Waterloo Regional Health Network (WRHN) was formed on April 1, 2025, uniting two hospitals into one integrated healthcare organization. Built on more than 90 years of partnership, WRHN is home to seven regional programs and a full range of healthcare services to support 1.5 million people across Waterloo-Wellington and beyond.
WRHN is reimagining the healthcare experience with patients at the centre of every decision we make. Through collaboration and innovation, we reduce barriers to access and advance the delivery of high-quality, compassionate, and community-empowered care.
Our person-centred approach focuses on timely, equitable, and safe care. By improving patient flow, reducing unnecessary hospital stays, and strengthening partnerships with healthcare partners, patients receive the right care, in the right place, at the right time. We prioritize health equity through education, policy development, and collaboration, including ongoing efforts toward Truth and Reconciliation, to reduce disparities and better serve our diverse communities.
Patient and family voices guide our work, shaping care processes and supports that reflect what matters most to those we serve. As Waterloo Region continues to grow toward one million residents by 2050, we are dedicated to meeting these needs. Through new models of care and continuous quality improvement initiatives, we will improve outcomes and foster an inclusive, innovative, and safe environment.
Guided by our values, WRHN is committed to delivering outstanding care that is personal, seamless, and reimagined, leading boldly, serving with compassion, and partnering to advance health for all.
WRHN has embarked on a multi year quality planning journey and has adopted quality aims that will inform the annual Quality Improvement Plan (QIP) for the next three years. The quality aims are to enhance communication and compassionate patient-centred care across the care journey; provide timely care and reduce unnecessary waiting in the Emergency Department; eliminate preventable hospital harm; and reduce unnecessary tests and treatments by implementing Choosing Wisely Recommendations
Optimizing patient flow is essential to delivering high-quality outcomes, positive patient experiences, and equitable access to care. As WRHN continues to evolve as an integrated hospital system, patient flow remains a foundational priority. Standardized approaches support transparency, strengthen decision-making, and allow WRHN to manage capacity more proactively.
Demand for acute care across Waterloo Wellington continues to increase each year. WRHN’s acute care regularly operates above funded capacity, especially during peak surge periods. These sustained pressures reinforce the need for a coordinated, system-wide approach to occupancy management and surge readiness. In response, WRHN is enhancing its surge protocols to clearly define actions when demand exceeds established capacity thresholds, that are scalable to support operations during “super surge” events.
Existing surge protocols have been aligned and updated to create a consistent approach across all WRHN sites, standardizing processes, terminology, and escalation pathways to promote consistent and timely decision-making. Improvements to prioritization practices further strengthen patient access by ensuring those with the longest Emergency Department waits are matched to inpatient beds first, improving flow while reducing delays to program-specific care.
The implementation of Oculys has further advanced patient flow management by providing real-time visibility into patient volumes, discharges and alternative level of care (ALC) pressures across sites. Continued focus on optimizing bed capacity and utilization will improve system resilience during peak demand and support timely access to care for patients presenting through the Emergency Department at WRHN.
WRHN established a Social Accountability portfolio to advance health equity. This portfolio provides leadership within a social accountability framework across Diversity, Equity, Inclusion and Belonging (DEIB), Indigenous Health, Reconciliation, Accessibility, and Sustainability, ensuring these priorities are embedded into daily practice and quality improvement.
Organizational capacity is growing through DEIB education delivered via e-learning and in person, supporting equitable, accessible, and culturally safe care. Inclusive leadership expectations are embedded into leadership development and performance accountability. Employee Resource Groups, including Black, Pride, Indigenous Employee Circle and Disability, provide team member-led insights that inform equity-focused practices. WRHN also continues to advance the Black Health Plan for Ontario in collaboration with the KW4 Ontario Health Team.
Sociodemographic data collection has advanced across clinical areas, and changes to the electronic health record are on track to enable patients to record their chosen name, pronouns, and gender identity. Expansion of “Count Me In” workforce demographics initiative remains a priority, aligned with ongoing system integration work.
In 2025/26, WRHN established an Indigenous Health and Reconciliation Team, onboarding two new roles, and supporting two Indigenous navigators within the Regional Cancer Program. Early work focused on processes, documentation, frameworks, and strengthening the WRHN and Cambridge Memorial Hospital Indigenous Advisory Circle (IAC).
Indigenous Cultural Awareness training is a key priority for 2026/27. Priorities include culturally safe complaints processes, continued support for recently expanded Indigenous navigation roles, access to traditional healing and ceremony, and a sustainable education program, in co-creation with Indigenous community partners and the IAC.
Improving patient experience remains central to WRHN’s quality and safety strategy. Over the next year, we will strengthen how patient and family feedback informs decision making, planning, and the delivery of care across the organization.
