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Chapter 2: Health Care Administration in Athletic Training


Chapter 2: Health Care Administration in Athletic Training System of Healthcare Management Strategic Plan Development Determine why there is need for such a program ... – PowerPoint PPT presentation

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Title: Chapter 2: Health Care Administration in Athletic Training

Chapter 2 Health Care Administration in Athletic
System of Healthcare Management
  • Strategic Plan Development
  • Determine why there is need for such a program
  • Determine function of program within scope of
    athletic program
  • Decision of administrators will determine extent
    of health care program
  • Develop written mission statement to focus
    direction of program

  • Strategic Plan Development (cont.)
  • Strategic plan development must include
    administrators, student-athletes, coaches,
    physicians, athletic trainers, parents and
    community health leaders
  • Ongoing process that reviews strengths and
    weaknesses of program

  • Policy and Procedure Development
  • Creation of policies and procedures for all
    involved in health care of athletes necessary
  • To be covered throughout presentation
  • Abbreviated version of policies and procedures
    should be provided to athletes and parents (if
    financially feasible)

Facility Design
  • Design will vary drastically based on number of
    athletes, teams, and various needs of the program
  • Size
  • Varies between settings
  • Must take advantage and manage space effectively
  • Interact with architect relative to needs of
    program and athletes

  • Location
  • Outside entrance (limits doors that must be
    accessed when transporting injured athletes)
  • Double door entrances and ramps are ideal
  • Proximity to locker rooms and toilet facilities
  • Light, heat and water source should be
    independent from rest of facility
  • Illumination
  • Well lighted throughout
  • Reflective ceilings and walls will aid in process
  • Natural lighting is a plus

  • Special Service Areas
  • Treatment Area area that accommodates 4-6
    adjustable treatment tables, 3-4 stools, and
    hydrocollator and ice machine accessibility
  • Electrotherapy Area area that houses ultrasound,
    diathermy, electrical stim units, storage units,
    grounded outlets, treatment tables and wooden
    chairs, under constant supervision
  • Hydrotherapy Area area with centrally sloping
    floor to drain, equipped with 2-3 whirlpools,
    shelving and storage space and outlets 5 feet
    above the floor

  • Exercise Rehabilitation Area area that provides
    adequate space and equipment to perform
    reconditioning of injuries
  • Taping, Bandaging Orthotic Area 3-4 taping
    tables and storage cabinets to treat athletes
    with proximity to a sink
  • Physicians Exam Room space for physician to
    work which may hold exam table, lockable storage,
    sink, telephone, refrigerator
  • Records Area space devoted to record keeping
    which may include filing system or computer based
    database, that allows access only to medical

  • Storage Facilities
  • Training rooms often lack ample storage space
  • Storage in training room that holds general
    supplies and special equipment
  • Large walk-in storage cabinet for bulk supplies
  • Refrigerator for equipment, ice cups, medicine
    and additional supplies
  • Athletic Trainers Office
  • Space at least 10x12 feet is ample
  • All areas of training room should be supervised
    without leaving office space (glass partitions)
  • Equipment should include, desk, chair, tack
    board, telephone, computer (if necessary) and
    independent locking system

  • Additional Areas
  • Pharmacy Area separate room that can be secured
    for storing and administrating medications
    (records must be maintained concerning
  • Rehabilitation Pool if space permits, must be
    accessible to individuals with various injuries,
    with graduated depth and non-slip surface
  • X-Ray Room separate room with lead shielding in
    walls, large enough to house necessary equipment

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Athletic Training Program Operations
  • Scope of Program
  • Who will be served by program?
  • Athlete to what extent and what services will be
    rendered (systemic illness, musculoskeletal
  • Institution who else can be served medically and
    educationally and what are the legalities
  • Community outside group and community
    organizations with legalities again being an issue

  • Clinical and Industrial Settings patient care
    outside high school and collegiate athletes, with
    a broader scope of practice that could include
  • Pediatric work
  • Work hardening
  • Orthopedic and neurological patients
  • Athletic trainers should be sure to work within
    their scope (physically active)
  • Fitness programming may also become an ATCs
    responsibility in this setting

Providing Coverage
  • Facility Personnel Coverage
  • Appropriate coverage of facility and sports
  • Setup of treatments, rehabilitation, game and
    practice coverage vary
  • Sports Coverage
  • Certified athletic trainer or at least a student
    should attend all practices and games (home and
  • Different institutions (including high schools)
    have different levels of coverage based on
    personnel and risks involved with sports

