Knox County's ambulance provider innovates to shorten wait times: Crews in trucks

Next time you call 911 in Knoxville, the medical team that arrives might look different.

Knox County's ambulance provider started a new system to shorten the time it takes for medical experts to arrive when patients in city limits need help , according to records obtained by Knox News. American Medical Response is deploying medical technicians ‒ but not always in ambulances ‒ to shorten wait times and decrease penalties the company has to pay when crews take too long to arrive.

The change means help should arrive faster but doesn't automatically prevent delays in getting patients to hospitals because the crews arrive in vehicles that aren't equipped for transport.

Within Knoxville city limits, AMR is considered compliant when ambulances arrive within 10 minutes 90% of the time. Early data shows the times are improving.

The three-month pilot program started June 1. In the datas available from May compared to June, AMR's response times in city limits improved:

May

• Ambulances arrived for Priority 1 calls within 10 minutes 69% of the time
• AMR owed Knox County $376,656.97 fines for failing to meet compliance goals

June

• Ambulances arrived for Priority 1 calls within 10 minutes 85% of the time.
• AMR owed Knox County $163,106.56 in fines for failing to meet compliance goals

Knox County can lower AMR's fines to account for factors outside their control, such as long waits at emergency rooms that prevent crews from getting back on the road.

What changed?

911 calls are ranked by seriousness, with Priority 1 being the most serious and Priority 3 being the least. AMR is now using rescue trucks to get help to the scene of Priority 1 calls, according to a May 31 memo to Knox County.

Rescue trucks carry teams to a patient for lifesaving care but they can't bring patients to a hospital. Medics must still wait for an ambulance to arrive. Rescue trucks that serve the most serious Priority 1 calls will be staffed with paramedics, while the ones that serve lower priority calls will have EMTs.

Jerry Harnish, the director of operations for AMR in Knox County, told Knox News it's beneficial to have "three or four" advanced EMT ambulances with one medic in a separate rescue truck who can meet up with the ambulances if the medic's skills are required.

He said the majority of patients don't actually need care from highly trained paramedics. Ambulances can still serve the most serious calls with only advanced EMTs, but they can't provide all of the skills a medic can.

EMTs in rescue trucks can serve patients in lower-priority calls to alleviate backups caused by patients calling 911 for primary care. Harnish told Knox News those calls amount to 35% of requests for aid.

"Deploying (rescue trucks) for first response and intercept keeps transport units (ambulances) available for patients that need transport to the (hospital)," Harnish said in an email.

How the program will cut down compliance fines for AMR

Ambulances that respond up to one minute late are penalized $266.63 per call. Ambulances that are more than one minute late are penalized $598.12. In Knoxville city limits, "late" means it took an ambulance longer than 10 minutes to arrive.

Before the changes, if ambulances weren't available for a Priority 1 call, patients would be left waiting. In those scenarios, KFD paramedics often arrived first to provide life-saving care until an ambulance got there within Knoxville.

There are two types of ambulances used in Knox County: advanced and basic. Advanced are equipped for Priority 1 calls, while basic ambulances serve priorities 2 and 3. Harnish estimated out of 200 calls in a day, half are Priority 1.

With the new program, a basic ambulance can arrive at the scene once it becomes available, and the paramedic who arrived in the rescue truck can "upgrade" it to an advanced ambulance.

Allie Feinberg reports on politics for Knox News. Email her: allie.feinberg@knoxnews.com and follow her on X, formerly known as Twitter, @alliefeinberg.

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This article originally appeared on Knoxville News Sentinel: Knox County's ambulance provider innovates to shorten wait times: Crews in trucks