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Emergency patients forced to wait 22 hours for a bed

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King Edward VII Memorial Hospital (Photograph by Akil Simmons)

People attending the emergency department at King Edward VII Memorial Hospital were left waiting for an average of 22 hours for an inpatient bed on Sunday, The Royal Gazette has learnt.

The Bermuda Hospitals Board apologised yesterday for the “high wait times”, which it said had occurred on a number of occasions recently.

Monday and Tuesday saw the number of patients seeking emergency care surge to 117 people a day, an almost 20 per cent increase on the daily average of 96.

Delays in discharging patients were cited as an important factor in bed delays.

A spokeswoman for the BHB told The Royal Gazette: “Patients waited an average of 22 hours for an inpatient bed on Sunday, April 2, 9.5 hours on Monday, April 3, and 12.1 hours on Tuesday, April 4.

“It is important to note that BHB makes arrangements when these delays for an acute bed take place.

“These arrangements include an additional nurse and a nominated doctor from inpatient services coming to the emergency department so that we provide the care needed by the patient.”

She admitted: “Over the last month, we have experienced a number of times where wait times for an inpatient bed has been high.

“This has not always been caused by emergency admissions and visits being high, but speaks to delays in discharges, something the Minister of Health spoke to earlier in March.”

The spokeswoman added: “The average time spent in emergency, from arrival to departure, over the last month was 3.6 hours, and over the last three days it has been 3.8 hours.

“The major impact, however, is patients waiting for an inpatient bed.”

The organisation insisted that the past week had been “extremely challenging”.

The spokeswoman said: “BHB apologises to the people in emergency and their families who, once their immediate medical needs were attended to, waited for an inpatient bed.

“This week has been extremely challenging for us, and our staff have been working very hard to ensure services are delivered safely.

“In the last few days, we have been impacted by an increase in emergency visits and inpatient admissions, as well as delays in being able to discharge people who are medically fit to leave hospital. This is reflected in our figures.

“On Monday, April 3, and Tuesday, April 4, 235 people attended the emergency department, an average of about 117 per day.

“The average number of daily attendances for the month preceding was 96.”

Kim Wilson, the Minister of Health (Photograph by Akil Simmons)

She added: “About a third of emergency attendances over the last month have been for non or less urgent conditions that could have been managed in a primary care setting, for example at a GP clinic, and not at the emergency department.

“Admissions have also increased. The average number of daily admissions to an inpatient acute care unit from emergency for the last month has been about nine admissions. Over the last three days — April 2 to April 4 — 37 people have been admitted.”

She said that the hospital had also had patients who came in for outpatient surgery, meaning they were expected to go home after their procedure, but instead had to be admitted.

The BHB urged people leaving a hospital bed to arrange to be picked up before 11am to ease discharge pressure.

The spokeswoman said: “The challenges of patient flow from emergency to the inpatient unit does impact the time people spend in emergency for people with lower-acuity conditions.

“The delays experienced in discharging patients sometimes are hard to navigate as they relate to ensuring services are in place to support someone at home, or a wait for a nursing home placement.

“But there are times that the delays are avoidable.

“Picking up relatives ready for discharge each day by 11am makes a huge difference for us being able to clean a vacated room and admit a waiting patient.”

She added: “People who decide to pick their loved one up after work at around 5pm directly cause someone in emergency to wait an additional seven or more hours as it takes 90 minutes to sanitise a room so it is safe for the next patient.

“Anything families can do to help a loved one leave hospital when they are ready makes big difference to us managing our beds.”

The news comes after the BHB warned last month that it will struggle to maintain its facilities or to pay a basic cost-of-living increase to its staff because government funding is not keeping up with medical inflation.

The BHB, which is $16 million short of the funds promised to it by the Government in 2019, said that even if the Government made good the shortfall, failures to increase the spending cap meant that it had received a single 1 per cent increase in five years.

It emerged this year that the BHB had been shortchanged by up to $31.6 million in funding over the past four years.

The BHB and the Government agreed in 2019 that it would receive an annual block grant of $322 million — made up of a government grant, Mutual Reinsurance Fund transfers and taxpayer subsidies — but that financial commitment was never paid in full, resulting in a shortfall.

David Burt acknowledged in his Budget address that the hospital had to run on an overdraft, and said the Cabinet had approved a $15 million payment to the BHB in the current year and would need to increase funding in the Budget for 2023-24.

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Published April 07, 2023 at 7:57 am (Updated April 07, 2023 at 7:57 am)

Emergency patients forced to wait 22 hours for a bed

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