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Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
Chapter 2: Health Care Administration in Athletic Training
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Chapter 2: Health Care Administration in Athletic Training

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  • 1. Chapter 2: Health Care Administration in Athletic Training
  • 2. System of Healthcare Management <ul><li>Strategic Plan Development </li></ul><ul><ul><li>Determine why there is need for such a program </li></ul></ul><ul><ul><li>Determine function of program within scope of athletic program </li></ul></ul><ul><ul><li>Decision of administrators will determine extent of health care program </li></ul></ul><ul><ul><li>Develop written mission statement to focus direction of program </li></ul></ul>
  • 3. <ul><li>Strategic Plan Development (cont.) </li></ul><ul><ul><li>Strategic plan development must include administrators, student-athletes, coaches, physicians, athletic trainers, parents and community health leaders </li></ul></ul><ul><ul><li>Ongoing process that reviews strengths and weaknesses of program </li></ul></ul>
  • 4. <ul><li>Policy and Procedure Development </li></ul><ul><ul><li>Creation of policies and procedures for all involved in health care of athletes necessary </li></ul></ul><ul><ul><li>To be covered throughout presentation </li></ul></ul><ul><ul><li>Abbreviated version of policies and procedures should be provided to athletes and parents (if financially feasible) </li></ul></ul>
  • 5. Facility Design <ul><li>Design will vary drastically based on number of athletes, teams, and various needs of the program </li></ul><ul><li>Size </li></ul><ul><ul><li>Varies between settings </li></ul></ul><ul><ul><li>Must take advantage and manage space effectively </li></ul></ul><ul><ul><li>Interact with architect relative to needs of program and athletes </li></ul></ul>
  • 6. <ul><li>Location </li></ul><ul><ul><li>Outside entrance (limits doors that must be accessed when transporting injured athletes) </li></ul></ul><ul><ul><li>Double door entrances and ramps are ideal </li></ul></ul><ul><ul><li>Proximity to locker rooms and toilet facilities </li></ul></ul><ul><ul><li>Light, heat and water source should be independent from rest of facility </li></ul></ul><ul><li>Illumination </li></ul><ul><ul><li>Well lighted throughout </li></ul></ul><ul><ul><li>Reflective ceilings and walls will aid in process </li></ul></ul><ul><ul><li>Natural lighting is a plus </li></ul></ul>
  • 7. <ul><li>Special Service Areas </li></ul><ul><ul><li>Treatment Area : area that accommodates 4-6 adjustable treatment tables, 3-4 stools, and hydrocollator and ice machine accessibility </li></ul></ul><ul><ul><li>Electrotherapy Area : area that houses ultrasound, diathermy, electrical stim units, storage units, grounded outlets, treatment tables and wooden chairs, under constant supervision </li></ul></ul><ul><ul><li>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 </li></ul></ul>
  • 8. <ul><ul><li>Exercise Rehabilitation Area: area that provides adequate space and equipment to perform reconditioning of injuries </li></ul></ul><ul><ul><li>Taping, Bandaging & Orthotic Area: 3-4 taping tables and storage cabinets to treat athletes with proximity to a sink </li></ul></ul><ul><ul><li>Physician’s Exam Room: space for physician to work which may hold exam table, lockable storage, sink, telephone, refrigerator </li></ul></ul><ul><ul><li>Records Area: space devoted to record keeping which may include filing system or computer based database, that allows access only to medical personnel </li></ul></ul>
  • 9. <ul><li>Storage Facilities </li></ul><ul><ul><li>Training rooms often lack ample storage space </li></ul></ul><ul><ul><li>Storage in training room that holds general supplies and special equipment </li></ul></ul><ul><ul><li>Large walk-in storage cabinet for bulk supplies </li></ul></ul><ul><ul><li>Refrigerator for equipment, ice cups, medicine and additional supplies </li></ul></ul><ul><li>Athletic Trainer’s Office </li></ul><ul><ul><li>Space at least 10x12 feet is ample </li></ul></ul><ul><ul><li>All areas of training room should be supervised without leaving office space (glass partitions) </li></ul></ul><ul><ul><li>Equipment should include, desk, chair, tack board, telephone, computer (if necessary) and independent locking system </li></ul></ul>
  • 10. <ul><li>Additional Areas </li></ul><ul><ul><li>Pharmacy Area: separate room that can be secured for storing and administrating medications (records must be maintained concerning administration) </li></ul></ul><ul><ul><li>Rehabilitation Pool: if space permits, must be accessible to individuals with various injuries, with graduated depth and non-slip surface </li></ul></ul><ul><ul><li>X-Ray Room: separate room with lead shielding in walls, large enough to house necessary equipment </li></ul></ul>
  • 11.  
