Bermuda has won “a major victory” in getting hospital failures under independent review, a former hospital official turned whistleblower said.

However, Edward Schultz added: “As a community, we should not accept any emergency department boarding. We can eliminate it through the appropriate processes and avoid preventable deaths and increases in morbidity from boarding.

“We just have to stand up and demand that it’s done.”

Dr Schultz, who started in King Edward VII Memorial Hospital in 1988, was Chief of Emergency Services and Hyperbaric Medicine until he stepped down in 2018.

In April, he went public with calls for a non-partisan inquiry into “critical overcrowding” at the emergency department and hospital wards.

The Bermuda Hospitals Board announced last Thursday that it had taken on the British consultancy Acumentice to examine its operations and give a report with its recommendations, likely to come after about six weeks, which the board said would be made public.

Dr Schultz told The Royal Gazette he was encouraged to see that the firm had worked closely with the National Health Service in the UK because standards of accountability were generally higher there compared with Bermuda.

“I suspect this will be a good organisation to review the hospital. I’m glad to see that KEMH didn’t select one of its overseas partners, where I think there would have been a temptation there to sugar-coat a report.”

Dr Schultz said he pulled no punches in going public on April 10 about emergency room boarding, when admitted patients stay in the ER because no inpatient beds are available.

He said a review of the issue would inevitably encompass operations across the hospital.

He added: “I was interested that I wasn’t challenged by the hospital on anything I said. I expected to hear a rebuttal from the hospital but didn’t.”

The physician continues to insist that boarding could be ended in a matter of weeks.

Dr Schultz said ER boarding had “significantly” worsened from 20 to 30 patients a day to as many as 40 in the months between sharing his concerns with the ministry in January, and going public.

He praised the ministry and highlighted the overall “excellent care at KEMH for a community hospital”, but condemned the “intransigence” among management on facing flaws that had been well known for years.

Dr Schultz called “super user” patients a major driver of hospital overcrowding: a “very small number of patients”, often elderly and chronically unwell, who tax resources by getting admitted to the inappropriate setting of hospital “over and over again”, instead of a setting more suitable to their needs.

He added: “The Mid-Atlantic Wellness Institute, which is part of BHB, has used case management for years. They can see it’s been very successful. What I am arguing for now is case management for emergency patients and patients who are in the hospital and being discharged.”

Dr Schultz said there were entrepreneurs in the community “trying to introduce case management for the discharge of patients”.

He conceded that “hiring someone to do the case management and keep people from being admitted and readmitted to the hospital” would come at a price.

He added: “Even if you have to pay, it’s still more cost-effective.”