Hospital outsources beds strategy

  • What a rip-off: Mark Selley, Silvia DeSilva and Allan DeSilva have founded an advocacy group for dissatisfied patients of KEMH

    What a rip-off: Mark Selley, Silvia DeSilva and Allan DeSilva have founded an advocacy group for dissatisfied patients of KEMH

A total of $1.5 million is to be paid to a professional services firm to help hospitals management to ease bed shortages and cut down on surgery cancellations.

The Bermuda Hospitals Board has signed up international company KPMG on a six-month contract in an attempt to come up with a plan to improve efficiency in medical care.

A patients’ pressure group claimed the deal was a waste of money and that the improvements it aimed to deliver could be achieved by in-house staff.

Mark Selley, the Bermuda Healthcare Advocacy Group chairman, said: “What a rip-off. Why call the fire brigade when you’ve got your own fire extinguishers? Why call KPMG, why can’t they figure it out themselves?”

He added he was “very cynical” about the use of taxpayers’ dollars.

Mr Selley said: “Our advocacy group is trying to curb costs and pull people in, so it’s flying in our face.”

He pointed out the hospital has well-paid individuals whose job it is to ensure services run smoothly. He added: “It’s just an added expense, what does KPMG know about the medical business? They’re financial people.”

KPMG was called in after King Edward VII Memorial Hospital reached crisis point in 2017 when every bed in its emergency department and acute care wing was occupied.

A BHB spokeswoman said last week the company was recruited to help the board improve quality of service and patient satisfaction as well as cut costs, in line with BHB’s strategy.

Details published in the Official Gazette showed the $1,498,503 contract started last October and is scheduled to finish at the end of March.

The spokeswoman said the KPMG team worked with staff in the acute inpatient unit to “minimise delays in care, and catch challenges that may impact a safe discharge very early on”.

The spokeswoman explained: “For example, KPMG worked with staff to pilot a ‘bullet round’ process, essentially a very focused daily meeting of staff from across all disciplines — doctors, nurses, physiotherapists, speech therapist and pharmacists — who quickly review how care is progressing for each patient and raise any issues.

“This enables us to discharge people safely as soon as they are ready, which is better for patients and opens more beds for people who need to be admitted.”

She added: “It also highlights systemic issues — areas where delays are common — which is a flag that further process improvements may be needed.”

BHB reviewed surgical cancellations after 12 operations were delayed in March, 2017.

Venetta Symonds, the chief executive, who is on sick leave for three months, said at the time that all beds in the emergency department and acute care wing were full, which meant patients had to be treated in the maternity and children’s wards instead.

The BHB found bed capacity management needed improvement, as well as problems with patients who did not turn up, were too unwell for treatment or with incomplete preoperative preparation.

The spokeswoman said: “A small number of beds are now protected just for elective surgery patients.

“The result is that from September 1 to December 31, there were zero surgical cancellations due to bed capacity.

“In January, there were two, both on January 2, due to a surge of admissions on New Year’s Eve.

“Surgical staff are also trialling a process of calling people for their initial health check up and are looking to introduce other ways of reminding patients of their surgical date.”

Outpatient department staff also partnered with KPMG to try the reminder process.

The spokeswoman explained: “People who do not turn up for their appointments with specialist doctors or allied health services — physiotherapy, occupational therapy, speech therapy and dietitians — effectively cause delays for other patients who could have had that slot, and they also increase costs for the system.

“Our hope is to either avoid cancellations or have early enough warning that other patients can be rescheduled for an earlier date.”

The BHB said it was too early to confirm some of the schemes’ success because of the “very recent” implementation of the trials.

But Jennifer McCarron, a BHAG member, said: “This is just a huge waste of taxpayers’ money, this will also increase healthcare costs.

“They’re just throwing money away unnecessarily to achieve something that the current staff members should be doing.”

Andrea Smith, also a group member, said she was involved in earlier workshops designed to find where improvements could be made at the hospital.

She added: “They’ve done this exercise already and as far as I’m concerned nothing has changed.”

But the BHB spokeswoman said the hospital did not have the staff to manage care and implement improvement projects at the same time.

She added: “KPMG are also able to provide people with specialist skills and training that the hospital doesn’t have in-house and would be expensive and time-consuming to hire directly.”

A KPMG spokeswoman said the company did not comment on its work for clients.

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Published Jan 21, 2019 at 8:00 am (Updated Jan 21, 2019 at 6:12 am)

Hospital outsources beds strategy

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