A British healthcare consultancy firm has been taken on for an independent review of serious shortfalls flagged up within the hospital’s emergency department.

The hiring of Acumentice, described as specialists in improving the running of hospital and clinic settings, comes two months after a damning assessment from a former Chief of Emergency Services exposed crisis conditions in hospital operations.

In April, the Ministry of Health ordered Bermuda Hospitals Board to contract an external body after Edward Schultz highlighted overcrowding, poor structural design and chronic bed shortages, that he called “a life-or-death issue”, which had persistently failed to get attention from authorities.

Dr Schultz went public in The Royal Gazette several months after his lengthy submission on the crisis was sent to the ministry and BHB in January.

His report said the island faced “a healthcare crisis that is worsening by the day”.

Dr Schultz urged that “an independent, non-partisan commission of inquiry be appointed” to take on the review.

The BHB announced on Thursday that the London-based Acumentice would look into operations at King Edward VII Memorial Hospital’s emergency department, where Dr Schultz said delays and a bottleneck in securing hospital space posed grave risks to patient health.

The hospitals board pledged that the review would be made public upon completion.

The BHB, which was queried this month by the Gazette on its procurement process for the assessment, said the review would take about six weeks. Citing internal rules, the organisation declined to reveal the procurement background until after it had selected a reviewer.

Acumentice states on its website that its clients have included Britain’s National Health Service.

Its review team was said to be due to arrive on the island “in the coming weeks” to begin on-site inspections. The BHB said updates would come once the group began work.

Acumentice’s tasks will include examining patient flow, capacity pressures, operational processes and opportunities to strengthen emergency care.

The firm is to deliver evidence-based recommendations delivering support to frontline staff, improve patient experiences and enhance care efficiency and effectiveness.

The BHB, which is autonomous of the Bermuda Government, conducts procurement under its own financial instructions and governance rules.

It said getting the “time-sensitive review” in place took an emergency “exceptional resolution” taken up by the board on April 22, authorising the chairman and executive committee to oversee and conduct procurement.

The process followed an emergency framework designed to adhere “as closely as possible to the principles of transparency, fairness, accountability, integrity, competition and value for money”, the BHB said.

Selecting the reviewer used a “competitive negotiations approach” where “an urgent requirement makes open tendering impractical, provided the urgency was neither foreseeable nor caused by delay on the part of the procuring authority”.

At least seven vendors were examined under the identical documents and criteria that came with “blind scoring for shortlisting, interviews, reference checks and contractual negotiations”.

The BHB added: “Information regarding the contract awarded to Acumentice will be disclosed in accordance with BHB's normal disclosure practices and statutory obligations, including publication of contract information through the mechanisms routinely utilised by BHB and reflected on the organisation's website.”

It highlighted improvements to “longstanding pressures” in the emergency department, where median boarding times were said to have fallen from roughly 50 hours earlier this year to about 20 hours by May, a 60 per cent reduction.

The BHB said emergency department overcrowding had been eased through enhanced discharge processes and the introduction of a new discharge lounge.

“Most patients who are not admitted continue to be treated and discharged within a median of less than four hours, while admitted patients are experiencing significantly shorter waits as patient flow initiatives take effect.”

The BHB said the review would inform “the next phase of improvements”. It said staff had worked “diligently to improve patient flow” in the meantime.

“This review provides an opportunity to benefit from external expertise and benchmark our operations against international best practices.”