AMR improves but still misses mark on 28% of calls in March and 14% in April
Knox County's ambulance provider showed improved response times, but still missed its goals on 32% of emergency calls in March and 14% in April. That's short of the 10% maximum for missed response times set for American Medical Response under a new contract.
Where you live plays a big role in whether an ambulance will arrive in the targeted range: within 10 minutes in Knoxville city limits and 20 in the greater county.
Ambulances were more compliant with the contract in outer parts of the county. AMR Regional Director Josh Spencer said that can happen because of a higher volume of calls in the city.
"While not at the 90% mark yet, we set the expectation of continued improvement month-over-month until that mark is met," Kevin Parton, Knox County Health Department senior director, told Knox News in an email. "Two months into the new contract and new model, we are seeing that."
AMR made its first quarterly report to commissioners about the new contract May 13. Spencer said the "theme" is continued progress and touted the collaboration between agencies in county.
AMR has started subcontracting the transport of people who have already died, Spencer said, which puts ambulances back on the road more quickly. Spencer told Knox News that typically amounts to 100 calls a month.
How much are things improving?
Response times were compliant with the contract's requirements 72% of the time in March and 86% in April.
AMR is required to meet those response times for 90% of calls or face a penalty.
In the report, the county is split into three different zones: Knoxville, East Knox County and West Knox County. The report measures the seriousness of calls, with priority 1 being life-threatening and priority 3 being more minor.
March response compliance:
Response times in Knoxville were within 10 minutes 66% of the time overall and 66% of the time for priority 1 calls.
Response times in East Knox County were within 20 minutes 76% of the time overall and 84% of the time for priority 1 calls.
Response times West Knox County were within 20 minutes 84% of the time overall and 90% of the time for priority 1 calls.
April response compliance:
Response times in Knoxville were within 10 minutes 81% of the time overall and 74% of the time for priority 1 calls.
Response times in East Knox County were within 20 minutes 87% of the time overall and 91% of the time for priority 1 calls.
Response times West Knox County were within 20 minutes 89% of the time overall and 92% of the time for priority 1 calls.
Nurse Navigation steps in
Under the new contract, AMR and Knox County have instituted a program called Nurse Navigation, which will alleviate the strain caused by patients using ambulances for primary care. 911 calls with nonemergency injuries or illnesses are transferred to a state-licensed nurse who can assist.
Nurses can arrange for rides, including through Uber and Lyft, to take patients to urgent care facilities, provide telehealth or recommend at-home care for lesser illnesses.
In March, 196 patients were referred to nurses:
10 received advanced life support transportation
94 received basic life support transportation. That number includes patients who declined other options presented to them by nurses.
1 was ordered a ride share to an urgent care facility
33 were ordered ride shares to the emergency room
6 were referred to primary care physicians
47 were advised to self-care
4 were administered telehealth care
1 was administered telehealth care and then referred to the emergency room
Unlike February's reports, March's did not include a breakdown of nurse navigation patients' insurance coverage. It did, however, include a list of clinics patients were referred to:
Fast Pace Health Urgent Care - Cedar Lane
Fast Pace Health Urgent Care - Farragut
Fast Pace Urgent Care - Karns
Fast Pace Health Urgent Care - Middlebrook Pike
Fast Pace Health Urgent Care - South Knoxville
Fast Pace Health Urgent Care - Western Avenue
Summit Express Clinic Farragut
UT Urgent Care Northshore
UT Urgent Care Seymour
Well-Key Urgent Care
AMR's report to the commission did not include April's nurse navigation data.
Deployment changes
AMR is also changing its ambulance deployment methods.
The first round of AMR reports to Knox County included a target deployment method based on response time data. Spencer said the company took February's data and worked backward to figure out how many ambulances to have available at certain times to meet the demand.
They've adjusted "several units to correspond with areas where (they) need improvement from the data pulled," March's report said.
They've also purchased a new vehicle meant to respond to lower-priority calls.
"We've seen an improvement from February to March," Spencer said. "In March to April, we'll see substantially more of the same, I think."
AMR is working with Knox 865 Academy
AMR is planning to participate in the Knox 865 Academy, which prepares Knox County Schools students for life after graduation.
"This is a good start to highlighting our EMS services and professionals who tackle the job daily," March's report says.
The hope is to eventually teach emergency medical response to students to make it easier for them to transition to paying jobs.
Knox County officials are on alert
Knox County Mayor Glenn Jacobs in his 2024 State of the County Address promised to hold AMR accountable. Complaints from Knox County residents have become more common since others are speaking out.
Knoxville Police Department spokesperson Scott Erland told Knox News in September "there’s no guarantee an ambulance will show up quickly or at all." Sanford Edlein, a Sequoyah Hills resident, nearly died of a heart attack in December. He waited over an hour for transport and told Knox News he owes his life to Knoxville Fire Department responders.
Since Knox News published his story April 18, Edlein spoke with county staff members and several candidates seeking county office.
Delayed ambulance response times, long emergency room wait times and hard-to-access services plague more than the county. They're evident all over the country.
Jacobs' proposed budget includes over $2 million to pay for the county's new ambulance contract with American Medical Response. It's the first time in years the county's paid for services, and taxpayers are footing the bill for improved response times.
An AMR representative is getting a spot on a committee that advises the mayor and the commission on fire and technical rescues. Having an EMS specialist present will allow the committee to take a deeper look at emergency protocols.
"We can look at patient outcomes and do what we can to provide a better outcome for the folks in our communities (with AMR at the table)," Knox County's public safety director Brent Seymour said.
Allie Feinberg reports on politics for Knox News. Email her: allie.feinberg@knoxnewsws.com and follow her on X, formerly known as Twitter, @alliefeinberg.
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This article originally appeared on Knoxville News Sentinel: AMR Knox County ambulance response times improve at start of contract
