Development of On-Site Medical System for Mass-Gathering Events During TOKYO 2020: Vulnerability Analysis Using Healthcare Failure Mode and Effect Analysis.

Ryo Yamamoto,Noriko Yamazaki,Katsuya Maeshima,Yusho Nishida,Akina Haiden,Shoko Asakawa,Junichi Sasaki,Koichiro Homma

doi:10.1017/dmp.2021.329

Abstract

At mass-gathering events of the Olympic and Paralympic Games, a well-organized, on-site medical system is essential. This study evaluated the vulnerabilities of the prehospital medical system of the TOKYO 2020 Olympic and Paralympic Games (TOKYO2020) to propose corrections that can be generalized to other mass gatherings. The healthcare failure mode and effect analysis (HFMEA) was adopted to analyze vulnerabilities of the on-site medical system proposed by the organizing committee of TOKYO2020. Processes from detecting a patient on the scene to completing transport to a hospital were analyzed. Ten processes with 47 sub-processes and 122 possible failure modes were identified. HFMEA revealed 9 failure modes as vulnerabilities: misidentification of patient, delayed immediate care at the scene, misjudgment of disposition from the on-site medical suite, and inappropriate care during transportation to hospital. Proposed corrections included surveillance to decrease blind spots, first aid brochures for spectators, and uniform protocol for health care providers at the scene. The on-site medical system amended by HFMEA seemed to work appropriately in TOKYO2020.

Highlights

As international sporting events, the Olympic and Paralympic Games draw thousands of athletes and hundreds of thousands of spectators from around the world.[1–3] This temporary population surge in a local area challenges health care delivery systems and requires plans for a mass-gathering medical system.[3,4] Previous studies of public health preparedness and procedures for summer sporting events, including Olympic and Paralympic Games, found that medical response plans should involve health-related agencies, volunteers, and sponsors, as well as risk assessment with system correction that should be performed during the planning process.[3,5]
Ten processes with 47 sub-processes were identified between recognizing a patient and completing transfer to a hospital
The healthcare failure mode and effect analysis (HFMEA) identified 9 failure modes as critical vulnerabilities in the system (Table 2): 3 failure modes related to misidentification of patient by first aiders, 2 related to delayed immediate care by the mobile medical unit at the scene, 1 related to misjudgment of disposition from the main on-site medical suite, and 3 related to inappropriate care during transportation to hospital

Summary

Introduction

The Olympic and Paralympic Games draw thousands of athletes and hundreds of thousands of spectators from around the world.[1–3] This temporary population surge in a local area challenges health care delivery systems and requires plans for a mass-gathering medical system.[3,4] Previous studies of public health preparedness and procedures for summer sporting events, including Olympic and Paralympic Games, found that medical response plans should involve health-related agencies, volunteers, and sponsors, as well as risk assessment with system correction that should be performed during the planning process.[3,5]. The Olympic and Paralympic Games draw thousands of athletes and hundreds of thousands of spectators from around the world.[1–3] This temporary population surge in a local area challenges health care delivery systems and requires plans for a mass-gathering medical system.[3,4]. An interview-based study suggested that emergency care delivery at an out-of-hospital location by a designated on-site medical team would provide timely access to health care systems and eventually reduce unnecessary hospital visits.[10]. Such an on-site medical response system should be tailored to event components, participant characteristics, geography, and availability of local resources.[9,11]. The healthcare failure mode and effect analysis (HFMEA),[12] a systematic and prospective method of process mapping to identify how a complex task might fail and which corrective interventions are needed,[12–15] was adopted for the vulnerability analysis

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