Knox County's ambulance provider has met its required response times for the first time since its new contract began in February, meaning help arrived for the injured or sick faster and more often in July.
That doesn't mean, however, that patients are seeing doctors faster, and Knox County officials want to know why. American Medical Response, or AMR, ambulance crews had to wait more than an hour, on average, to transfer patients from their care to the care of emergency room staffers.
Those delays point to another important factor in the complicated and sometimes dangerous delays caused by extended wait times.
Knox News reached out to representatives from Covenant Health, Tennova Healthcare and the University of Tennessee Medical Center but did not get response from any of the health care organizations to questions about wait times.
The delays are frustrating to patients and prevent ambulances from going back into circulation. Under the new contract, AMR is required to arrive within Knoxville city limits within 10 minutes on 90% of calls for help and in the rest of Knox County in 20 minutes on 90% of calls.
"I think we're at a place where it might do some good for us to make some phone calls to our hospital partners and just encourage them to work on anything, any efforts that they can to decrease these wait times," Commissioner Kim Frazier said after AMR's most recent quarterly report.
AMR credits its improved response to two new initiatives it started this year. Nurse Navigation gets patients help for primary care when an ambulance might not be the best option. Nurses can secure rides for patients or access to urgent care facilities.
AMR also piloted a program that gets skilled paramedics to patients in trucks while an ambulance with lesser-trained medical technicians arrives separately.
The new contract included time requirements because of extended delays in patient care. AMR was given a grace period of two months, and racked up fines in May and June for late arrivals.
Here's how AMR performed in July:
East Knox County: Ambulances arrived within 20 minutes 95% of the time
West Knox County: Ambulances arrived within 20 minutes 93% of the time
Knoxville city limits: Ambulances arrived within 10 minutes 90% of the time
Patients and EMS providers waited almost an hour on average in the emergency room
So far in 2024, the transfer of patient care from ambulances to emergency rooms has taken close to an hour on average.
Emergency rooms triage patients, meaning patients experiencing life-threatening emergencies get treated first while others wait their turn.
Loved ones of injured and sick patients aren't the only ones kept waiting.
AMR policy says EMS providers who bring patients in on ambulances also have to stand by. EMTs, advanced EMTS and paramedics aren't allowed to leave their patients until a doctor or nurse can treat them.
That also means ambulances can't get back on the road.
AMR reported how long providers waited each month on average:
January: 59 minutes, 51 seconds
February: 58 minutes, 53 seconds
March: 58 minutes, 17 seconds
April: 56 minutes, 4 seconds
May: 57 minutes, 57 seconds
June: 58 minutes, 29 seconds
July: 1 hour, 2 minutes, 15 seconds
What are providers doing to solve the problem?
Mike Cohen, a spokesperson for AMR, told Knox News there's a "real spirit of cooperation" among hospitals, Knox County's health department, the county's dispatch and AMR.
The stakeholders met Aug. 20 to discuss offload times.
When a patient isn't experiencing an acute emergency but needs to go to a different facility, they sometimes must wait in the emergency room until a special type of transport vehicle is available. That means that patient's hospital bed is unavailable to new patients, and EMS providers must wait, too.
There's a software that allows providers to see what nonemergency ambulances are available, and stakeholders think it could take some of the pressure off hospitals.
"It would allow the discharge manager at the hospitals to see all of the available assets," Harnish said. "If it were in greater use, it would totally improve ... patients getting out of the hospitals so other patients could get in."
Right now, only two nonemergency transport services use the software, but more could buy in at the request of the county, Harnish said.
Allie Feinberg reports on politics for Knox News. Email her: allie.feinberg@knoxnews.com and follow her on X, formerly known as Twitter, @alliefeinberg.