Hygiene and Sanitation
  • Athletic Training Facility
  • Rules concerning room cleanliness and sanitation
    must be set and made known to population using
  • Examples
  • No equipment/cleats in training room
  • Shoes off treatment tables
  • Shower prior to treatment
  • No roughhousing or profanity
  • No food or smokeless tobacco

  • Cleaning responsibilities are divided between
    athletic training staff and maintenance personnel
  • Division of responsibilities
  • Maintenance crew
  • Sweep floors daily, clean and disinfect sinks and
    tubs, mop hydrotherapy room, empty waste baskets
  • Athletic Training staff
  • Clean treatment tables, disinfect hydrotherapy
    modalities daily, clean equipment regularly

  • Gymnasium (general issues concerning facility and
    equipment cleanliness)
  • Facility
  • Cleaning of gymnasium floors
  • Drinking fountain and shower/locker facility
  • Matted service cleaning (wrestling)
  • Equipment and clothing
  • Proper fitting equipment
  • Frequent clothing and equipment laundering
  • Appropriate equipment for weather conditions
  • Use of clean dry towels and equipment daily

  • Athlete
  • Promotion of good health and hygiene is critical
  • Athlete clearance to participate
  • Athlete insurance
  • Prompt injury and illness reporting
  • Follow good living habits
  • Avoid sharing clothes and towels
  • Exhibit good hygiene practices
  • Avoid common drinking sources

Emergency Telephones
  • Accessibility to phones in all major areas of
    activity is a must
  • Should be able to contact outside emergency help
    and be able to call for additional athletic
    training assistance
  • Radios, cell and digital phones provide a great
    deal of flexibility

Budgetary Concerns
  • Size of budget??
  • Different settings different size budgets and
    space allocations
  • Equipment needs and supplies vary depending on
    the setting (college vs. high school)
  • Continuous planning and prioritizing is necessary
    to effectively manage monetary allocations to
    meet programmatic goals

  • Supplies
  • Expendable (supplies that cannot be reused- first
    aid and injury prevention supplies)
  • Non-expendable (re-useable supplies -ace wraps,
  • Yearly inventory and records must be maintained
    in both areas
  • Equipment
  • Items that can be used for a number of years
  • Fixed (remain in the training room- ice machine,
  • Non-fixed (crutches, coolers, training kits)

  • Purchasing Systems
  • Direct buy vs. competitive bidding
  • Lease alternative
  • Additional Budget Considerations
  • Telephone and postage expenses
  • Contracts for outside services
  • Purchases relative to liability insurance and
    professional development

Developing a Risk Management Plan
  • Security Issues
  • Accessibility to training room (staff,
    physicians, student athletic trainers)
  • Supervision issues
  • Fire Safety
  • Post evacuation plan in case of fire
  • Smoke detectors/alarm system and fire
    extinguisher should be tested and in place

  • Electrical and Equipment Safety
  • Major concern
  • Be aware of power distribution system to avoid
  • Emergency Injury Management
  • Accessing emergency personnel outside setting in
    the event of emergency
  • Include transportation of athletes to emergency
  • Meeting with outside personnel is necessary to
    determine roles and rules regarding athlete and
    equipment care

Accessing Community Based Health Services
  • Must have knowledge of local and community health
    services and agencies in the event of referrals
  • Referrals should be made with assistance from a
  • Parental involvement is necessary when dealing
    with psychological and sociological events

Human Resources and Personnel Issues
  • The sports medicine team is only as good as the
    individuals in the group
  • Recruitment, hiring and retaining qualified
    personnel is necessary to be effective
  • Specific policies are established relative to
    hiring, firing, performance evaluations and
  • Must adhere to these principals

  • Roles and responsibilities must be established
  • (job descriptions - job specifications,
    accountability, code of conduct, and scope)
  • Head athletic trainer must serve as a supervisor
    and work to enhance professional development of
  • Performance evaluations should take place

Record Keeping
  • Major responsibility
  • Rule not the exception - accurate and up-to-date
  • Medical records, injury reports, insurance
    information, injury evaluations, progress notes,
    equipment inventories, annual reports

Administering Preparticipation Examinations
  • Initial pre-participation exam prior to start of
    practice is critical
  • Purpose it to identify athlete that may be at
  • Should include
  • Medical history, physical exam, orthopedic
    screening, wellness screening
  • Establishes a baseline
  • Satisfies insurance and liability issue