We have advanced administrative and technical processes and are now fully participating in the OHA’s provincial patient experience survey benchmarking initiative. Patient survey tools and approaches have been harmonized, and we continue to expand surveying to additional areas. Pilot projects are underway at WRHN with programs such as mental health and complex care, to increase survey participation and improve the quality and inclusiveness of data collected. Patient experience survey results will also be integrated into existing quality dashboards to provide clinical leaders with real-time insights that support timely improvement efforts.
WRHN has established regular collaboration touchpoints among the Patient Experience, Patient Safety and Risk teams to help proactively identify and respond to cross-cutting trends that affect care quality and safety.
In June 2025, WRHN launched its inaugural Patient and Family Partnership Council (PFPC) and is redesigning its Patient and Family Partnership Program to include clear goals and metrics for impact. As the redesign transitions to implementation, the PFPC will guide ongoing evaluation and integration of patient and family partners across hospital committees, policy development, and recruitment activities.
Finally, WRHN is strengthening its relationships with diverse communities and co-designing an updated Patient Declaration of Values. Together, these initiatives ensure that patient and family perspectives are embedded across the organization’s strategic and quality improvement priorities.
In 2026/2027, WRHN will strengthen recruitment and retention by advancing talent priorities that reinforce a compelling employer value proposition that builds a more stable, engaged, and future ready workforce during a critical period of system integration and workforce transformation.
A core priority is strengthening WRHN’s employer value proposition by elevating the team member experience that embeds a values-based culture across leadership practices, recognition, and decision making. An integrated listening and engagement strategy will enable leaders to act on timely insights and strengthen trust, belonging, and well-being. Enhanced investments in employee well-being and recognition will ensure teams feel supported, appreciated, and equipped to thrive.
To support long term workforce sustainability, WRHN will build a future-ready workforce through strategic workforce planning, enhanced talent practices, and leadership development. This includes identifying critical roles, strengthening career pathways, advancing internal mobility, and launching a WRHN Leadership Academy to build leadership capability and succession readiness. Targeted skills development will support recruitment and retention in high-demand roles, including clinical and patient facing positions.
Finally, we will leverage workforce data to proactively strengthen workforce planning, anticipate critical staffing gaps, and inform targeted actions to retain key talent. This will support more effective planning, reduce administrative burden, and timely, evidence-based decision-making.
Together, these initiatives position WRHN to attract and retain talent, foster a strong and inclusive culture, and deliver a consistent, high-quality employee experience that supports excellent patient care.
At WRHN, patient safety is at the heart of everything we do. Our commitment to preventing hospital harm is guided by the principle that certain events, known as “never events”, should never occur in a safe, high-quality healthcare environment. WRHN is working with teams to monitor and address these events. By targeting these events, WRHN is driving a culture of safety and continuous improvement.
One impactful example of this work is our initiative to reduce hospital-acquired pressure injuries. Pressure injuries are not only painful and debilitating for patients but are also considered a never event when they reach severe stages. Recognizing this, WRHN continues to implement a comprehensive multidisciplinary prevention strategy in collaboration with the Wound Care Team, Health Informatics, and Nursing that combines evidence-informed practices, education, and real-time monitoring to strengthen prevention strategies. Interventions include dedicated on-unit daily support to ensure timely assessment and management of pressure injuries at the unit level, and co-designed documentation enhancements to identify at-risk patients and guide targeted interventions, including separating Braden Score categories for more precise care planning.
When a never event occurs, WRHN conducts a structured, multidisciplinary review to identify contributing factors and implement corrective actions to prevent recurrence. By focusing on never events, WRHN not only protects patients from harm, but also reinforces trust in our care. Every initiative, every conversation, and every action reflect our unwavering commitment to safe care.
WRHN commissioned an expert review of palliative care services in 2022/2023. As a result, WRHN established the Regional Palliative Care Collaborative (RPCC). The RPCC provides leadership to all sectors in the use of evidence-informed palliative care delivery frameworks and aligns with regional and service-specific quality standards and indicators. As part of this work, the RPCC established the Referral Pathway and Education Working Groups.
For team members who could benefit from palliative education, WRHN partners with Hospice of Wellington to provide resources and palliative education days. The RPCC Education Working Group is developing recommendations on how to access these education resources for other hospitals and will be reviewing and developing an education plan for the region. WRHN will develop a structure for palliative care oversight and a plan for team member education.
Goals of care conversations continue to be a pillar of palliative care, and WRHN will embed these conversations throughout the organization, building upon the work in our Regional Cancer and Renal teams.
Three specific examples that demonstrate this commitment are: patient involvement in decision-making related to goals of care and wishes for place of death in collaboration with the multidisciplinary palliative care consultant team; shared documentation of patient and family care plans and choices via regular family meetings and patient portal access; and care closer to home in partnership with Ontario Health atHome so patients can be transferred to the best possible destination for care such as home, hospital, or hospice.
