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dc.contributor.authorLeary, Alison
dc.contributor.authorKemp, Anthony
dc.contributor.authorGreenwood, Peter
dc.contributor.authorHart, Nick
dc.contributor.authorAgnew, James
dc.contributor.authorBarrett, John
dc.contributor.authorPunshon, Geoffrey
dc.date.accessioned2019-09-23T16:52:47Z
dc.date.available2019-09-23T16:52:47Z
dc.date.issued2017-12
dc.identifier.citationLeary, A. et al, 2017. Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach. BMJ Open, 7 (12), e018619.en_US
dc.identifier.issn2044-6055
dc.identifier.doi10.1136/bmjopen-2017-018619
dc.identifier.urihttp://hdl.handle.net/20.500.12417/290
dc.description.abstractObjectives To evaluate the new model of providing care based on demand. This included reconfiguration of the workforce to manage workforce supply challenges and meet demand without compromising the quality of care. Design Currently the Sports Ground Safety Authority recommends the provision of crowd medical cover at English Football League stadia. The guidance on provision of services has focused on extreme circumstances such as the Hillsborough disaster in 1989, while the majority of demand on present-day services is from patients with minor injuries, exacerbations of injuries and pre-existing conditions. A new model of care was introduced in the 2009/2010 season to better meet demand. A realist approach was taken. Data on each episode of care were collected over 14 consecutive football league seasons at Millwall FC divided into two periods, preimplementation of changes and postimplementation of changes. Data on workforce retention and volunteer satisfaction were also collected. Setting The data were obtained from one professional football league team (Millwall FC) located in London, UK. Primary and secondary outcomes The primary outcome was to examine the demand for crowd medical services. The secondary outcome was to remodel the service to meet these demands. Results In total, 981 episodes of care were recorded over the evaluation period of 14 years. The groups presenting, demographic and type of presentation did not change over the evaluation. First aiders were involved in 87.7% of episodes of care, nurses in 44.4% and doctors 17.8%. There was a downward trend in referrals to hospital. Workforce feedback was positive. Conclusions The new workforce model has met increased service demands while reducing the number of referrals to acute care. It involves the first aid workforce in more complex care and key decision-making and provides a flexible registered healthcare professional team to optimise the skill mix of the team. https://bmjopen.bmj.com/content/7/12/e018619.long This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/bmjopen-2017-018619
dc.language.isoenen_US
dc.subjectEmergency Medical Servicesen_US
dc.subjectCrowdingen_US
dc.subjectFirst Aiden_US
dc.subjectPatient Care Teamen_US
dc.subjectReferral and Consultationen_US
dc.titleCrowd medical services in the English Football League: remodelling the team for the 21st century using a realist approachen_US
dc.typeJournal Article/Review
dc.source.journaltitleBMJ Openen_US
dcterms.dateAccepted2019-08-22
rioxxterms.versionNAen_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2019-08-22
refterms.panelUnspecifieden_US
refterms.dateFirstOnline2017-12
html.description.abstractObjectives To evaluate the new model of providing care based on demand. This included reconfiguration of the workforce to manage workforce supply challenges and meet demand without compromising the quality of care. Design Currently the Sports Ground Safety Authority recommends the provision of crowd medical cover at English Football League stadia. The guidance on provision of services has focused on extreme circumstances such as the Hillsborough disaster in 1989, while the majority of demand on present-day services is from patients with minor injuries, exacerbations of injuries and pre-existing conditions. A new model of care was introduced in the 2009/2010 season to better meet demand. A realist approach was taken. Data on each episode of care were collected over 14 consecutive football league seasons at Millwall FC divided into two periods, preimplementation of changes and postimplementation of changes. Data on workforce retention and volunteer satisfaction were also collected. Setting The data were obtained from one professional football league team (Millwall FC) located in London, UK. Primary and secondary outcomes The primary outcome was to examine the demand for crowd medical services. The secondary outcome was to remodel the service to meet these demands. Results In total, 981 episodes of care were recorded over the evaluation period of 14 years. The groups presenting, demographic and type of presentation did not change over the evaluation. First aiders were involved in 87.7% of episodes of care, nurses in 44.4% and doctors 17.8%. There was a downward trend in referrals to hospital. Workforce feedback was positive. Conclusions The new workforce model has met increased service demands while reducing the number of referrals to acute care. It involves the first aid workforce in more complex care and key decision-making and provides a flexible registered healthcare professional team to optimise the skill mix of the team. https://bmjopen.bmj.com/content/7/12/e018619.long This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ http://dx.doi.org/10.1136/bmjopen-2017-018619en_US


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