Iowa county struggling with rising call volume, lack of ambulances
Johnson County Ambulance Service responded to 11,777 calls for service in 2019, a 9% increase over the 10,773 calls the previous year
By Lee Hermiston
IOWA CITY, Iowa — Adaptation is at the core of the emergency medical service profession.
Typically that ability to adapt comes into play when responding to a call for service when minutes can mean the difference between life and death for a patient. But at the Johnson County Ambulance Service, adapting also means responding to an ever-increasing call volume in Iowa’s second-fastest growing county.
“It’s a constant process of looking to see where we’ve been, where we are and where we’re going,” said Fiona Johnson, the ambulance service’s director.
The Johnson County Ambulance Service responded to 11,777 calls for service in fiscal 2019, a 9 percent increase over the 10,773 calls the previous year. Among those fiscal 20-19 calls were 6,375 in Iowa City, a 13 percent increase; 2,303 calls in Coralville, a nearly 11 percent increase; and 832 calls in North Liberty — a 9 percent decrease.
West Branch and Tiffin had 198 and 144 calls for service in fiscal 2019, respectively. While those numbers are small compared with the overall total, they were growing fast — 53 percent and 40 percent over the previous fiscal year.
So far in fiscal 2020, which began July 1, the ambulance service’s call volume is up 7 percent, Johnson said.
Each year is another record year when it comes to call volume.
“Every year it gets higher and higher,” Johnson said, who began her career with the ambulance service in 1999. “I don’t think there’s ever been a drop in our call volume.”
That constant increase is where the need to adapt comes in. That largely takes the form of looking at where and when ambulance resources are allocated.
For instance, in Iowa City, the ambulance service sees the most call volume on a Thursday, driven largely by underage drinking. While Friday and Saturday nights had adequate staffing, Johnson said, she now staffs a third ambulance on Thursday nights.
“Thursday night was running a little short because of underage drinking, primarily,” she said.
An ambulance stationed at Iowa City’s Fire Station 4 at the northeast corner of the city now operates 24 hours on Fridays, Saturdays and Sundays, Johnson said. That gives the ambulance service four, 24-hour trucks running all weekend and helps decrease their response times in West Branch and Solon.
Johnson said she’s also increased staffing at the Coralville Fire Department’s Station 2 on Friday and Saturday nights in response to more calls for service in that part of the county.
“We know North Liberty is busy,” she said. “Tiffin is extremely busy. But then with this huge Interstate 80-Interstate 380 construction project, we’ve seen a lot more traumatic injuries as a result of that. ... We’re just having a lot more presence in that area and will be for the foreseeable number of years into the future.”
The operation, whose budget is set by the Johnson County Board of Supervisors, had nearly $4.5 million in expenses in fiscal 2019. Of that, it took in $3.2 million of revenue and had a $1.2 million county subsidy.
Unlike the Johnson County Ambulance Service, the Cedar Rapids-based Area Ambulance Service has seen its call volume remain flat year over year, said Chief Executive Officer Keith Rippy. Area Ambulance, a not-for-profit organization, typically has about 22,000 calls for service per year, Rippy said.
While the call volume doesn’t change much, Area Ambulance shifts its resources literally on a call-by-call basis. Each day, ambulances are deployed into the community based on historical data on where calls of service are most likely to originate. When an ambulance is dispatched to a call for service, the remaining units are redeployed within Area Ambulance’s coverage area in order to minimize response time.
Every 20 weeks, Area Ambulance also does a “demand analysis” to ensure it’s deploying resources for maximum efficiency.
“That shows day by day, hour by hour, where our call volume is and how many ambulances do we have deployed versus how many calls for service,” Rippy said. He called the dispatch system, “very accurate.”
More changes are likely coming for the Johnson County Ambulance Service in the coming years. With the demand for service in northwestern Johnson County — North Liberty and Tiffin are among Iowa’s fastest-growing communities and the ambulance service currently doesn’t cover Swisher or Shueyville, which are served by Area Ambulance — Johnson would like to get a station in North Liberty or Tiffin.
“When I first started here 20 years ago, we had two ambulances in Iowa City and one in Coralville, and that wasn’t even a 24-hour ambulance,” she said. “Now we’ve evolved. We’re in the eastern side of Iowa City at the fire department and the western side at Coralville, but we need to expand our bases,” she said.
One way to do so would be to partner with Johnson County Emergency Management on a joint facility. The emergency management agency is housed in the county’s joint emergency communication center, but coordinator Dave Wilson said he’d like a storage facility for some of the equipment either close to the interstates or to the county’s major bodies of water — Coralville Lake and Lake Macbride.
“If we could co-locate with ambulance and help meet some of their needs, that is of interest to us as well,” Wilson said. “There’s no point in building separate facilities when we can do a combined facility that meets both of our needs.”
Wilson said it would likely be at least 18 to 24 months before such a facility could become a reality. In the meantime — Johnson, who is also debuting an ambulance with a redesigned interior to be safer for both patients and paramedics — will keep adapting.
“The pillars of our service are safety and education,” she said. “As long as we are continually assessing our safety needs, educating our staff and taking that education and safety out to the public, that’s really where we rest. With those support structures, that creates the ability to give that quality care to the residents. To be able to get there timely. To be able to get there safely.”
©2019 The Gazette (Cedar Rapids, Iowa)