As a long-standing partner in the KW4 Ontario Health Team (KW4 OHT), WRHN collaborates with health, social, academic, community partners, patients and care partners to advance system integration and health equity. Using a population health management approach, demographic, utilization, and outcome insights are refreshed regularly to better understand community health and social needs by neighbourhood and priority populations.
In 2026/2027, targeted initiatives focus on improving access and reducing avoidable visits for people with complex, non-acute needs including: Seamless Care Optimizing Patient Experience (SCOPE), connecting newcomers, marginalized populations, and those facing social barriers with navigation and supports; Rapid Access to Primary Care (RAP), strengthening pathways for unattached patients to primary care; and WRHN’s PREVENT Clinic, supporting cardiovascular risk identification and early intervention for underserved populations. A Home-First philosophy remains central, supported through partnerships with Ontario Health atHome, Community Support Services, Hospital to Home service providers, and programs such as Let’s Go Home (LEGHO), and Home at Last.
Together with the KW4 OHT and Primary Care Network, WRHN will continue advancing a plan toward 100% primary care attachment by 2029, including Neighbourhood Health Home models. Enrollment in the Mental Health Hospital to Home program will continue to expand, supporting transitions and timely access to community-based support.
Partner engagement is a guiding principle of WRHN’s 2026–2029 Clinical Services Plan. System and community partners remain actively engaged in WRHN’s Redevelopment Plan through a dedicated Patient and Family Advisory Council, supported by the Indigenous Advisory Circle, ensuring diverse experiences inform future system design.
WRHN @ Midtown
Audit results in 2024/25 identified the need for better managed care of pediatric patients. The Emergency Department (ED) team arranged a simulation training series, supported by McMaster Children’s Hospital, for team members addressing topics and conditions encountered less frequently. Virtual access to a McMaster Pediatrician is available in the ED in real time when a pediatric case presents challenges. These initiatives, along with the addition of a Pediatric Education Lead available for the ED, helps support all members of the multidisciplinary ED team. A Pediatric/ED Working Group has also been established that meets monthly to help improve collaboration and optimize care.
The current 2025/26 audit results showed a need for better adherence to documentation standards by nursing and medical staff. The educational practice lead and unit leaders will work with specific individuals to improve awareness and adhere to standards with additional educational opportunities and learning plans. Documentation omissions arising from the medical team will be addressed by the Chief and Medical Directors for clarification and further education.
WRHN @ Queen’s Blvd
The 2024/25 audit identified access to ultrasound as an area for improvement. In response, Queen’s Blvd. opened additional ED-only ultrasound appointments for return visits. Ultrasound appointments are available at the Midtown site for patients who are likely to need specialty services, not available at Queen’s Blvd.
The audit also highlighted challenges with access to Primary Care and community supports. To address this, Social Work hours within the ED were increased, and the Transitional Care Case Managers (TCCM) were added to our team. These changes helped speed up transitions out of the ED. In addition, the department posted information to help patients identify local primary care providers accepting new patients.
The 2025/26 return visit program identified the need for a review of practice and education for physicians, identifying and minimizing readmission risk. This is conducted by the Chief of Emergency Medicine in the form of 1:1 coaching sessions. An additional finding was the need for improvement of Elder Care and identifying older adults at risk of returning post discharge. As a result, WRHN evaluated our Geriatric Assessment tool and constructed a new tool based on ISAR (Identification of Seniors at Risk) to identify patients and flag consultations with Geriatric Emergency Medicine (GEM) specialists and other team members, where appropriate.
Executive compensation is tied to performance indicators, including the Quality Improvement Plan indicators.
Quality Improvement Plan (QIP) 2025/2026
Waterloo Regional Health Network (Org ID 930)
Access and Flow:
Measure Type:
Timely
Indicator:
Emergency Department wait time (90th percentile) from arrival to physician initial assessment
Population:
Emergency Department patients
Data Source:
CIHI NACRS / ERNI
ERNI hospitals:
Dec 1, 2023 – Nov 30, 2024
Non-ERNI hospitals:
Apr 1, 2024 – Sept 30, 2024 (Q1–Q2)
Current Performance:
5.78 hours
Target:
4.60 hours
Goal:
Achieve the provincial target of 4.0 hours by the end of Q4, with gradual improvements in Q1–Q3
External Partner:
St. Mary’s General Hospital
Change Idea:
Refine surge plans to better manage the number of admitted patients waiting for beds in the Emergency Department
Implementation Approach:
Actions:
Define clear thresholds for activating different levels of the surge protocol. Align surge protocols and practices across all sites
Process Measures & Targets:
100% of volume targets identified
100% of surge protocols standardized across sites
Report Date:
March 31, 2025