Emergency Department performance better than international benchmarks for time in emergency

Friday 20 June 2025: As part of national Emergency Day on 27 May, BHB collated its Emergency Department (ED) data to highlight the achievements of the ED team.

The BHB Emergency Department (ED) team includes doctors, nurses, nurse’s aides, emergency medical technicians, social workers and environmental services and security personnel, as well as all the BHB supporting departments. It is also important to acknowledge others such as our pre-hospital first responders (Bermuda fire and rescue service team and St John’s voluntary emergency medical technicians) and community surgeons in Bermuda who all respond to emergencies or support emergency care in one form or another.

CEO & President Scott Pearman notes. “As a front-line service, Bermuda Hospitals Board would like to recognise all the dedicated professionals who provide emergency care around the clock. This year has been extremely challenging for the ED. The high number of medically-fit-for-discharge patients in KEMH has caused long wait times for patients waiting for admission to an inpatient unit, and those people waiting in the ED for a bed then fill up the Emergency Department itself. Amazingly, despite this, outside of patients waiting for an inpatient bed, the majority of people are seen and discharged from our ED faster than international benchmarks.

“I would like to thank our ED staff who have continued to care throughout this very challenging year to date and ensure every person in Bermuda got the care they needed.”

Chief of Staff, Anna Neilson-Williams says, “KEMH’s Emergency Department carries a unique responsibility as Bermuda’s only hospital ED, handling every emergency on the island. Despite this challenge, the team consistently delivers care that meets rigorous standards.

“Notably, KEMH is a designated Primary Stroke Centre through a partnership with Johns Hopkins Medicine International. This affiliation has brought global best practices for stroke diagnosis and treatment to Bermuda, ensuring patients receive expert care close to home. Work is also underway with Johns Hopkins to improve our emergency medical response to trauma and burns and improve outcomes for our most seriously injured patients.”

Chief of Emergency, Dr Chikezie Dean Okereke, explains that his department’s ability to meet international benchmarks has continued even through this year’s challenges.

“For the twelve months, April 2024 to March 2025, the ED recorded approximately 29,105 visits, involving about 18,123 individuals, 96% of whom were Bermuda residents. Among them, 1,188 patients presented with life-threatening conditions such as heart attacks, major trauma or severe respiratory distress that required immediate, high-priority care.

“About 15,000 other attendances involved urgent but not immediately dangerous conditions — these still required significant resources such as tests, imaging and consultations to diagnose and manage.

“Despite the high volume, the emergency department team consistently delivered timely care. The median time from arrival to triage (initial nurse assessment) was just 14 minutes, and patients who did not require admission typically spent around three hours and eight minutes from registration to treatment and discharge. About 12% of patients were admitted to hospital for further care, while the remainder were safely treated and discharged. It should be noted that internationally, most public emergency departments aim to keep the median time between registration and discharge to within four hours.”

Dr Okereke warns, however, that people shouldn’t use this as a reason to come to hospital instead of seeing their primary care physicians (GPs).

“Just under half our patient are in the lowest two levels of acuity – meaning they have conditions or injuries that do not require Emergency care. They should see their doctor, or if it is the weekend go to the Lamb Foggo and other community urgent care centres.

“For a start, when we are busy, they are taking up our time which should be focused on those who truly need emergency care. Secondly, while our average wait times are and remain generally very good, people who come in with conditions that don’t truly need emergency care will likely wait a lot longer than those who come in with life-threatening injuries and illnesses. So, if you are not that unwell, you will wait longer than the average wait times.”

Keeping patients informed has been a key focus this year. Patients in the waiting room can now see a large display includes the wait times. It also advises how many low, medium and critical care patients there are, and how many are waiting in the department for bed. A KEMH Performance Data Snapshot report is also published every month on the BHB website’s statistics page, with a day-by-day summary of wait times, admissions, outpatient appointments and surgeries.

“We hope the community is proud of its Emergency Department,” says Dr Okereke. “This team is dedicated to your care every day and we are happy we can share our data to highlight the quality of our service.”

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