  • Examination by Personal Physician
  • Yields an in-depth history and ideal
    physician-patient relationship
  • May not result in detection of factors that
    predispose the athlete to injury
  • Station Examination
  • Provides athlete with detailed exam in little
  • Team of nine is ideal (2 physicians, 2
    non-physicians and 5 managers/student athletic

  • Medical History
  • Complete prior to exam to identify past and
    existing medical conditions
  • Update yearly and closely review by medical
  • Collect medical release and insurance info at the
    same time
  • Physical Examination
  • Should include assessment of height, weight, body
    composition, blood pressure, pulse, vision, skin,
    dental, ear, nose, throat, heart, lungs, abdomen,
    lymphatic, genitalia, maturation index,
    urinalysis and blood work

  • Maturity Assessment
  • Means to protect young physically active athletes
  • Methods
  • Circumpubertal (sexual maturity)
  • Skeletal
  • Dental
  • Tanners five stage assessment is most expedient
  • Orthopedic Screening
  • Part of physical exam or separate
  • Various degrees of detail concerning exam

  • Wellness Screening
  • Purpose is to determine if athlete is engaged in
    a healthy lifestyle
  • Sport Disqualification
  • Certain injuries and illnesses warrant special
    concern when dealing with sports
  • Recommendations can be made
  • American with Disabilities Act (1990)
  • Dictates that athlete makes the final decision
  • Potential disqualifying factors should be
    determined during the preparticipation exam

Injury Reports and Injury Disposition
  • Injury reports serve as future references
  • Reports can shed light on events that may be hazy
    following an incident
  • Necessary in case of litigation
  • All reports should be filed in the athletic
    training room

Treatment Log
  • Sign-in to keep track of services
  • Daily treatments can be recorded
  • Can be used as legal documentation in instances
    of litigation
  • Personal Information Card
  • Contains contact information for family, personal
    physician, and insurance information

Injury Evaluation and Progress Notes
  • Injuries and progress should be monitored by
    athletic trainer and recorded
  • SOAP note format
  • S Subjective (history of injury/illness)
  • O Objective (information gathered during eval)
  • A Assessment (opinion of injury based on
    information gained during evaluation)
  • P Plan (short and long term goals of

Supplies and Equipment Inventory
  • Managing budget and equipment/supplies is
    critically important
  • Inventory must be taken yearly in order to
    effectively replenish supplies

  • Annual Report
  • Summary of athletic training room functioning
  • Can be used to evaluate recommend potential
    changes for program
  • Includes number and types of injuries
  • Release of Medical Records
  • Written consent is required
  • Waiver must be signed for any release (include
    specifics of information to be released and to

Computer as Tool for Athletic Trainer
  • Indispensable tool
  • Can make the job more efficient with appropriate
  • Must maintain security
  • Can also be used for other administrative tasks

Collecting Injury Data
  • Accident - unplanned event resulting in loss of
    time, property damage, injury or death
  • Injury- damage to the body restricting activity
  • Case study- looks at specific incident of injury
  • Injury study falls under numerous categories
  • Age, gender, body part, occurrence in different
  • Contact vs. non-contact sports

  • Catastrophic Injuries
  • 98 of injuries requiring hospital emergencies
    are treat and release relative to sport
  • Sports deaths (struck with object, heat stroke)
  • Catastrophic injuries also include spinal cord
    trauma, cardiorespiratory injuries/problems
  • Most injuries are related to appendages
  • Strains, sprains, contusions, fractures, abrasions

  • Current National Injury Data-Gathering Systems
  • State of the art injury surveillance is still
  • Ideal situation
  • Epidemiological approach that studies
    relationship of various factors that influence
    frequency and distribution of injury in sport
  • Extrinsic factors (activity, exposure,
  • Intrinsic factors (age, gender, neuromuscular
    aspects, structural aspects.etc)
  • Number of different surveillance systems in place

  • Surveillance Systems
  • National Safety Council (general sports injury
  • Annual Survey of Football Injury Research (public
    school, college, professional, sandlot football
    injury data)
  • National Center of Catastrophic Sport Injury
    Research (Tracks catastrophic injuries in all
    levels of sports)
  • NCAA Injury Surveillance System (data collected
    on most major sports- ATC data collection)

  • National Electronic Injury Surveillance System
    (Monitor injuries relative to different products
    --consumer safety, determine if products are
    hazardous or defective)
  • National High School Sports Injury Registry
    (tracks injuries in specific sports at 150-200
    high schools)