A ten-bed discharge lounge has been established at King Edward VII Memorial Hospital to ease pressure on the Emergency Department and reduce the need for bed boarding.

The move, which was promised last month, complements an enhanced discharge process consisting of co-ordinated steps to improve patient movement through the system, the Bermuda Hospitals Board and the Ministry of Health said in a joint statement.

The move comes as the BHB prepares to conduct an independent review to improve care and ease bed blocking after a directive by the ministry.

In April, the ministry issued a formal directive to the BHB to take on a third party for a review after warnings of potentially fatal “critical overcrowding” at King Edward VII Memorial Hospital.

It came after Edward Schultz, a former Chief of Emergency Services, went public with his longstanding complaints over the hospital’s beds crisis.

The BHB and the ministry said an expedited procurement process is under way to appoint a suitably qualified, independent third party to conduct the operational review of the hospital’s Emergency Department.

The BHB will oversee the appointment process to ensure independence, integrity and credibility, and the scope and terms of reference will be published at the appropriate stage, the statement said.

“The review will provide a clear, evidence-based assessment of current pressures and support long-term improvements that benefit patients, families and staff,” it said.

“The independent review will be a valuable opportunity to strengthen how we manage patient flow, discharge processes and overall service delivery,” Collin Anderson, the chairman of the BHB said.

“Our teams remain committed to providing safe, high-quality care for every patient, even during periods of sustained demand.”

Kim Wilson, the Minister of Health, said: “We recognise the pressures that patients, families and staff experience during busy periods in the Emergency Department.

“At the same time, we are seeing meaningful progress across the system. The new 30-bed Transition Unit will help patients who are ready to leave hospital move into a more appropriate setting with the right support.

“Alongside expanded home care, stronger day services and investments such as Lefroy House and the Sylvia Richardson Care Facility expansion, these initiatives will ease pressure on the hospital and improve quality of life for patients.

“We remain committed to building a stronger, more responsive health system for our community.”

For immediate improvements, the BHB has established a patient flow steering committee, which includes an independent patient adviser, and implemented a Bed Capacity Management Plan to improve patient movement through the hospital and reduce discharge delays.

The Emergency Department at KEMH normally has 23 treatment spaces comprising 15 standard beds, four resuscitation beds and four fast-track beds.

When demand is high, there are “well-established mechanisms to safely expand capacity”, the BHB and the ministry said.

The hospital has 20 hallway spaces, a ten-bed Clinical Overflow Unit, four fracture clinic spaces, up to 12 contingency beds in the Gosling and maternity wards as well as a weekday evening fast-track service for up to 12 patients.

The BHB and the ministry said approximately 40 patients each day are medically fit for discharge but remain in hospital while awaiting appropriate placement or supports.

As such, an estimated 14,600 acute care bed days each year are not available for new patients and this contributes to operational pressures, including approximately $2 million annually in additional staffing and infrastructure costs.

The BHB’s enhanced discharge planning processes are already helping to reduce these pressures and the two bodies said the challenges reflect broader system needs.

The BHB and the ministry said the island has approximately 367 licensed long-term care beds in the community, with a further 160 individuals with long-term care needs being accommodated within the hospital system.

They said about 46 per cent of acute care beds are regularly occupied by patients who are medically fit for discharge.

“Strengthening community-based care options, expanding home care supports and improving placement pathways are all contributing to better patient flow,” they added.

Projections indicate that by 2035, approximately 930 seniors will require some level of formal long-term care support, and they said while many lower-acuity needs can be safely met at home, demand for higher-acuity skilled nursing care is expected to grow.

The numbers also indicate that Bermuda may require 365 skilled nursing facility beds by 2035 — an increase of about 40 per cent over current levels.

“Continued investment in purpose-built skilled nursing capacity will help ensure patients receive care in the most appropriate setting while protecting acute hospital operations,” the two entities said.