The Yukon Hospital Corp. (YHC) is facing challenges to nurse staffing, specialist wait times and hospital space.

Two executives of the corporation provided testimony in the legislature Nov. 21 and answered questions from MLAs on these issues.

“We operate in an environment of unlimited need, but with limited resources,” Brian Gillen, chair of the YHC’s board of trustees, told the house in his opening remarks.

“There are considerable challenges ahead for both of us, but we are working within our means to respond.”

Gillen spoke alongside Jason Bilsky, the chief executive officer of the YHC.

Bilsky addressed the challenge of maintaining a full complement of nursing staff, a hot button issue in this legislative session.

“There’s a national shortage that’s currently underway and is increasing as we speak,” Bilsky said.

“As nursing becomes more specialized and standards of care change and models of care change, this shortage will continue to impact us.”

The Canadian Nurses Association projected a shortage of 60,000 nurses in Canada by 2022, Bilsky said.

Gillen pointed out that though the problem is nation-wide, the Yukon is uniquely affected because the territory’s three hospitals are remote, and Yukoners do not have alternative options for care.

This week, the Yukon Party tabled several pages of email correspondence evidencing the YHC’s struggles to staff hospital shifts in Watson Lake, procured through an access to information request.

The emails, dated between Aug. 29 and Sept. 3, showed YHC staff discussing how to fill hospital shifts in Watson Lake just a few days prior to the shifts.

The correspondence showed that all shifts were covered in the Watson Lake hospital thanks to multiple nurses picking up last-minute and overtime shifts.

A Sept. 3 email from Stefanie Ralph, the executive director of Patient Experience at the YHC, outlined the potential need to move nurses to Watson Lake from other hospitals.

“Many of you are aware we have had significant staffing challenges in Watson Lake through August,” Ralph wrote.

“These challenges are ongoing, and we need concrete plans in place to ensure the continuity of operations at all three of our facilities.”

A resulting letter was sent to all nurse union employees in September reminding them that, as per their contract, short-term location transfers were a possibility.

In October, a YHC representative told the Star there was “no immediate need” for such transfers and called the letter a “proactive update.”

NDP Leader Kate White pressed the YHC representatives on the shortages. Bilsky said that, so far, the YHC has weathered the storm.

“I am proud to say that we have never had a curtailment of services even though we have had some significant challenges,” Bilsky said.

Gillen added that the YHC is currently working to attract nurses to the territory from Outside, particularly from Alberta, where “there is a lot of discontent” within the nursing confraternity.

“We are doing what we can,” Gillen said.

Yukon Party MLA Patti McLeod questioned Gillen and Bilsky on the current state of wait times for specialist services.

She referenced additional documents procured through an access to information request, which showed specialist wait times to be substantially longer than goal wait times.

It showed a high number of patients in 2019-20 waiting between 15 and 40 months for treatment.

This is significantly longer than the benchmark wait times, which span between two and 12 months.

Bilsky clarified that the referenced document refers specifically to visiting specialists, and the wait times are for rotating clinics hosted by the YHC.

Those rotating clinics are not the only avenue to receive specialist service, he said.

He said patients requiring urgent care can also visit resident specialists or travel Outside for care.

“I don’t want to understate the fact that we’re very busy; we’re at capacity,” Bilsky said.

“We’re definitely bursting at the seams when it comes to our visiting specialists, and our constraint here is basically physical space –– to be able to provide in our particular setting that we have within the hospital.”

He said the YHC is working to alleviate those pressures, and has so far managed to cut waitlists for ophthalmology in half and doubled the number of cataract surgeries conducted.

To further combat wait times, the YHC is looking to increase the frequency of visiting specialists and opportunities for resident specialists to build a practice here, Bilsky said.

Gillen and Bilsky referenced several times they are suffering a lack of physical hospital space in which to conduct treatment.

“We are constantly challenged to find space to do certain things,” Gillen said.

In an effort to conserve space, the hospital’s new simulation room shares a space with medical imaging services.

Bilsky said the hospital reaches full capacity 30 per cent of the time, an improvement from 2018 where the hospital reached capacity 50 per cent of the time. Currently, 1.9 patients per day are held in the emergency department because they are waiting for a bed, Bilsky sad. On average, the hospital hovers around 90 per cent occupancy.

Bilsky told the house that the hospital is waiting on the Yukon government to approve an increase in core funding for this fiscal year.

The additional funds are necessary to report a balanced budget, Bilsky said, because of increased costs owing to the new orthopaedic program and changes to out-of-territory patient revenue.

McLeod has since questioned the government’s delay in approving the funding.

“We are far along in the fiscal year, so it must be getting somewhat urgent,” McLeod said.

She told the Star last Monday she felt the house received valuable information on the YHC’s status, but is concerned by the wait times, core funding delay and and lack of plans for community services.

“I don’t want to speak for the hospital corporation, that’s their thing, but for us, the wait times need to better suit Yukoners. It’s a complicated issue, but when the hospital corporation makes an ask for money, I would assume the government would be a little bit faster to deal with it,” McLeod said.

“I hear from a lot of Yukoners that they would like to receive services in their own community … and I would like to know what the government is going to reach the benchmarks they’ve set for providing services to Yukoners.”