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References

Our references page compiles all the sources that informed our proposal, including key data, research studies, and insights gathered from focus group discussions with Ontario healthcare personnel. All stock images used in this project are licensed under Canva Pro, which grants us the rights to reproduce, distribute, and publicly display the visuals in a professional and compliant manner. Please refer to this page for full citations and additional resources.

  1. Apexpro Consulting Inc. (2019). Region of Waterloo paramedic services master plan update. Public Health and Emergency Services, Paramedic Services. Region of Waterloo.

  2. Betts, M. (2024, Sept 09). Cambridge Memorial Hospital saw spike in hallway patients in early 2024. Retrieved from CambridgeToday: https://www.cambridgetoday.ca/local-news/cambridge-memorial-hospital-saw-spike-in-hallway-patients-in-early-2024-9480160

  3. Cambridge Memorial Hospital. (2023, March 23). Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario. Cambridge. Retrieved from https://www.cmh.org/sites/default/files/2024-12/Policy%201-A-11_0.pdf

  4. Cambridge Memorial Hospital. (n.d.). Emergency Department. Cambridge, Ont. Retrieved from https://cmhfoundation.ca/wp-content/uploads/2020/10/Emergency_CMH_ProgramsOfCare.pdf

  5. Canadian Institute for Health Information. (2023). National health expenditure trends. Retrieved from https://www.cihi.ca/en/national-health-expenditure-trends

  6. Government of Ontario. (n.d.). Ontario ambulance documentation standards. Retrieved from https://www.ontario.ca/page/ontario-ambulance-documentation-standards

  7. Government of Ontario. (n.d.). Emergency health services. Ontario Ministry of Health. Retrieved from https://www.ontario.ca/page/emergency-health-services

  8. Grand River Hospital. (2023, September 15). Fit2Sit program. Retrieved from https://www.grhosp.on.ca/care/services-departments/emergency/fit2sit-program

  9. Kitching, H. (2024, January 08). Family angry after man spends 11 hours waiting for care at Cambridge, Ont., hospital. Cambridge, Ontario: CBC News. Retrieved 2025, from https://www.cbc.ca/news/canada/kitchener-waterloo/waterloo-offload-delays-1.7076315

  10. Li, M., Vanberkel, P., & Carter, A. J. (2019). A review on ambulance offload delay literature. Health Care Management Science, 22, pp. 658-675. doi:10.1007/s10729-018-9450-x

  11. MBN Canada. (2015). Emergency medical services performance report. MBN Canada.

  12. MBN Canada. (2016). Emergency medical services performance report. MBN Canada.

  13. MBN Canada. (2017). Emergency medical services performance report. MBN Canada.

  14. MBN Canada. (2018). Emergency medical services performance report. MBN Canada.

  15. MBN Canada. (2019). Emergency medical services performance report. MBN Canada.

  16. MBN Canada. (2020). Emergency medical services performance report. MBN Canada.

  17. MBN Canada. (2021). Emergency medical services performance report. MBN Canada.

  18. Ontario Ministry of Health. (n.d.). Ontario's public hospitals. Retrieved from https://www.ontario.ca/page/ontarios-public-hospitals

  19. Paramedic Chiefs of Canada (PCC) . (2022). Statement on hospital offload delays in Canadian hospital emergency departments. Paramedic Chiefs of Canada (PCC).

  20. Piercey, J. (2025). Ford in Cambridge to celebrate $280M hospital redevelopment project. City News. Retrieved 2025, from https://kitchener.citynews.ca/2025/01/10/premier-ford-in-cambridge-to-celebrate-280-million-hospital-redevelopment-project/

  21. Region of Waterloo. (n.d.). Budget and financial statements. Retrieved from https://www.regionofwaterloo.ca/en/regional-government/budget-and-finance-archives.aspx

  22. Region of Waterloo. (2016). Performance measurement report (mid-year) for the period of January - June 2016. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  23. Region of Waterloo. (2017). Performance measurement report (mid-year) for the period of January - June 2017. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  24. Region of Waterloo. (2017). Performance measurement report (year-end) for the period of January - December 2016. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  25. Region of Waterloo. (2018). Performance measurement report (year-end) for the period of January - December 2017. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  26. Region of Waterloo. (2018). Performance measurement report for the period of January – August 2018. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  27. Region of Waterloo. (2019). Performance measurement report for the period of January - December 2018. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  28. Region of Waterloo. (2019). Performance measurement report for the period of January – June 2019. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  29. Region of Waterloo. (2020). Appendix A - Paramedic services performance measurement report for the period of January - December 2019. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  30. Region of Waterloo. (2020). Performance measurement report for the period of January - December 2019. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  31. Region of Waterloo. (2020). Public health and emergency services career profiles: Paramedic. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  32. Region of Waterloo. (2021). Year-to-date performance measurement report Jan to Aug 2021. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  33. Region of Waterloo. (2023). Appendix A - Paramedic services performance measurement report charts and figures, January – December 2022. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  34. Region of Waterloo. (2023). Appendix A - Paramedic services performance measurement report charts and figures, January – June 2023. Public Health and Emergency Services, Paramedic Services. Waterloo: Region of Waterloo.

  35. Region of Waterloo. (2024). Paramedic Services' Key Performance Measurement Indicators Update January to June 2024. Public Health and Emergency Services, Paramedic Services. Waterloo: Community and Health Services Committee.

  36. Region of Waterloo. (2024, Apr). Region Yearbook. Retrieved from Region of Waterloo: https://www.row2023yearbook.ca/paramedic-services-initiatives/

  37. Region of Waterloo. (2025). Paramedic Services Annual Key Performance Measurement Indicators. Paramedic Services, Public Health and Emergency Services. Waterloo: Region of Waterloo.

Anchor 1

Improving Ambulance Offload Times

Created By:​

​

Larissa Musy, Chelsea Ford, Alice Myers, Jamila Vanstaalduinen

​

Bachelor of Applied Health Information Sciences

Year 1, Term 2

 

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