Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T06:49:26.407Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  07 January 2019

Amy N. B. Johnston Open the ORCID record for Amy N. B. Johnston [Opens in a new window] ,
Jasmine Wadham ,
Josea Polong-Brown ,
Michael Aitken ,
Jamie Ranse ,
Alison Hutton ,
Brent Richards  and
Julia Crilly
Amy N. B. Johnston*
Affiliation:
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Gold Coast, Queensland, Australia Currently: Department of Emergency Medicine, Princess Alexandra Hospital Metro South, Woolloongabba, Queensland, Australia; School of Nursing, Midwifery, and Social Work, University of Queensland, Brisbane, Queensland, Australia
Jasmine Wadham
Affiliation:
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Josea Polong-Brown
Affiliation:
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Michael Aitken
Affiliation:
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Gold Coast, Queensland, Australia
Jamie Ranse
Affiliation:
School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
Alison Hutton
Affiliation:
School of Nursing, University of Newcastle, New Castle, New South Wales, Australia
Brent Richards
Affiliation:
Intensive Care Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Julia Crilly
Affiliation:
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia Menzies Health Institute Queensland, Griffith University Gold Coast Campus, Gold Coast, Queensland, Australia
*
Correspondence: Amy Johnston, PhD Department of Emergency Medicine Princess Alexandra Hospital Metro South, 199 Ipswich Road Woolloongabba 4102 QLD Australia E-mail: amy.johnston@uq.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

Mass 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.

Purpose

The 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).

Methods

A 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.

Findings

Important 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.

Conclusions

This 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.

Keywords

emergency department avoidanceemergency servicesin-event health caremarathonmass gathering
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 1 , February 2019 , pp. 62 - 71
Copyright
© World Association for Disaster and Emergency Medicine 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest/funding: Funding for the full-scale exercise was provided by the Central Massachusetts Homeland Security Advisory Council (Worcester, Massachusetts USA). Funding for the research aspect of the project was provided by the University of Massachusetts Medical School (Worcester, Massachusetts USA). The authors declare no conflicts of interest.

