Open letter to all Yukoners: Ensuring a hospital bed or service is available when you need it

Date: 
11/10/2017

Each day, Yukoners come to and are admitted to hospital due to illness or injury. Their expectation is that if they need a hospital bed or service, it will be available to them.

For most, this is a reality. They will be admitted to a bed, and that is where they will receive most of their care and treatment. However, our hospitals are busy, particularly Whitehorse General Hospital, which, as Yukon’s primary acute care centre, operates most times near or over capacity.

To put this in perspective, WGH sees nearly 34,000 emergency visits on an annual basis – this is the equivalent of every Yukoner visiting this ER at least once this past year alone. In addition, WGH’s occupancy ranged between 95-115%. Ideally, hospital occupancy should only be about 75% – this gives some room to manage the care of incoming acute patients, especially in times when there is a surge in demand such as flu season. Unfortunately, half the time, we do not have a bed to meet this need.

We experience limited bed availability because, in many cases, some of our admitted patients at WGH no longer require hospital care, but are awaiting a spot in another level or type of care such as long-term continuing care. About 35-40% of our patients should be in another type of health care facility – this is about four times higher than what most Canadian hospitals consider manageable.

Unfortunately, while the average acute patient is in hospital for five days or less, those awaiting an alternate level of care can be in hospital for well over 30 days, and in some cases, more than a year. A hospital bed is not an appropriate place for a non-acute, elderly person to receive long-term care.

For us, safe and excellent hospital care is not just our mission – it is paramount.

We must use all hospital system beds and resources to full potential. Yukon is fortunate to have three modern, well-equipped hospitals. Each is staffed with a team of skilled and talented health providers. When Yukoners come to hospital, they can expect to be cared for at any one of these facilities and receive exceptional care.

Download: full text of open letter (PDF)
See also: Managing overcapacity - how Yukon's hospitals maintain access to care when volume exceeds capacity

The Yukon Hospital Corporation is a hospital system, and our aim is to ensure that you receive optimal care in the most efficient way possible.

This means, from time to time, some patients may be moved from Whitehorse to one of our community hospitals in Dawson City or Watson Lake. We identify patients who can be cared for in these communities based on clinical criteria and discussion with the physician responsible for the patient’s care. We speak with patients and families about their thoughts or concerns. Moving patients to another hospital bed in the territory allows us to use our resources in the best way possible and ensures you continue to be well cared for at all times. Since this past June, about 15 patients have been transferred to community hospitals to alleviate capacity pressures at WGH.

We acknowledge this move within Yukon’s hospital system and to a facility outside of Whitehorse is not ideal and can be stressful and difficult for many patients and families. A transfer is only for a temporary period of time (usually 3-6 weeks) and then patients return to Whitehorse. We can assure you that this is only done if it is safe and care is appropriate. We also do our best to consider all personal circumstances and provide information to make the transfer easier.

Transferring patients allows us to provide care for those who may no longer require hospital care and allow people who do need an acute care bed or service only available in Whitehorse to receive care in a more timely and safe manner.

If we transfer patients, they continue to get great care, but may be apart from personal supports and familiar surroundings. If we do not transfer patients, WGH will continue to see an unmanageable increase in patients who are admitted, but have to remain in the emergency department or another space not intended for a longer hospital stay. It also means we have to postpone or cancel surgical procedures.

Imagine if you experience severe stomach pain in the middle of night and require emergency surgery. Our hospital team is here to safely perform surgery and support your recovery, but all beds are full. You may have to stay in the emergency department or hallway. These areas are not appropriate for recovery, putting you at a higher risk for infection, offering minimal privacy in a noisy environment and making it more difficult to provide nursing care. This could result in other complications, longer hospital stay or extended recovery time.

Now imagine if you have surgery scheduled as part of your cancer treatment or for a knee replacement. You’ve possibly made the trip in from a community, you’ve prepared in advance of your procedure by fasting, and you’ve arranged for family or friends to support you. You’re also extremely anxious about your condition. You’re then told the day before that your surgery has to be postponed because an appropriate bed is not available. For you, this now means a period of uncertainty where you wait for the procedure to be rescheduled and you prepare for the process again.

Both of these scenarios are real-life situations, which highlight how Yukon’s hospital system has to balance the rights of a patient who no longer requires hospital care with the rights of hundreds of others whose care may be negatively affected, delayed or denied because a hospital bed or service is not available in Whitehorse when needed.

Managing availability of beds is a daily, if not hourly, effort by our entire team. If we can consistently use one more bed in a community hospital, over the course of a year, it can translate into an open bed in Whitehorse for approximately 100 patients requiring acute care that year.

The solution to this particular issue is not more hospital beds, but rather more health care options, both in terms of facilities and community supports that meet the needs of Yukoners.

This would include more long-term continuing care beds and the continued expansion of home care services. It may also include other strategies that help people access services within their community to avoid admission to hospital when hospital care is not necessary. We are working with our health system partners on a daily basis on a number of fronts to find solutions and put them into action.

In the meantime, we as a hospital system must continue to determine how we can best meet the needs of all Yukoners and ensure each person has access to safe and appropriate care. This is your right and our entire team is working together to honour it every day.

 

Brian Gillen
Chair, Board of Trustees
Yukon Hospital Corporation

Jason Bilsky
CEO
Yukon Hospital Corporation

Dr. Wayne MacNicol
Chief of Medical Staff
Yukon Hospital Corporation

Last Updated:Wed, 11/29/2017 - 21:44