[For Healthcare, Nursing, and Welfare Professionals] Safe Implementation Manual for Outdoor Recreation!

Outdoor recreation activities in the fields of healthcare, nursing care, and welfare hold significant importance for improving the quality of life (QOL) of elderly and disabled users or patients. However, there are numerous risks to consider, such as changes in physical condition on the day or troubles during transportation. Many may wonder, "What should be checked to ensure safe supervision?" or "How can we prevent oversights in preparation?"

This article, compiled by Ayumi, who has been handling barrier-free information for safe outdoor recreation for healthcare, nursing care, and welfare workers, organizes and explains insights based on the "Universal Tourism Product Development and Sales Manual" issued by the Japan Tourism Agency in March 2023. It covers everything from safety management concepts to role distribution on the day, necessary items, and emergency response.

If you are looking for ideas for planning outdoor recreation or want to prepare handover materials for new staff, please read to the end.

1. Why Healthcare and Welfare Workers Should Conduct Pre-Checks Before Outdoor Recreation

Outdoor recreation is a valuable opportunity for users and patients to step away from their daily routines, but it requires different risk management from the staff compared to normal times. We will organize why pre-checks are essential from both safety management and QOL perspectives.

1-1. Importance of Safety Management and Risk Management

Activities outside the facility involve risks such as transportation, environmental changes, and crowds that are not anticipated within the facility. The "Universal Tourism Product Development and Sales Manual" (issued in March 2023) by the Japan Tourism Agency categorizes these risks into "information issues," "mobility issues," and "facility/service issues." For example, even if a location is officially stated to be "wheelchair accessible," it often differs from the actual situation. Confirming information from multiple sources, such as phone confirmations or requesting photos, is the first step in preventing troubles on the day.

By systematically identifying risks, decisions at the site can be made consistently without being person-dependent, allowing for the establishment of a consistent safety management system as an organization.

参照：2-3 旅行における参加者の【お困りごと】（P12）｜ユニバーサルツーリズムの商品造成・販売マニュアル｜観光庁

1-2. Improving Participants' (Users/Patients) QOL and Reducing Staff Burden

Outdoor recreation is a vital activity that contributes to the improvement of QOL (Quality of Life) by creating opportunities for social participation and refreshing experiences. New scenery, interactions with people, and seasonal experiences provide stimuli that are difficult to obtain within the facility, contributing to the maintenance of cognitive functions and mental stability. This is particularly significant for the elderly.

参照：社会参加（P46）｜あたまとからだを元気にするMCIハンドブック｜厚生労働省・国立長寿医療研究センター

On the other hand, insufficient preparation during the planning stage can directly lead to increased staff burden and near-miss incidents on the day. Systematizing pre-check items can reduce "initial confusion" and significantly alleviate the psychological burden on on-site staff. The time spent on preparation will surely return as a margin of safety on the day.

2. [Before Departure] Pre-Check List for Outdoor Recreation

Many of the troubles on the day of the outing stem from oversights before departure. From here, we will explain specific check items to be noted from 7 days before departure until the morning of the day from four perspectives.

2-1. Checking Participants' Health Status, Vital Signs, and Medication

In addition to checking the physical condition the day before departure, perform a final check of all participants' vitals (temperature, blood pressure, pulse, etc.) on the morning of the day. It is recommended to carry extra medication in addition to the day's supply, in case of delays or loss.

Additionally, copies of medication notebooks and insurance cards are essential for sharing information during emergency transport, so the supervising leader should manage them collectively. Prepare a "Medical Information Sheet" for each user (summarized on an A4 sheet with name, age, type of disability, regular medications, allergies, primary care physician, and family contact information) and ensure it is carried during outings.

2-2. Checking the Barrier-Free Status and Wheelchair Routes at the Destination

Do not rely solely on official website information; it is fundamental to confirm from multiple sources such as phone confirmations, photo requests, and Google Maps Street View. The discrepancy between "wheelchair accessible" labels and reality is often observed on-site.

