said BHB CEO & President Dr Michael Richmond. “We consider her our PEARL. Her birth is a historic event for BHB and we are pleased her parents have consented to us sharing the news, her name and photos.”

“I had read the article about the hospital moving to electronic record keeping in the media and thought it was a big step and a positive move for the hospital and the island,” said new mother Kaitlin Edwards. “But I never really thought about what it might mean for my child. It is exciting to recognise that she’s the first to have a paperless medical record at the hospital. I was born here, my husband was born here and so was our son, but she’s not just the first in our family to have a digital birth record, she’s the first in the island. It’s a fun fact she can always be proud of.”

 

 

3 November 2022 Home Page, News

Mid-Atlantic Wellness Institute thanks Markel Bermuda Limited

Monday 31 October 2022: Bermuda-based Markel Bermuda Limited has long held that good mental health is vitally important. In fact, a gift from the insurance giant to Bermuda Hospitals Board’s (BHB) Mid-Atlantic Wellness Institute (MWI) during the height of the COVID-19 pandemic helped improve MWI’s service offerings.

“The theme of World Mental Health Day, which was celebrated on 10 October, was Make Mental Health and Wellbeing for All a Bermuda Priority,” said Preston Swan, BHB acting chief operating officer and VP of MWI clinical operations.

“Markel Bermuda Limited’s donation to us certainly demonstrates that the company already has this firmly established in its culture. We not only thank them, but also salute them,” he added.

Markel Bermuda donated audio-visual equipment to MWI during the pandemic so treatment for clients requiring mental health services was not interrupted. The gift also allowed MWI inpatients to meet virtually with their families and loved ones.

“The equipment proved invaluable,” said Mr Swan. “It allowed our clients to interact virtually with their clinical teams. In fact, in many cases the virtual meetings were preferred by clients and have continued.”

“We recognise that for many, there is a stigma associated with physically attending MWI,” said BHB Chief of Psychiatry Dr Anna Neilson-Williams. “The Markel Bermuda gift gave our clients a choice in accessing our services. Being able to attend their sessions from their homes was a welcome change for many of them and in several instances boosted their spirits.

“This is particularly significant as clients were largely negatively impacted by the stresses of being in lockdown and the pandemic itself. That they were able to continue their therapies in that climate is important.

“Equally valuable was that our inpatients were able, thanks to the equipment, to maintain connections with their families and loved ones during the lockdown and post lockdown as, out of necessity, we reduced visitation considerably.

“And the equipment, although specifically intended for use during the pandemic, continues to benefit clients as we still use it,” she added.

“It is heartening to learn that our gift has had this impact on MWI clients and staff,” said Markel Bermuda Limited HR Business Partner Sarah Randall. “At Markel, we recognise the importance of proactively attending to our mental health and certainly ascribe to the theme set for Mental Health Awareness in Bermuda this year – Make Mental Health and Wellbeing for All a Bermuda Priority. We are pleased our gift has aided the community in this goal.”

31 October 2022 Home Page, News

PEARL Go-Live Milestone Celebrated

Saturday 29 October 2022: BHB’s CEO & President, Michael Richmond, provides this update on the go-live over the new electronic medical record, PEARL (Patient Electronic & Administrative Records Log) that took place overnight:

“I’m happy to state that BHB’s new electronic medical records system, called PEARL, is now being used across BHB in inpatient units and Emergency, at KEMH and MWI, including group homes. We are on target for the outpatient clinics to start using PEARL when they open on Monday 31 October. The system went live just after midnight and we had a very busy night with staff across MWI and KEMH working hard to input and validate data. As is expected with a new system of this complexity, we’ve had issues to address through the day, but the response by staff has been magnificent. PEARL is live and for the first time in BHB’s history, we have a BHB-wide electronic medical record. While our staff members are going to be a bit slower in these first few days as they get used to PEARL, we have multiple supports in place as they put their training and preparations into practice. Today is a milestone day in the delivery of care BHB and we are all looking forward to the benefits having an electronic medical record are going to bring to safety, quality and efficiency at BHB. I’m incredibly proud of what our staff have achieved – they have been at the forefront of this major change and have gone above and beyond the call of duty to make it happen. As we get through this adjustment period, it is something that Bermuda is going to be proud of too.”

29 October 2022 Home Page, News

BHB prepares for PEARL’s implementation

Thursday 27 October 2022: Bermuda Hospitals Board (BHB) today provided an update to the community about its first BHB-wide electronic medical record system, which goes live in the early morning of Saturday 29 October. The system has been called PEARL (Patient Electronic & Administrative Records Log) by staff.

