Functional areas that a medical coordinator must be aware of, and develop a working relationship with, might include any or all of the following:

1. Competition Manager

No one is more interested in areas that affect the participant than the individual charged with managing the competition. That person quite often becomes your primary support system in areas of budget, logistics, credentials, and access to the field of play.

2. Event and Venue Management

Most established facilities have basic plans for spectator care, and disasters, and will provide some direction and assistance with equipment in the venue. Issues such as medical space and location, vehicle access and routes are established within this functional area.

3. Law Enforcement, Security and Site Control

Success of your participant-disaster and emergency-evacuation plans will rely heavily on your relationship with law enforcement and weaving your plan into the existing venue plan. Identification of key personnel and your ability to develop a working relationship will make the behind-the-scenes effort work smoothly.

4. Technology

Define and justify your communication and technology needs to the technology manager early. These might include radios, hard-line and cellular telephones, pagers, facsimile access, computer access, and live-feed monitors for medical and doping-control areas.

5. Food and Beverage

As trivial as it may seem, compared to the development of a disaster plan, the timely feeding of medical volunteers is paramount to morale. Establish the unusual demands of medical management's schedule early in your discussions with the event management. Food-service coordinators should understand that medical management has a special need to be fed because of its arrive-early, depart-late work ethic. Beverage services might be responsible for the procurement and delivery of water, soft drinks, fruit juices, and assorted sport drinks (often at the direction of sponsorships).

6. Transportation

Transportation issues such as parking for personal and event vehicles, procurement of a nonemergency vehicle from the LOC, and travel routes for Emergency Medical Service vehicles are significant details to discuss. Make this an early agenda item. It might take significant time to establish travel routes.

7. Logistics and Equipment Personnel

The fine-tuning of any operation includes capturing items that do not neatly fit into any particular functional area or might be shared by several groups and therefore are often overlooked. These items fall upon the personnel who accept deliveries, handle laundry, towel services, ice delivery, or repair items during the event. Do not underestimate the relationship with the support personnel.

8. Media Relations

Define a clear policy on chain of command when dealing with the media. The medical director and the media director need to agree upon the dissemination of participant medical information. A single voice should be heard from an event on all matters relating to the health and safety of the participants.

Governing bodies of the various sports have a variety of regulations regarding the medical services and the conduct of medical personnel within the event structure. Rules that affect medical services can be obtained from the event sport manager or directly from the sport's governing body.

9. Personnel

The right mix of personnel is key to any operation, and the careful selection of a qualified medical staff must provide the participants with medical personnel who understand the event and have an appreciation for its medical goals.

Personnel selection begins with defining roles and medical needs working within a sometimes-limited credentials allotment. Personnel who have multiple skills or a multi-credential are valuable. Understand that the event limits the exposure to the participant; individuals who are skilled in acute or short-term care are most valuable in this environment. Examples might be pre-event therapeutic soft-tissue massage or postevent hypothermic emergency; in each case, the care-provider may never see the participant again.

Certified athletic trainers (ATCS) have proven to be the most well-trained fundamental health-care providers in the short-term event environment. Following is a list of other health-care providers who bring the needed skills to these events but are in no particular order:

10. Medical Operations Plan

Continuing to formulate your staff will no doubt allow you the opportunity to call upon its resources for additional assistance in establishing your medical operations plan, which should include attention to the following areas:

a. Policy and Procedures

Develop a standard of action for situations and conditions that might arise during the event. It is important to in-service your staff before the event and ensure their ability to work effectively with the equipment. They should be required to sign-off on use of all equipment. Included in this section is an emergency plan that covers disasters.

b. Medical Stations

Establish a residential medical station within the housing area, a separate medical area for noncredential personnel, athletic training site medical station, competition site station and FOP roving teams.

c. Equipment and Supplies

It is your responsibility to make available those items needed to service your scope-of-service statement. Your personnel rely upon having the tools to provide their skills, while at the same time it is important to have personnel who are flexible enough to work with new and unusual tools. Hard supplies such as tables, chairs, and modalities can be provided by sponsors.

d. Local Hospitals

Establish a line of communication with local hospital emergency rooms, laboratories and radiology departments before the event to ensure a quick response. Ask the hospital management to rehearse their emergency and disaster plans in preparation for the event.

e. Record Keeping

Use standard techniques for recording medical encounters within the scope of medical services provided. Determine who will manage these records during and after the event. Computerization of records in highly desirable, as disks can store information that can go from event to event in some instances.

The provision of quality health care for an event is complex. It demands the attention of the coordinating committee to ensure a safe and comfortable event for the participant. The development of a thorough scope of service that will force the nurturing of relationships within the host organization will help to establish a participant-focused medical system.

Ralph Reiff, ATC, M.Ed., has been the Director of Sports Medicine at Butler University for 16 years. Reiff was the Program Manager-Athlete Care for the Atlanta Committee for the Olympic Games in 1996. He is a partner in EMM Group, a medical and education consulting group. Correspondence to Reiff may be mailed to Ralph Reiff, ATC, Director of Sports Medicine, Butler University, 4600 Sunset Avenue, Indianapolis, Indiana 46208, or faxed to 317/940-9891.