John Doyle's latest report, released on Thursday, found the emergency medical provider lacks monitoring and clear goals.
"(It is) unable to demonstrate the quality, timeliness and safety of its patient care," the report states.
Dispatch decisions are often inadequately reviewed, and the air ambulance service doesn't fully assess whether paramedics are situated in the best locations to meet patient needs, the report concludes.
It also criticizes the service for not having consistent procedures for reporting and addressing safety issues.
It said that staffing shortages mean lesser-skilled paramedics have sometimes been sent to emergencies in pairs because higher skilled responders were unavailable.
"As these services have a direct impact on peoples' lives, I expected to find that the BC Ambulance Service was monitoring performance," Doyle said in the report. "(It should have been) using the information to improve the performance of its air ambulance services."
The report makes three recommendations: to manage performance, periodically review distribution of staff and aircrafts, and to create samples of air ambulance dispatches.
After reviewing the report, the service said it's taking steps to implement the recommendations and will "use the audit findings to further enhance air ambulance operations."
It said it already monitors its service when issues or complaints arise, but will find a more consistent way of doing so.
Les Fisher, the service's chief operating officer, said Thursday the service intends to install some changes by the end of 2013 and get fully up to speed by March 2015.
"(The service) personnel are committed to providing quality, timely and safe patient care," Fisher said in a release.
He said it aims to develop concrete service standards and improve data collection.
During Doyle's audit, which started in 2012, oversight of the BC Ambulance Service was transferred from the health ministry to the Provincial Health Services Authority, which Doyle said should allow it to better manage patient outcomes.
— By Cara McKenna in Vancouver
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