Nurse on an acute care ward with a ‘workstation on wheels’ that can be used in patient rooms

PEARL is an electronic medical record system that makes patient information, from medical history to the latest physician notes and test results, immediately available to those who are involved in a patient’s care. This information will no longer be on paper or limited to fragmented systems. This means BHB staff caring for patients won’t have to wait for paper records to be delivered, check multiple systems for key information and results, or wait for information that might not have been filed yet. PEARL makes it easier to avoid duplications and delays because everything a clinician needs is immediately available in one place, and always up to date.

CEO & President Michael Richmond notes: “We are preparing for an exciting and significant transition in how we work. A big thank you must go to our staff across BHB for their hard work. PEARL’s implementation rests on the shoulders of hundreds of staff involved in designing, building and testing the system since the project started in April 2021, and over 1,400 staff who
are attending training, even as they meet their duties as care providers.

Staff involved in integrated testing earlier this year

“Our focus now is ensuring BHB maintains services safely throughout the go-live. There will likely be a couple of weeks where staff will be getting used to new processes, and we will run slightly slower than normal, but our ability to use PEARL will quickly become more sure and faster each day. Once we are used to using the system, the opportunities for improvements are going to help us soar.

“Going live with PEARL is just the beginning. PEARL is a tool our staff will use to deliver what they strive to do each day – the best possible levels of care and the best patient outcomes, something of which Bermuda can be truly proud.”

Key information about how BHB is managing PEARL’s go-live:

  • PEARL will be used across all BHB services – at King Edward VII Memorial Hospital, Mid-Atlantic Wellness Institute, Lamb Foggo Urgent Care Centre, and across all BHB group homes
  • All BHB services will continue throughout the go-live process, but it will initially take staff a bit longer to complete tasks as they put their training into practice
  • Elective activity (for example, non-urgent surgeries and outpatient appointments) will continue throughout, but there will be a phased reduction in work – at 50% of normal level in the first week after go-live and 75% of normal level in the second week after go-live. This will give staff some breathing room as they get used to using PEARL, minimising any potential patient safety or care risks. This is a best practice for implementing this kind of system, and follows advice from other hospitals and Cerner on how to successfully manage the transition
  • Emergency services will be open, but patients with minor conditions may experience longer waits. People are advised to see their GP if they have minor issues or need help managing their chronic illnesses
  • Additional Cerner employees and BHB staff who are PEARL super users will be positioned in departments, supporting staff ‘at the elbow’ in the first two weeks after go-live
  • A multi-level command centre structure is in place for the first two weeks in case there are issues that can’t be resolved at the department level, but need quick and effective resolution
  • After 10 November, we anticipate normal levels of elective activity will be restored, including surgeries

Chief of Staff Wesley Miller explains: “I am very proud to work with our staff as we prepare for this implementation. PEARL is going to transform what is possible in delivering the very best in safe, quality care across BHB. A system implementation of this size and complexity isn’t easy, but the reward of working through it will be in the enhanced ability to improve patient care and outcomes, which is at the heart of all we do.”

Chief Hospital Information Officer Keltie Jamieson adds: “Our focus over the next few weeks is on maintaining safe services as staff adjust. There will be a lot of on-the-ground support in departments as well as escalation processes for issues as our hard-working staff get used to something new. Patients and visitors in the first two weeks will see additional people in bright t-shirts who are the in-department support. We have done all we can to test and test PEARL again, but issues are normal in any major system implementation. The key is having robust structures to escalate and resolve them, which we have.

“There is so much to look forward to once we are through this implementation period, but step one is a successful implementation. That will give us the strong foundation we need to use PEARL as a tool of constant improvement in our pursuit of excellence.”

Click here for more information about PEARL

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Editor’s Notes – PEARL’s development to date:

  • PEARL will replace multiple BHB systems, and was necessary as BHB’s main clinical system was old and no longer going to be supported by the vendor
  • Cerner was selected via a competitive process involving about 100 BHB staff starting in 2018, with final approval in 2019 from the Board
  • The project was due to start early in 2020, but was postponed for a year due to the pandemic
  • The electronic medical record project started on 1 April 2021
  • The system was designed and built by the vendor, Cerner, in partnership with over 350 BHB staff
  • There have been two extensive rounds of integrated testing, involving BHB staff who ran patient scenarios to test all parts of the system
  • Although the project was undertaken because BHB’s main clinical system is being retired by the vendor, electronic medical records are the international standard of care. With all information in one place and clinicians across BHB able to share real-time orders and notes, care processes – such as a patient visiting emergency and being triaged, tested, diagnosed and admitted to an inpatient ward – can take place more efficiently
27 October 2022 Home Page, News