Region of Waterloo to Improve Emergency Medical Services Delivery

August 01, 2025

Waterloo Region – The Region of Waterloo is implementing a major initiative within the Emergency Medical Services Division to improve the consistency of EMS Service delivery.  The initiative has the identified goal of “Excellence in Patient Care”.

This initiative was launched to address specific issues affecting the consistency in the provision of EMS service in Waterloo Region.  These issues were first identified by an internal investigation by the Region of Waterloo and confirmed by an external review completed recently by the Ministry of Health and Long Term Care (MOHLTC). These investigations identified issues related to lack of consistency in following patient care protocols, patient care documentation, and compliance with dispatch directions. There was no evidence of patient harm in the sample of call reports reviewed by the Ministry.

“The Region is committed to providing consistent, high quality Emergency Medical Services,” said Ken Seiling, Regional Chair. “Once the Region became aware of these issues, Regional Council directed staff to undertake a full external investigation. The Region has cooperated fully with the Ministry of Health in their investigation, and is now releasing the Ministry’s recent report to the public.”

To deal with the identified issues, the Region has developed and is implementing a significant initiative with the goal of ensuring “Excellence in Patient Care”.

A number of actions have already been implemented including; 

  • Arthur Graham has been appointed Interim Director EMS and Sheryl Jackson has been appointed Special Advisor, Quality Assurance, both for a six month period. Both individuals have extensive experience in EMS, management and quality assurance. They are ensuring smooth day-to-day operations and have undertaken an assessment of quality assurance gaps. Mr. Graham and Ms. Jackson were seconded from Toronto EMS following the departure of the Region’s Chief of EMS on March 1, 2013.
  • EMS staff and management have received training and reminders regarding the need to ensure all legislated standards are consistently met. Several new quality assurance processes have been implemented to improve monitoring practices and compliance with Ministry of Health requirements.
  • EMS has initiated a focused process to improve our quality assurance programs, engaging all staff and management in the process. The outcome will be optimized quality assurance practices and successful completion of the MOHLTC certification review, as required through the routine recertification process.
  • EMS management has engaged with key local stakeholders, specifically the Base Hospital and the Ambulance Dispatch in Cambridge. They have started the dialogue to collaboratively make improvements to operational challenges and quality assurance issues.

“The Region is taking these issues very seriously,’ said Dr. Liana Nolan, Medical Officer of Health. ‘We have already taken a number of steps to improve our EMS service, we have additional improvements planned, and we will be reporting our progress regularly to Regional Council.” 

Over the medium term (within the next three to six months) further actions will include:

  • The Region will initiate a recruitment process for a new Director of EMS.
  • The Region will engage expert consulting assistance to conduct an in-depth analysis of management structure and roles, and to make recommendations for optimization. There will also be a 3rd party random audit process by the consultant and a monitoring process established.
  • A third party audit of a sample of Ambulance Call Reports will be undertaken via contract by Ministry Review Team members. Feedback will be provided to individual paramedics, as appropriate. 
  • The Region will work with the Base Hospital to review the current Memorandum of Understanding, and roles and responsibilities with a view to optimizing quality assurance practices collaboratively.

The Region of Waterloo Action Plan “Excellence in Patient Care’ will be presented to Community Services Committee on April 9, 2013.

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 For further information please contact:       

Bryan Stortz, Director of Corporate Communications, Region of Waterloo, 519 575-4408