STAFF REPORT
January 25, 2000
To: Community Services Committee
From: Barry H. Gutteridge, Commissioner, Works and Emergency Services
Subject: Ambulance Services, Quality Assurance Report - 1999
Purpose:
The purpose of this report is to inform the Community Services Committee of the 1999 Quality Assurance Report. The
information is based on statistical data compiled on the quality assurance initiatives processed and directed through the
Quality Service Review Unit, Toronto Ambulance.
Financial Implications and Impact Statement:
There are no financial implications associated with this report.
Recommendations:
It is recommended that: This report be received for information.
Background:
Toronto Ambulance is a public service, licensed to operate under the authority of the Ambulance Act and the Ministry of
Health. As such, the Division has the responsibility of ensuring that we are compliant to the Ambulance Act and to the
Ministry of Health's regulations issued under that Act. This includes not only the standards for patient care and service
operations, but also for reporting requirements.
Toronto Ambulance exists in a highly regulated and competitive healthcare marketplace that demands that we recognize
the importance of customer service and clinical excellence. We recognize our need to create the image of excellence and
meet the expectations of our customers. We have addressed these needs through the development of a quality assurance
process which captures activity related to customer service complaints, customer satisfaction, clinical excellence and data
collection.
Quality Service Review is primarily responsible for ensuring that complaints regarding our service are investigated
thoroughly, objectively and addressed in a timely manner. The Quality Service Review Unit is committed to excel in
interpersonal communications, problem solving, conflict resolution, system compliance and process improvement.
Comments:
One of the most important qualities of Toronto Ambulance Services is the provision of exceptional customer service.
Toronto Ambulance is committed to recognizing the patient, family members, first responders, health care providers and
our employees as vital components of the customer service link. In order for our business to be successful, we must
maintain a high level of service and continue to ensure all customer complaints are addressed appropriately.
In 1999, Toronto Ambulance received 198 service complaints. This represents approximately 1/10th of a percent (1 per
every 2,720) of all calls serviced during the year and is well below the industry average of 1 % for Emergency Medical
Services (E.M.S.) complaints. The total number of complaints is 12% lower than 1998. The complaints are divided into 10
categories, each descriptive of the type of complaint:
Professional Attitude, Paramedic 71
Driving 11
Patient Care 53
Delayed Response, Operations 5
Other, Operations (CRR, etc.) 13
Delay, Emergency 11
Delay, Transfer 6
Professional Attitude, E.M.D. 10
Allied Service 5
Other, Communications 13
TOTAL 198
Of all complaints received, it was determined that 52% were substantiated based on the investigation findings. As a part of
any continuous quality improvement program, the information collected on the type of complaint assists the operating units
that support the Division. This information guides the managers in targeting skill deficiencies and developing programs to
ensure adequate training is provided to the front-line staff.
In 1999, the largest single group of complaints, comprising 40% of the total complaints received, involved the professional
attitude of the front-line providers of service. Information such as this is essential to the development of programs that will
provide future training for the front-line staff on dealing effectively with the patient and customer.
The investigation findings assisted us in determining that the majority of these customer concerns were the result of a
misinterpretation of the treatment they received during their call for assistance. We have gained valuable insight into how
our customers perceive the service we provide and have used this information as the basis for public education programs
that will serve to increase the awareness of the customer.
In 1999, we conducted a Satisfaction Survey based on the public's experience with our complaint management process.
The review of the Complaint Management Process was entirely positive in its intent. We examined the way we do things,
to determine if they could be done differently, and to see if we could offer a higher level of service beyond that which
exists today.
The survey was sent to approximately 20% of all complainants who had expressed some dissatisfaction about our service
during 1999. Our return rate was 30%.
Complaint Management Process. We were able to identify what our customers valued most with respect to complaint
management and identified some aspects of our internal process that led to service improvements. These areas were largely
focused on coordinating the process between the Quality Service Review Unit and the operational unit.
Toronto Ambulance staff have such an impact on our community that our customers feel it is important to publicly
acknowledge their professionalism. These acknowledgments describe the profound impact our service has had on the
emotional and physical well being of these customers. The letters and expressions of gratitude totalled 122, in 1999.
Conclusions:
Customer complaints are valuable management tools that provide insight into patient and/or customer frustration,
divisional problems and function, and practice patterns of service providers. A consistent method of handling complaints is
essential, and the Quality Service Review unit will continue to provide the mechanism for fair access to this process. We
will continue to ensure all service complaints are investigated in a timely and unbiased manner, and ensure the quality of
the process is maintained.
Toronto Ambulance is committed to providing excellent clinical care and customer service. To maintain our excellence, we
must continue to work towards understanding the customer's needs and expectations when using our ambulance service.
Contact:
Elizabeth Glibbery, Manager, Quality Services Review
Phone: 392-4916; Fax: 392-2039
Ronald L. Kelusky Barry H. Gutteridge
General Manager Commissioner
Ambulance Services Works and Emergency Services
