Judy Ferguson wants to see better co-ordination among health-care providers and services.
She says in her 2015 report that more followup would improve outcomes for patients, but also help the health region better manage its beds.
Ferguson is also calling on the Regina health region to send post-discharge information to care providers such as nursing homes more quickly.
She says staff say they are often too busy to complete paperwork, which leaves care providers guessing what medications were administered in hospital.
She says being more timely would help reduce medication errors and could prevent patients from having to be readmitted to hospital.