Conditions at Whitehorse hospital's secure unit broke health and safety rules, records show

Months after a psychiatrist was assaulted while working at Whitehorse General Hospital's secure medical unit, there's still no date set for the return of psychiatric services on the unit.

CBC News has learned that an inspection of the secure unit by Yukon's Workers' Compensation Health and Safety Board (WCB) found six violations of the territory's Occupational Health and Safety Act.

The inspection report was obtained through an access to information request. The report found:

• staff lacked violence prevention training;

• personal emergency alarms that were supposed to be provided to unit staff could not be found;

• the nurses station, work desk and isolation units lacked basic security features;

• there was no formal procedure to file safety plans for potentially violent patients.

In an email, Workers' Compensation Board (WCB) spokesperson Heather Avery said the hospital corporation has yet to comply with those four orders, despite an initial due date of Dec. 29, 2020.

Avery said the due dates were extended to March 24, 2021 at the request of the hospital corporation.

The inspection also found that the Yukon Employees' Union complained about shortcomings with a joint health and safety committee with hospital management. The WCB ordered the hospital corporation to provide six months worth of committee meeting notes for review.

"Although this order is considered to be compliance as documentation was provided, the documentation demonstrates that the [joint health and safety committee] was not functioning as required by the OHS Act," Avery wrote.

The sixth compliance order required the corporation to provide written notice of compliance with the other five orders.

Hospital corporations says it has beefed up security

Matt Davidson, a spokesperson for the Yukon Hospital Corporation, said hospital officials have introduced a 90-day plan to add security guards and improve training for staff on the unit, as well as a full program review in cooperation with the Centre for Addiction and Mental Health.

"We view the [WCB's] report and actions we're taking as an important opportunity to make the hospital a safer environment for everyone, and to provide the best possible mental health care within our hospital's mandate," Davidson wrote in an email.

He said the corporation is also continuing to provide staff with code white training, to help staff respond to any situation involving violent or out-of-control patients. That training began shortly after the assault. Before that, code white training had not been offered to hospital staff for 14 years, a fact psychiatrists called "truly terrifying."

The inspection report also revealed new information about the assault of a psychiatrist by a patient on the unit, which took place in late October 2020. 

Patient allegedly involved in assault allowed walks 

According to the report, the patient had been admitted to the unit "due to past acts of violence and recent threats of harm."

The patient was kept in one of the unit's isolation rooms, which are typically reserved for patients who are either in police custody or pose a risk to themselves or others. Staff developed a safety plan to allow the patient to go on walks for 15 minutes at a time that required at least one doctor or nurse and one security guard to be present.

At the time of the assault, there were two nurses, one security guard and the psychiatrist present. The report says the psychiatrist got a "STAT call" from the emergency department and was assaulted as he tried to go to the emergency room.

The report includes no other details about the incident. It's still not clear if the patient was ever charged. The Yukon RCMP didn't respond to a request for comment Wednesday.

Internal hospital corporation emails obtained through the same access to information request are heavily redacted. But they show the corporation launched a "critical incident review" on Nov. 2, 2020. Staff contacted the psychiatrist for his version of events and he agreed, though any details he provided did not appear to be included in the emails.

In the wake of the assault, psychiatrists pulled their services from the hospital because they said the working environment is unsafe. There's no sign they'll return to the unit any time soon.

"While there's no confirmed date for the return of on-site psychiatry services at Whitehorse General Hospital, psychiatrists continue to provide dedicated support by phone to help stabilize patients," Davidson wrote.

The incident prompted opposition party calls for the government to hurry up plans for a replacement secure medical unit in vacant space above the hospital's new emergency room.

The territorial budget released last week includes $5.7 million to begin construction of the new secure unit. Hospital corporation CEO Jason Bilsky has previously put the full cost of the project at between $14 million and $21 million.

Construction is scheduled to begin in 2022.