The Pemberton Health Centre is bracing for the fallout of this weekend's massive music festival, the first major event of the summer that will be monitored for the financial burden it places on the region's health system.
For the first time ever, Vancouver Coastal Health will be keeping a running tab on all increased costs from four events in the Sea to Sky corridor this summer: this weekend's five-day long, 25,000-strong Pemberton Music Festival, Ironman, the Squamish Valley Music Festival and Crankworx.
Those costs will also include the use of the provincial Mobile Medical Unit — a hospital on wheels — for two weeks spanning the Squamish Valley Music Festival and Crankworx, Whistler's annual mountain biking festival. It is the first time the MMU has been used in the corridor for event overflow.
"I think the ultimate reason (for collecting data) is just to identify the true cost of these events to Vancouver Coastal Health (VCH), and to possibly take them forward to either the event organizers, and to also make the Ministry of Health aware of the various costs to our system based on these events," said Laurie Leith, operations director with VCH, adding that a report will be produced at the end of the summer.
The financial burden has become more pronounced lately as the corridor plays host to back-to-back major events throughout the summer — events that spin millions into the local and provincial economies, but which have quietly and steadily been putting stress on the health care system.
This past year VCH has been working in collaboration with event producers and their medical teams to determine any shortfalls in their medical plans.
"We don't have authority to say 'yes' or 'no' to their plans, but we do have a collaborative working relationship in which we work together to ensure plans will provide safe care to our community residents and visitors during these events," said Leith.
For example, she said they have a good relationship with Rockdoc Consulting, a Vancouver-based company that provides on-site emergent, urgent and continuing care for events and other organizations. It will be used in Pemberton this weekend and at Ironman the following weekend.
Festival organizers also provide extra ambulances through BC Ambulance Service (BCAS).
"BCAS works closely with event organizers to determine how much extra paramedic coverage is required," said Kelsie Carwithen, manager of media relations with BCAS. "This extra coverage is paid for by the event, not BCAS."
And yet, even with the on-site medical tents and the extra ambulance coverage, there are still financial and operational impacts on the local health centres.
Staffing for overflow
First up for study is the impact on the small rural health centre in Pemberton that services the village and outlying areas. It is setting up to cope with this weekend's festival overflow as patients overheat, drink too much in the sun, do too many drugs, and struggle with the respiratory effects of dry and dusty camping, among other things.
There will be extra nurses on staff during the day; radiology and diagnostics will be open on the weekend; there will be more security, more admitting staff, additional housekeeping and laundry services; and the nighttime on-call nurse and doctor will double from one each to two.
The blood bank will more than double from its standard five units of fresh frozen plasma on site.
"We're hoping that they (Rockdoc) can manage most of the patients that come through," said Leith. "Really, we're their overflow."
Rockdoc is also providing services for Ironman.
In its inaugural year last year, 13 competitors were treated at the Whistler Health Care Centre; at least six were transferred to Vancouver.
The centre stayed open throughout the night to deal with the late-night arrivals. Last year there was just enough of a specific drug used to treat the gastrointestinal bleeds sometimes suffered by endurance athletes.
This year, the clinic will close for the night, but it will be staffed to deal with these potential patients.
Hospital on wheels
The Mobile Medical Unit will be a pilot project for the Squamish Valley Music Festival and Crankworx, parked in the corridor for almost two weeks in August, first in Squamish and then in Whistler.
"That's a major augmentation to Whistler and Squamish," said Leith.
And that's a relief for Whistler's chief of staff Dr. Bruce Mohr, who has been actively lobbying for the MMU.
"It will be great to have," said Mohr, who remembers how his staff had its back against the wall one day during Crankworx 2013, just able to cope with the successive traumas.
"Like I say, we hopefully won't have to use it at all, but that first day when you wish you had had it and you didn't... It could make a life-saving difference."
Mohr confirmed that the MMU would be stationed in the health care centre parking lot.
"...They couldn't place it where we wanted it (on space between WHCC and Olympic Plaza), so it will have to go in the WHCC parking lot, which isn't optimal because it compromises patient parking," said Mohr. "It will be staffed with surgical capacity and surgical consultation should we need it, but everything will be triaged through WHCC."
The MMU will have a full OR team available in case somebody needs emergency life-saving surgery and cannot be flown, or driven, out of Whistler.
"We don't anticipate that it will be used, but we will have full trauma-team staff available to do that during the last week of Crankworx," said Leith.
"Even if the OR capacity isn't utilized we do have... additional trauma bays so should they be overwhelmed at the Whistler clinic, we can overflow."
The six provincial health authorities share the cost of the MMU, kicking in $147,000 each per year. VCH however, will need to pay for staffing, fencing, and electrical hook up, over and above this annual fee.
Leith said: "We're confident that all this pre-planning will make the corridor safe and we're confident that we'll have our services in place to respond and that's our ultimate goal — to make sure that we have safe patient care."