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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*
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
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Josea Polong-Brown
Department of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Michael Aitken
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
School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia
Alison Hutton
School of Nursing, University of Newcastle, New Castle, New South Wales, Australia
Brent Richards
Intensive Care Unit, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
Julia Crilly
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:



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.


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).


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.


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.


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.

Original Research
© World Association for Disaster and Emergency Medicine 2019 

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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.


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