On March 21, 2012 the Auditor General released his report on Ornge Air Ambulance and made 5 recommendations to the Ontario Legislature.

In 2005, the Ministry of Health and Long-Term Care (MOHLTC) announced that it was appointing a not-for-profit corporation, Ornge, to become responsible for all air ambulance operations. In the 2010-2011 fiscal year, Ornge was responsible for the transport of more than 19,000 patients, medical teams and organs for transplant. More than 90% of these are "inter-facility" transfers of patients between health-care facilities. Ornge received $150 million in ministry funding in the 2010-2011 fiscal year.

With growing public and media concerns related to Ornge’s finances, the Honourable Deb Matthews, Minister of Health and Long-Term Care in December 2011 asked the Auditor General of Ontario to investigate the public dollars being spent at Ornge.

On March 21, 2012, the Auditor General released his report and made the following recommendations to the Ontario Legislature. His five recommendations are:

  1. Ensure the amount paid for air ambulance and related services are reasonable. MOHLTC should consider renegotiating Ornge’s performance agreement, determine if amounts paid to Ornge are reasonable and establish measureable performance indicators for air and land ambulance services.  
  2. MOHLTC should conduct a formal program evaluation that includes assessing current total demand for critical care land ambulance transports, the optimal number of land ambulances required by Ornge to operate, the capacity for municipal land ambulances to take on transport services, and explore whether there are other more cost effective services than the current model while ensuring safe patient transport.
  3. Ornge should work more efficiently by choosing the most cost effective aircraft associated with flight distance, work with MOHLTC to link dispatch to land ambulance system run by MOHLTC and municipalities, review number of times a patient may need to be accompanied by hospital staff rather than Ornge paramedics, and report the number of cancelled and declined calls by the main reasons.
  4. To ensure response times to be assessed against performance standards and reasonableness, Ornge should record all key times in call handling process with trends and variances investigated. MOHLTC should expand the service agreement performance requirements to include indicators on response times.
  5. To ensure the safe provision of air ambulance services, MOHLTC should conduct unannounced service reviews of air ambulance service providers and its dispatch communications centre, and clarify which complaints, incidents and resulting investigations Ornge must forward to the Ministry. Ornge should track systematic issues and follow up and continue to review quality assessment evaluation measures to reflect good patient care.
As land ambulance services are cost-shared between the province and Ontario’s municipalities and many of the above recommendations may have implications to those services and related dispatch, AMO will continue to represent the interests of its membership as these recommendations are implemented and will provide updates as available.
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