Jackson County Community Ambulance Service Assessment Survey

The Center for Public Safety Management (CPSM) is working with Jackson County and the local EMS and healthcare community re-imagine the future of ambulance delivery and revise the County’s ordinance to embrace future innovations in ambulance services in the county.

Community input into this process is very important and valuable.

We’d like to ask community members for feedback related to current and future ambulance service delivery in Jackson County.

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* 1. How long have you lived in Jackson County?

Less than 3 years

3 – 10 years

More than 10 years

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* 2. In which community do you reside?

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* 3. Do you know which ambulance agency services your community?

Yes

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* 4. If YES, which ambulance agency?

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* 5. Do you know which fire department/agency services your community?

Yes

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* 6. If YES, which fire agency/department?

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* 7. On a scale of 1-5, with 5 being most knowledgeable, how knowledgeable are you about the level of services provided to you by your ambulance agency (i.e.: level of clinical care, response times, etc.)?

	1	2	3	4	5
Ambulance Agency Awareness	Ambulance Agency Awareness 1	Ambulance Agency Awareness 2	Ambulance Agency Awareness 3	Ambulance Agency Awareness 4	Ambulance Agency Awareness 5

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* 8. On a scale of 1 – 5, with 5 being the highest, how would you rate the services provided by your local ambulance agency:

	1	2	3	4	5	Don't Know
Overall reputation	Overall reputation 1	Overall reputation 2	Overall reputation 3	Overall reputation 4	Overall reputation 5	Overall reputation Don't Know
Ability to meet the community’s EMS needs.	Ability to meet the community’s EMS needs. 1	Ability to meet the community’s EMS needs. 2	Ability to meet the community’s EMS needs. 3	Ability to meet the community’s EMS needs. 4	Ability to meet the community’s EMS needs. 5	Ability to meet the community’s EMS needs. Don't Know
Professionalism of the staff.	Professionalism of the staff. 1	Professionalism of the staff. 2	Professionalism of the staff. 3	Professionalism of the staff. 4	Professionalism of the staff. 5	Professionalism of the staff. Don't Know
Medical care provided.	Medical care provided. 1	Medical care provided. 2	Medical care provided. 3	Medical care provided. 4	Medical care provided. 5	Medical care provided. Don't Know
Facilities and equipment.	Facilities and equipment. 1	Facilities and equipment. 2	Facilities and equipment. 3	Facilities and equipment. 4	Facilities and equipment. 5	Facilities and equipment. Don't Know
Response time.	Response time. 1	Response time. 2	Response time. 3	Response time. 4	Response time. 5	Response time. Don't Know
Overall value to the community.	Overall value to the community. 1	Overall value to the community. 2	Overall value to the community. 3	Overall value to the community. 4	Overall value to the community. 5	Overall value to the community. Don't Know

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* 9. Have you been a patient cared for by one of Jackson County’s ambulance agencies within the past 3 years?

Yes

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* 10. If YES, which one?

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* 11. If YES, On a scale of 1 – 5, with 5 being the highest, how would you rate these components as part of the ambulance response?

	1	2	3	4	5	Don't Know
Interaction with the 911 dispatcher.	Interaction with the 911 dispatcher. 1	Interaction with the 911 dispatcher. 2	Interaction with the 911 dispatcher. 3	Interaction with the 911 dispatcher. 4	Interaction with the 911 dispatcher. 5	Interaction with the 911 dispatcher. Don't Know
Timeliness of the ambulance arrival.	Timeliness of the ambulance arrival. 1	Timeliness of the ambulance arrival. 2	Timeliness of the ambulance arrival. 3	Timeliness of the ambulance arrival. 4	Timeliness of the ambulance arrival. 5	Timeliness of the ambulance arrival. Don't Know
The medical care provided by the ambulance personnel.	The medical care provided by the ambulance personnel. 1	The medical care provided by the ambulance personnel. 2	The medical care provided by the ambulance personnel. 3	The medical care provided by the ambulance personnel. 4	The medical care provided by the ambulance personnel. 5	The medical care provided by the ambulance personnel. Don't Know
Extent that the ambulance personnel kept you informed about your care.	Extent that the ambulance personnel kept you informed about your care. 1	Extent that the ambulance personnel kept you informed about your care. 2	Extent that the ambulance personnel kept you informed about your care. 3	Extent that the ambulance personnel kept you informed about your care. 4	Extent that the ambulance personnel kept you informed about your care. 5	Extent that the ambulance personnel kept you informed about your care. Don't Know
The condition of the ambulance and equipment.	The condition of the ambulance and equipment. 1	The condition of the ambulance and equipment. 2	The condition of the ambulance and equipment. 3	The condition of the ambulance and equipment. 4	The condition of the ambulance and equipment. 5	The condition of the ambulance and equipment. Don't Know
The ambulance billing process.	The ambulance billing process. 1	The ambulance billing process. 2	The ambulance billing process. 3	The ambulance billing process. 4	The ambulance billing process. 5	The ambulance billing process. Don't Know
Likelihood of recommending the service to others.	Likelihood of recommending the service to others. 1	Likelihood of recommending the service to others. 2	Likelihood of recommending the service to others. 3	Likelihood of recommending the service to others. 4	Likelihood of recommending the service to others. 5	Likelihood of recommending the service to others. Don't Know

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* 12. Thinking about future ambulance service response in your community, do you have any suggestions about how ambulance services are provided, or should be provided in the future?