References

1. Hutton, A, Savage, C, Ranse, J, Finnell, D, Kub, J. The use of Haddon’s matrix to plan for injury and illness prevention at outdoor music festivals. Prehosp Disaster Med. 2015;30(2):175-183.Google Scholar
2. Hutton, A, Ranse, J, Verdonk, N, Ullah, S, Arbon, P. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehosp Disaster Med. 2014;29(2):160-166.Google Scholar
3. Lund, A, Turris, SA. Mass-gathering medicine: risks and patient presentations at a 2-day electronic dance music event. Prehosp Disaster Med. 2015;30(3):271-278.Google Scholar
4. Arbon, P. Planning medical coverage for mass gatherings in Australia: what we currently know. J Emerg Nurs. 2005;31(4):346-350.Google Scholar
5. Forero, R, McCarthy, S, Hillman, K. Access block and emergency department overcrowding. Critical Care. 2011;15(2):216.Google Scholar
6. Doherty, L. Going the extra mile: health care for marathon runners. Emergency Nurse. 2010;18(2):18-20.Google Scholar
7. Events Queensland. Gold Coast Airport Marathon. Events Queensland. http://goldcoastmarathon.com.au/. Accessed August 2017.Google Scholar
8. Jena, AB, Mann, NC, Wedlund, LN, Olenski, A. Delays in emergency care and mortality during major US marathons. New Eng J Med. 2017;376(15):1441-1450.Google Scholar
9. Roberts. 12-yr profile of medical injury and illness for the Twin Cities Marathon. Med Sci Sports Exer. 2000;32(9):1549-1555.Google Scholar
10. Hutton, A, Cusack, L, Zannettino, L. Building public policy to support young people in reducing alcohol-related harm when partying at Schoolies Festivals. Aust J Primary Health. 2012;18(2):96-100.Google Scholar
11. Barnes, C, Henrickson, KE. Economic development generated by investment in participation sports. J Bus Econ Policy. 2017;4(1):156-162.Google Scholar
12. Saayman, M, Saayman, A. Appraisal of measuring economic impact of sport events. South African J Res Sport, Phys Ed Rec. 2014;36(3):151-181.Google Scholar
13. Hutton, A, Roderick, A, Munt, R. Lessons learned at World Youth Day: collecting data and using postcards at mass gatherings. Prehosp Disaster Med. 2010;25(3):273-277.Google Scholar
14. Khorram-Manesh, A, Berner, A, Hedelin, A, Ortenwall, P. Estimation of healthcare resources at sporting events. Prehosp Disaster Med. 2010;25(5):449-455.Google Scholar
15. Enock, KE, Jacobs, J. The Olympic and Paralympic Games 2012: literature review of the logistical planning and operational challenges for public health. Public Health. 2008;122(11):1229-1238.Google Scholar
16. Gannon, DM, Derse, AR, Bronkema, PJ, Primley, DM. The emergency care network of a ski marathon. Am J Sports Med. 1985;13(5):316-320.Google Scholar
17. Agar, C, Pickard, L, Bhangu, A. The Tough Guy prehospital experience: patterns of injury at a major UK endurance event. Brit Assoc Accid Emerg Med. 2009;26(11):826-830.Google Scholar
18. Herbenick, MA, King, JS, Altobelli, G, Nguyen, B, Podesta, L. Injury patterns in professional arena football. Am J Sports Med. 2008;36(1):91-98.Google Scholar
19. Nguyen, RB, Milsten, AM, Cushman, JT. Injury patterns and levels of care at a marathon. Prehosp Disaster Med. 2008;23(6):519-525.Google Scholar
20. Videbæk, S, Bueno, AM, Nielsen, RO, Rasmussen, S. Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports Med. 2015;45(7):1017-1026.Google Scholar
21. Tang, N, Kraus, CK, Brill, JD, Shahan, JB, Ness, C, Scheulen, JJ. Hospital-based event medical support for the Baltimore Marathon, 2002-2005. Prehosp Emerg Care. 2008;12(3):320-326.Google Scholar
22. Jaworski, CA. Medical concerns of marathons. Curr Sports Med Reports. 2005;4(3):137-143.Google Scholar
23. Fredericson, M, Misra, AK. Epidemiology and aetiology of marathon running injuries. Sports Med. 2007;37(4-5):437-439.Google Scholar
24. Glick, J, Rixe, JA, Spurkeland, N, Brady, J, Silvis, M, Olympia, RP. Medical and disaster preparedness of US marathons. Prehosp Disaster Med. 2015;30(4):344-350.Google Scholar
25. Donabedian, A. The quality of care: how can it be assessed? J Am Med Assoc. 1988;260(12):1743-1748.Google Scholar
26. Irvine, D, Sidani, S, Hall, LM. Finding value in nursing care: a framework for quality improvement and clinical evaluation. Nurs Econ. 1998;16(3):110-131.Google Scholar
27. Baxter, P, Jack, S. Qualitative case study methodology: study design and implementation for novice researchers. Qual Report. 2008;13(4):544-559.Google Scholar
28. Queensland Health. Gold Coast Hospital and Health Service Annual Report 2015–2016. https://publications.qld.gov.au/dataset/gold-coast-health-annual-report/resource/72627cca-557f-45fe-9c3e-d8fd2de4f2ce. Published 2016. Accessed August 2017.Google Scholar
29. About the Gold Coast Airport Marathon. http://goldcoastmarathon.com.au/about/features/. Accessed July 2017.Google Scholar
30. Elo, S, Kyngäs, H. The qualitative content analysis process. J Advanced Nurs. 2008;62(1):107-115.Google Scholar
31. Petty, NJ, Thomson, OP, Stew, G. Ready for a paradigm shift? Part 2: introducing qualitative research methodologies and methods. Manual Therapy. 2012;17(5):378.Google Scholar
32. Bogdon, R, Biklen, S. Research for Education. An Introduction to Theories and Methods. London, United Kingdom: Pearson Education; 2007.Google Scholar
33. Lincoln, YS, Guba, EG. Naturalistic Inquiry. Beverly Hills, California USA: Sage Publications; 1985.Google Scholar
34. Tracy, SJ. Qualitative quality: eight “Big-Tent” criteria for excellent qualitative research. Qual Inquiry. 2010;16(10):837-851.Google Scholar
35. Campbell, JL, Quincy, C, Osserman, J, Pedersen, OK. Coding in-depth semi-structured interviews: problems of unitization and intercoder reliability and agreement. Sociol Methods Res. 2013;42(3):294-320.Google Scholar
36. Popping, R. Some views on agreement to be used in content analysis studies. Quality & Quantity. 2010;44(6):1067-1078.Google Scholar
37. AusRunning. Australian Marathon Statistics. https://ausrunning.net/stats/. Accessed October 2017.Google Scholar
38. Schwellnus, M, Derman, W. The quest to reduce the risk of adverse medical events in exercising individuals: introducing the SAFER (Strategies to reduce Adverse medical events For the ExerciseR) studies. Brit J Sports Med. 2014;48(11):869.Google Scholar
39. Zeitz, KM, Zeitz, CJ, Arbon, P. Forecasting medical work at mass-gathering events: predictive model versus retrospective review. Prehosp Disaster Med. 2005;20(3):164-168.Google Scholar
40. Woodall, J, Watt, K, Walker, D, et al. Planning volunteer responses to low-volume mass gatherings: do event characteristics predict patient workload? Prehosp Disaster Med. 2010;25(5):442-448.Google Scholar
41. Burton, JO, Corry, SJ, Lewis, G, Priestman, WS. Differences in medical care usage between two mass-gathering sporting events. Prehosp Disaster Med. 2012;27(5):458-462.Google Scholar
42. Grange, JT, Baumann, GW, Vaezazizi, R. On-site physicians reduce ambulance transports at mass gatherings. Prehosp Emerg Care. 2003;7(3):322-326.Google Scholar
43. Zeitz, K, Zeitz, C, Arbon, P, Cheney, F, Johnston, R, Hennekam, J. Practical solutions for injury surveillance at mass gatherings. Prehosp Disaster Med. 2008;23(1):76-81.Google Scholar
44. Arbon, P, Bridgewater, FH, Smith, C. Mass gathering medicine: a predictive model for patient presentation and transport rates. Prehosp Disaster Med. 2001;16(3):150-158.Google Scholar
45. Turris, SA, Lund, A, Hutton, A, et al. Mass-gathering health research foundational theory: part 2 - event modeling for mass gatherings. Prehosp Disaster Med. 2014;29(6):655-663.Google Scholar
46. Ranse, J, Hutton, A, Keene, T, et al. Health service impact from mass gatherings: a systematic literature review. Prehosp Disaster Med. 2017;32(1):1-7.Google Scholar
47. Daniel, J. Sampling Essentials: Practical Guidelines for Making Sampling Choices. Los Angeles, California USA: Sage; 2011.Google Scholar