Health Care Provision During a Sporting Mass Gathering: A Structure and Process Description of On-Site Care Delivery

Abstract

IntroductionMass gatherings such as marathons are increasingly frequent. During mass gatherings, the provision of timely access to health care services is required for the mass-gathering population, as well as for the local community. However, the nature and impact of health care provision during sporting mass gatherings is not well-understood.PurposeThe aim of this study was to describe the structures and processes developed for an emergency health team to operate an in-event, acute health care facility during one of the largest mass-sporting participation events in the southern hemisphere, the Gold Coast Marathon (Queensland, Australia).MethodsA pragmatic, qualitative methodology was used to describe the structures and processes required to operate an in-event, acute health care facility providing services for marathon runners and spectators. Content analysis from 12 semi-structured interviews with emergency department (ED) clinical staff working during the two-day event was undertaken in 2016.FindingsImportant structural elements of the in-event health care facility included: physical spaces, such as the clinical zones in the marathon health tent and surrounding area, and access and egress points; and resources such as bilingual staff, senior medical staff, and equipment such as electrocardiograms (ECGs) and intravenous fluids. Process elements of the in-event health care facility included clear communication pathways, as well as inter-professional care coordination and engagement involving shared knowledge of and access to resources, and distinct but overlapping clinical scope between nurses and doctors. This was seen to be critical for timely care provision and appropriate case management. Staff reported many perceived benefits and opportunities of in-event health care delivery, including ED avoidance and disaster training.ConclusionsThis in-event model of emergency care delivery, established in an out-of-hospital location, enabled the delivery of acute health care that could be clearly described and defined. Staff reported satisfaction with their ability to provide a meaningful contribution to hospital avoidance and to the local community. With the number of sporting mass gatherings increasing, this temporary, in-event model of health care provision is one option for event and health care planners to consider.JohnstonANB, WadhamJ, Polong-BrownJ, AitkenM, RanseJ, HuttonA, RichardsB, CrillyJ.Health care provision during a sporting mass gathering: a structure and process description of on-site care delivery. Prehosp Disaster Med. 2019;34(1):62–71.

Longitudinal description and evaluation of an emergency department avoidance strategy for a youth mass gathering (Schoolies) in Australia

“…Our results support those of other studies where findings suggested the provision of onsite healthcare that includes highly skilled clinicians (not simply a first aid post) ensures delivery of care for both acute physiological conditions and mental illness 14 and reduces impacts on local EDs. 23,24 It should be noted that no economic evaluation of this care model was undertaken and so its relative 'value' remains unclear.…”

“…Given the nature of the Schoolies event, where thousands of school-leavers gather to celebrate, the already busy EDs could be negatively impacted by surges in patient numbers. 14 Since the late 1990s, the Queensland Ambulance Service (QAS) instigated an evening In-Event Health Service (IEHS) for the Schoolies MGE. Such 'Pop-up' health services are designed to cope with an influx of patients linked to mass gatherings or health crises/pandemics.…”

“…‘Schoolies’ MGEs are held in many coastal tourist locations around Australia and overseas, the largest of which occurs in Queensland, on the Gold Coast. Given the nature of the Schoolies event, where thousands of school‐leavers gather to celebrate, the already busy EDs could be negatively impacted by surges in patient numbers 14 . Since the late 1990s, the Queensland Ambulance Service (QAS) instigated an evening In‐Event Health Service (IEHS) for the Schoolies MGE.…”

Emergency healthcare delivery for young adults during a planned mass gathering: A retrospective observational study

“…This was evident with the 420 cases seen within the facility over the 7‐day period with only a small proportion (0.03%, 0.3/1000) requiring transfer by ambulance to the ED. As noted in other out‐of‐hospital ED avoidance strategies the multi‐disciplinary and inter‐agency staffing configuration likely contributed to this success; however, accompanying comprehensive structure and process evaluations of this and other EHS located at MGEs is required to understand this further. Additional public messaging to young adults attending Schoolies may be considered by event planners to create awareness of the EHS which may further minimise the impact on the ED …”

“I loved it, absolutely loved it” a qualitative study exploring what student podiatrists learn volunteering as part of an interprofessional medical team at a marathon

“…1) are tents with a series of stretchers and chairs for participants to sit/ lie while care is delivered. In common with other major mass participation events, the aims of care are to prevent a competitor's complaints from worsening, facilitate onward progression to collect belongings, and meet family/friends [37][38][39]. Additionally there are mechanisms to facilitate removal to hospital for those with more serious injuries and/or for those whose overall condition deteriorates.…”