Specific items to check include:

・Steps, slopes, and surface conditions from the entrance to the destination

・Number and location of barrier-free restrooms

・Width of passageways (80cm or more for wheelchair passage, 90cm or more for easy passage)

・Seats and rest areas usable with chairs

・Location and capacity of elevators

参照：第2部第3章基本寸法｜高齢者、障害者等の円滑な移動等に配慮した建築設計標準｜国土交通省

If you want to know more about wheelchair-accessible routes, please check the article below.

2-3. Weather and Temperature Forecasts, Heatstroke, and Cold Weather Measures

4-3. Management and Loss Prevention of Personal Information (e.g., Insurance Card Copies)

Copies of insurance cards, medication notebooks, and disability certificates (necessary for discounts) are filed for each user and managed collectively by the supervising manager. To avoid the risk of loss, the originals are generally not taken out.

Additionally, labeling the cover with the user's name for easy identification is effective. After returning, promptly store them in a locked management location to minimize the risk of loss or leakage.

5. Recommended Spring and Early Summer Outing Activities: 6 Plans!

Once the pre-check system is in place, the next step is selecting specific plans. We introduce six outing plans that comply with the Tourism Agency's manual, complete with anticipated issues and tips for addressing them.

Plan 1. 'Everyone Can Play Day' at a Local Inclusive Park
Area	Nationwide (multiple in major cities like Tokyo, Kanagawa, Osaka)
Estimated Duration	Half-day (including travel, 3-4 hours)
Wheelchair Accessibility	★★★ Accessible even for those with wheelchairs or unstable walking
What is the plan about?	A plan to spend time at a park designed for everyone to play, regardless of disability, age, or gender. Unlike regular parks, it offers equipment accessible by wheelchair and quiet areas with reduced sensory stimuli.
Key Points of the Plan	In a "recreation at the park" scenario, regular parks may have equipment that some users cannot use. In an inclusive park, everyone can enjoy the same space. Bringing a packed lunch allows for a half-day experience with almost zero cost.
Anticipated Issues and Tips for Addressing Them	[Information] You won't know which equipment suits whom until you arrive at the park → Check the park's website or social media for equipment layout in advance, and if possible, do a preliminary visit. [Facilities] There might be only one accessible restroom in the park → Check the location on the park map and carry a health management sheet for users. [Soft] Users with sensory sensitivities may become unstable during crowded times → Choose a weekday morning or evening when it's less crowded

Plan 2. Day Trip Bus Recreation to Ghibli Park (Aichi)
Area	Nagakute City, Aichi Prefecture
Estimated Duration	1 day (including round trip)
Wheelchair Accessibility	★★★ All areas are wheelchair accessible, with barrier-free restrooms and elevators
What is the plan about?	A theme park that recreates the world of Studio Ghibli films. It can be enjoyed across generations, making it an outing activity easy to report to families.
Key Points of the Plan	The biggest concern with theme parks is whether they can be enjoyed with a wheelchair. Ghibli Park is fully accessible, making it easy to get approval for the plan. Checking for disability discounts and companion discounts is essential in advance.
Anticipated Issues and Tips for Addressing Them	The period right after Golden Week in mid-May is a prime season when tourist spots are less crowded and prices drop. Since "places our shuttle cannot reach" become options, the range of planning ideas expands significantly. Details on how to compare and book rental car companies are available in the article.
Potential Issues and Tips for Solutions	[Transportation] Rental welfare vehicles are limited in number and region, making them hard to secure during peak seasons → Book immediately after planning is finalized. At least 2 weeks in advance is recommended. [Personnel] If the driver has little experience with welfare vehicles, it may lead to issues on the day → Conduct a test drive, including lift operation, by the day before departure. [Facilities] Parking spaces at destinations may not fit welfare vehicles → Confirm parking dimensions in advance (phone verification is reliable).
Day-of Checklist (Items & Pre-checks)	□ Rental contract & driver's license (for the driver) □ Check lift operation at vehicle handover (ensure staff practice with the actual vehicle) □ Confirm quantity of securing belts and wheelchair restraints □ Pre-reserve parking at the destination (space for welfare vehicles) □ Confirm whether full tank return is required (depends on contract) □ Check loading space matches wheelchair type and size □ Pre-arrange boarding positions for users □ Road service contact & emergency contact for rental company

