Cancer care delivery during the Paris 2024 Olympic and Paralympic games: lessons from a crisis-driven Hospital at Home program.
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INTRODUCTION: The Paris 2024 Olympic and Paralympic Games posed logistical challenges for healthcare delivery, particularly for maintaining home-based cancer treatments amidst road closures and 15 million visitors. The Hospital at Home (HaH) program of Greater Paris University Hospitals (AP-HP) implemented innovative strategies to ensure uninterrupted care during this period. METHODS: HaH deployed a "Games Pass" system for its fleet of 500 vehicles and introduced electric bicycles and optimized pedestrian routes to address accessibility constraints. Dedicated lanes, in collaboration with city officials, ensured timely care. Personalized care plans were developed, accounting for patient locations and event schedules. Drug preparation was centralized, and advanced cold-chain methods facilitated delivery. Strategic pre-positioning of vehicles and personnel within restricted zones ensured continuous care, supported by real-time coordination through a dedicated management team. RESULTS: Between July 26 and September 8, 2024, HaH administered 1,946 chemotherapy/immunotherapy sessions to 535 patients (median age 72, IQR 60-79), including 29 pediatric cases. This represented 4.76% of AP-HP's total treated cancer patients, a significant increase from 2023 (3.9%, p < 0.05). Treatments included 31 drugs, with azacitidine (n = 1,025) and daratumumab (n = 248) being most common. Key indications were multiple myeloma (n = 235) and myeloid neoplasms (n = 175). No treatment delays or patient harm were reported. CONCLUSION: The HaH program ensured continuity of care during the Games, highlighting the importance of flexibility, real-time problem-solving, and patient-centered planning. These strategies offer valuable insights for improving routine HaH operations and managing healthcare during large-scale events.