  • 12.  
  • 13. Athletic Training Program Operations <ul><li>Scope of Program </li></ul><ul><ul><li>Who will be served by program? </li></ul></ul><ul><ul><li>Athlete: to what extent and what services will be rendered (systemic illness, musculoskeletal injuries) </li></ul></ul><ul><ul><li>Institution: who else can be served medically and educationally and what are the legalities </li></ul></ul><ul><ul><li>Community: outside group and community organizations with legalities again being an issue </li></ul></ul>
  • 14. <ul><ul><li>Clinical and Industrial Settings: patient care outside high school and collegiate athletes, with a broader scope of practice that could include: </li></ul></ul><ul><ul><ul><li>Pediatric work </li></ul></ul></ul><ul><ul><ul><li>Work hardening </li></ul></ul></ul><ul><ul><ul><li>Orthopedic and neurological patients </li></ul></ul></ul><ul><ul><li>Athletic trainers should be sure to work within their scope (physically active) </li></ul></ul><ul><ul><li>Fitness programming may also become an ATC’s responsibility in this setting </li></ul></ul>
  • 15. Providing Coverage <ul><li>Facility Personnel Coverage </li></ul><ul><ul><li>Appropriate coverage of facility and sports </li></ul></ul><ul><ul><li>Setup of treatments, rehabilitation, game and practice coverage vary </li></ul></ul><ul><li>Sports Coverage </li></ul><ul><ul><li>Certified athletic trainer or at least a student should attend all practices and games (home and away) </li></ul></ul><ul><ul><li>Different institutions (including high schools) have different levels of coverage based on personnel and risks involved with sports </li></ul></ul>
  • 16. Hygiene and Sanitation <ul><li>Athletic Training Facility </li></ul><ul><ul><li>Rules concerning room cleanliness and sanitation must be set and made known to population using facility </li></ul></ul><ul><ul><li>Examples </li></ul></ul><ul><ul><ul><li>No equipment/cleats in training room </li></ul></ul></ul><ul><ul><ul><li>Shoes off treatment tables </li></ul></ul></ul><ul><ul><ul><li>Shower prior to treatment </li></ul></ul></ul><ul><ul><ul><li>No roughhousing or profanity </li></ul></ul></ul><ul><ul><ul><li>No food or smokeless tobacco </li></ul></ul></ul>
  • 17. <ul><ul><li>Cleaning responsibilities are divided between athletic training staff and maintenance personnel </li></ul></ul><ul><ul><li>Division of responsibilities </li></ul></ul><ul><ul><li>Maintenance crew </li></ul></ul><ul><ul><ul><li>Sweep floors daily, clean and disinfect sinks and tubs, mop hydrotherapy room, empty waste baskets </li></ul></ul></ul><ul><ul><li>Athletic Training staff </li></ul></ul><ul><ul><ul><li>Clean treatment tables, disinfect hydrotherapy modalities daily, clean equipment regularly </li></ul></ul></ul>
  • 18. <ul><li>Gymnasium (general issues concerning facility and equipment cleanliness) </li></ul><ul><ul><li>Facility </li></ul></ul><ul><ul><ul><li>Cleaning of gymnasium floors </li></ul></ul></ul><ul><ul><ul><li>Drinking fountain and shower/locker facility disinfecting </li></ul></ul></ul><ul><ul><ul><li>Matted service cleaning (wrestling) </li></ul></ul></ul><ul><ul><li>Equipment and clothing </li></ul></ul><ul><ul><ul><li>Proper fitting equipment </li></ul></ul></ul><ul><ul><ul><li>Frequent clothing and equipment laundering </li></ul></ul></ul><ul><ul><ul><li>Appropriate equipment for weather conditions </li></ul></ul></ul><ul><ul><ul><li>Use of clean dry towels and equipment daily </li></ul></ul></ul>
  • 19. <ul><li>Athlete </li></ul><ul><ul><li>Promotion of good health and hygiene is critical </li></ul></ul><ul><ul><ul><li>Athlete clearance to participate </li></ul></ul></ul><ul><ul><ul><li>Athlete insurance </li></ul></ul></ul><ul><ul><ul><li>Prompt injury and illness reporting </li></ul></ul></ul><ul><ul><ul><li>Follow good living habits </li></ul></ul></ul><ul><ul><ul><li>Avoid sharing clothes and towels </li></ul></ul></ul><ul><ul><ul><li>Exhibit good hygiene practices </li></ul></ul></ul><ul><ul><ul><li>Avoid common drinking sources </li></ul></ul></ul>
