Beds Occupied By Patients Fit For Discharge
Bermuda Hospitals Board revealed that analysis undertaken on Wednesday [Dec 18] “showed that 42 of its 90 beds on the acute care inpatient units were filled with people who were medically fit for discharge.”
A spokesperson said, “That is 46% of all inpatient beds in the Acute Care Wing [ACW]. The average length of stay of these patients was 70 days [over two months] with longest stay patient being over nine months.
“Medically fit for discharge refers to patients who no longer require acute medical care but remain in the hospital due to barriers to safe and appropriate discharge.
“In the General Wing, where beds are used as acute care overflow, there are an additional 24 patients medically fit for discharge, with the longest stay being almost 2 years [23 months].”
Minister of Health Kim Wilson comments: “These figures will understandably concern the community, as behind each patient is an individual in need of assistance. We continue to support BHB’s efforts to enhance hospital capacity and remain committed to developing long-term solutions to improve care availability in the community.
“While healthcare systems must invest in these long-term solutions to address patients who are medically fit for discharge, families play a crucial role in the immediate response. By recognising the challenges faced by hospitals and the needs of their loved ones, families can make a significant difference by stepping up to assist in the discharge and care process.
“Ultimately, addressing this issue requires a collaborative effort among families, healthcare providers, and policymakers. By working together, we can ensure hospital resources are used effectively and patients receive the appropriate care in the most suitable setting.”
A spokesperson added, “CEO & President Scott Pearman noted that the number of patients medically fit for discharge in the acute care wing had increased over 50% since figures were last publicly shared in June 2023, when there were 25 patients in acute care inpatient beds.”
“This is something we have been experiencing over the last few months,” he says. “Its biggest impact has seen rising waits for emergency patients needing an inpatient bed.”
A spokesperson added, “The issue is mostly caused by patients who need either a nursing home or more care support at home in order to be safely discharged.”
Mr Pearman noted, “We obviously implore families to take their loved ones home as soon as they are ready to be discharged, when possible. We know Bermuda needs more affordable nursing home placements and affordable care support for people at home, but the impact on hospital services of these delayed discharges is detrimental to others needing acute, surgical* and emergency services**, and those patients trying to return from medical institutions overseas. It also increases hospital costs that the healthcare system overall has to bear.”
Data from 18 December shows:
Acute Care Inpatient Units [ACW]
- 42 of the 90 acute care inpatient beds had people medically fit for discharge in them [46%]
- The average age of the patients whose discharge is delayed is 76 years
- The average length of stay for these patients is over 2 months [70 days]
- Of the 42 patients, 24 % have been in hospital 3 months or more and 12% have been in hospital 6 months or more
- The longest stay patient has been in an acute care bed for over 9 months.
Acute Care Overflow Beds in the General Wing
- 24 medically fit for discharge patients are staying on units in the General Wing
- The average age of patients is 78 years
- The average length of stay of these patients is over 9 months [262 days]
- 88% of these patients have been in hospital over 3 months and 58% of these patients have been in hospital over 6 months
- The longest stay patient has been in hospital for nearly two years [23 months]
“Our longest stay patients whose discharge is delayed will find themselves eventually on a bed on the General Wing side. These patients do not need BHB’s long term care service, which is for seniors with higher care needs than a community nursing home can offer. This means they are still using beds that others need. Most importantly, they are not in the environment best suited for their needs, impacting their quality of life and putting them at risk of unnecessary physical deterioration.”
A spokesperson added, “A 100-day challenge undertaken at the beginning of 2024 had helped identify internal efficiency improvements relating to bed flow and some solutions were implemented. A task force was recently established to follow up on the improvements and work on some of the more complex solutions highlighted from this effort. But the increasing number of medically fit for discharge patients in hospital is something BHB cannot control.
“Mr Pearman urged the community to use emergency services wisely and ensure relatives ready for discharge are supported to go home as soon as possible. These actions will help relieve some of the pressure.”
He added, “While we are focusing on the impact of delayed discharges, we should also be wise about our own health and care. We have had as many as 30 people waiting for admission in our Emergency Departments and this impacts everyone coming in. So please use your GP in the weekday or go to the Lamb Foggo Urgent Care service between 9am and 9pm on Saturday and Sunday if it is not a true emergency. Avoid the need of emergency services by taking any medications for chronic conditions, getting available vaccines that safely prevent flu, measles and other diseases, and don’t drink or do drugs and drive. Make sure the emergency services can focus on the true emergencies, such as strokes, heart attacks and other life-threatening conditions.”
No surprises here. Historically Bermudians have used the hospital as a “dumping ground” for elderly relatives who might impact their free and easy life if cared for at home. They could take a leaf out of Thailand’s attitude to family where there are very few nursing/retirement homes: Thais acknowledge that their parents cared for them for their first 20 years and therefore they should care for their parents for their last 20 years. Unfortunately, selfishness trumps that philosophy in Bermuda.
“While healthcare systems must invest in these long-term solutions to address patients who are medically fit for discharge, families play a crucial role in the immediate response.”
I agree, but not everyone does.
No worries, the Government will form think tanks and committees followed up with reports, the town hall meetings before it goes to Ministerial review after some time a press conferrence will be held announcing a fairer strategy to be sent back to more committees for refinement.
SNAFU.
This is also a result of no planning in the last 20-30 years for the known aging of the population. Maybe some of the now vacant, and soon to be derelict without maintenance, schools could be converted into care homes. Not a repeat of the Grand Atlantic fiasco but maybe a PPP, which the PLP loved for the ACW, could be utilised.
Every patient “medically fit” for discharge have their each unique circumstance as to why they are still there. No room at Long Term in old wing, no room at the wards, no room at any Nursing/Rest Home. It’s a public outcry that this situation exists today!! I knew an elderly family member that had to be admitted to a ward and classed them as ‘medically fit’ to be discharged but was unable to be independent and walk or do things on her own. We had to take her back home and care for her ourselves, especially when she had angry dementia. It was stressful for us for last 2 years as we were on our own without any other family support. We got a care taker to come in while we worked but only for few hours 3x during weekdays because of the high expenses even with her “FutureCare” it didn’t even make a dent.
FutureCare got to do better. For $530/month, you only get annual $2,000 worth of prescriptions/medical claims, which always runs out by the 8th month and then everything comes out of pocket until April. They have not raised the $2,000 since they started. The health system is a joke. These insurance companies are making a fortune off of us!!!
Why is it that when the hospital was in planning stage, that nurses were not even consulted as to the needs in the ‘new’ hospital. The powers that be were more interested in the fabulous look and design rather than its necessary resources.
Why build only 3 floors of 1 bedroom suites (99 Rooms) when you could have added a further 2 floors up as a backup and make the rooms smaller to accomodate more space in each ward. Now you have this depictable situation where you have patients piling up in the hallways waiting up to 4 days and never getting a room and was discharged from the ER.
I speak from experience as a patient on several occasions and yes, every occasion it was necessary to get admitted into ER and wait for a room availability.
BTW.. It’s been almost 14 months and waiting to get surgery but because of the bed situation, they can not accomodate me. THAT SUCKS!!!
Anyone else experiencing these situations personally??
Would like to hear your experience…