Plan 4: Overnight Outdoor Recreation with Barrier-Free Glamping
Area	Omura Bay, Nagasaki Prefecture (Flat Glamping Nagasaki) and others
Estimated Duration	1 night, 2 days
Wheelchair Accessibility	★★★ Almost no steps, all rooms are barrier-free
What is the Plan?	An overnight recreation at a glamping facility where you can access the guest room and BBQ area while in a wheelchair. Outdoor experience × Accommodation at the same time.
Key Points of the Plan	"Overnight recreation" is often avoided due to the heavy burden on caregivers. In a facility specialized for barrier-free access, the assistance burden on-site is dramatically reduced. Promoting it as the 'highlight event' of the year increases satisfaction among users and families.
Potential Issues and Tips for Solutions	[Facilities] Users requiring specialized bathing assistance need prior confirmation → Ensure the facility offers shower chair and bathroom handrail rentals. [Health] Risk of health changes in an unfamiliar environment → List nearby medical facilities for emergencies before departure, carry double the usual medication. [Information] Food allergies and chopped meal options vary greatly by facility → Communicate all dietary restrictions at the time of booking
Day-of Checklist (Items & Pre-checks)	□ Regular medication (double amount), medical devices, health management sheet □ Medication notebook (for verification at emergency transport destinations) □ Change of clothes (including after bathing and spare), towels □ List of confirmed rental items from the facility (e.g., shower chair) □ Final reconfirmation of dietary restrictions (chopped meals, allergies) □ Emergency contact system for nighttime (facility night staff, family, primary doctor) □ Know the direction and distance to the nearest designated emergency hospital □ Indoor alternative plan for sudden weather changes < Reference:

Plan 6. Roppongi Stroll (Spring Urban Rec)
Area	Tokyo, Roppongi
Estimated Duration	Half-day
Wheelchair Accessibility	★★ Well-equipped due to urban area, but beware of crowds
What is this plan about?	A half-day urban recreation tour around Roppongi Hills and Tokyo Midtown, visiting barrier-free spots and gourmet locations.
Key Points of the Plan	An option when "tired of theme parks" or "nature has weather risks." Easily combined with museums, cafes, and observation decks, allowing flexible planning according to users' interests. Visiting on weekday mornings helps avoid crowds.
Anticipated Issues and Tips	[Transportation] Elevator locations at stations are complex, doubling expected transfer time → Use Google Maps' wheelchair-accessible route feature for pre-checks [Facilities] It's often unclear if restaurants are barrier-free → Use barrier-free restaurant guide sites and confirm by phone before visiting [Soft] Wheelchair users may feel isolated during crowded times → Visit on weekday mornings, set up more rest spots

Reference:

6. Conclusion

For healthcare, nursing, and welfare professionals to safely conduct outdoor recreation, it is crucial to systematize the four perspectives of pre-departure health, destination, weather, and emergency contact checks, staff allocation and information sharing on the day, preparation of belongings and equipment, and formalization of emergency response procedures as a pre-checklist.

The three key points to keep in mind are as follows:

・Identify risks in advance using the "Three Concerns" framework from the Tourism Agency manual

・Prepare and carry medical information sheets and emergency contact cards for each user

・When calling 119, do not specify a hospital, leave it to the judgment of the emergency team

Through outdoor recreation, let's safely create opportunities for elderly and disabled users and patients to encounter new experiences and the colors of the seasons.

[For Healthcare, Nursing, and Welfare Professionals] Safe Implementation Manual for Outdoor Recreation!

Table of Contents

1. Why Healthcare and Welfare Workers Should Conduct Pre-Checks Before Outdoor Recreation

1-1. Importance of Safety Management and Risk Management

1-2. Improving Participants' (Users/Patients) QOL and Reducing Staff Burden

2. [Before Departure] Pre-Check List for Outdoor Recreation

2-1. Checking Participants' Health Status, Vital Signs, and Medication

2-2. Checking the Barrier-Free Status and Wheelchair Routes at the Destination

2-3. Weather and Temperature Forecasts, Heatstroke, and Cold Weather Measures

5. Recommended Spring and Early Summer Outing Activities: 6 Plans!

6. Conclusion

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