  • 20. Emergency Telephones <ul><li>Accessibility to phones in all major areas of activity is a must </li></ul><ul><li>Should be able to contact outside emergency help and be able to call for additional athletic training assistance </li></ul><ul><li>Radios, cell and digital phones provide a great deal of flexibility </li></ul>
  • 21. Budgetary Concerns <ul><li>Size of budget?? </li></ul><ul><li>Different settings = different size budgets and space allocations </li></ul><ul><li>Equipment needs and supplies vary depending on the setting (college vs. high school) </li></ul><ul><li>Continuous planning and prioritizing is necessary to effectively manage monetary allocations to meet programmatic goals </li></ul>
  • 22. <ul><li>Supplies </li></ul><ul><ul><li>Expendable (supplies that cannot be reused- first aid and injury prevention supplies) </li></ul></ul><ul><ul><li>Non-expendable (re-useable supplies -ace wraps, scissors…etc) </li></ul></ul><ul><ul><li>Yearly inventory and records must be maintained in both areas </li></ul></ul><ul><li>Equipment </li></ul><ul><ul><li>Items that can be used for a number of years </li></ul></ul><ul><ul><li>Fixed (remain in the training room- ice machine, tables) </li></ul></ul><ul><ul><li>Non-fixed (crutches, coolers, training kits) </li></ul></ul>
  • 23. <ul><li>Purchasing Systems </li></ul><ul><ul><li>Direct buy vs. competitive bidding </li></ul></ul><ul><ul><li>Lease alternative </li></ul></ul><ul><li>Additional Budget Considerations </li></ul><ul><ul><li>Telephone and postage expenses </li></ul></ul><ul><ul><li>Contracts for outside services </li></ul></ul><ul><ul><li>Purchases relative to liability insurance and professional development </li></ul></ul>
  • 24. Developing a Risk Management Plan <ul><li>Security Issues </li></ul><ul><ul><li>Accessibility to training room (staff, physicians, student athletic trainers) </li></ul></ul><ul><ul><li>Supervision issues </li></ul></ul><ul><li>Fire Safety </li></ul><ul><ul><li>Post evacuation plan in case of fire </li></ul></ul><ul><ul><li>Smoke detectors/alarm system and fire extinguisher should be tested and in place </li></ul></ul>
  • 25. <ul><li>Electrical and Equipment Safety </li></ul><ul><ul><li>Major concern </li></ul></ul><ul><ul><li>Be aware of power distribution system to avoid accidents </li></ul></ul><ul><li>Emergency Injury Management </li></ul><ul><ul><li>Accessing emergency personnel outside setting in the event of emergency </li></ul></ul><ul><ul><li>Include transportation of athletes to emergency facilities </li></ul></ul><ul><ul><li>Meeting with outside personnel is necessary to determine roles and rules regarding athlete and equipment care </li></ul></ul>
  • 26. Accessing Community Based Health Services <ul><li>Must have knowledge of local and community health services and agencies in the event of referrals </li></ul><ul><li>Referrals should be made with assistance from a physician </li></ul><ul><li>Parental involvement is necessary when dealing with psychological and sociological events </li></ul>
  • 27. Human Resources and Personnel Issues <ul><li>The sports medicine team is only as good as the individuals in the group </li></ul><ul><li>Recruitment, hiring and retaining qualified personnel is necessary to be effective </li></ul><ul><li>Specific policies are established relative to hiring, firing, performance evaluations and promotions </li></ul><ul><ul><li>Must adhere to these principals </li></ul></ul>
  • 28. <ul><li>Roles and responsibilities must be established </li></ul><ul><ul><li>(job descriptions - job specifications, accountability, code of conduct, and scope) </li></ul></ul><ul><li>Head athletic trainer must serve as a supervisor and work to enhance professional development of staff </li></ul><ul><li>Performance evaluations should take place routinely </li></ul>
  • 29. Record Keeping <ul><li>Major responsibility </li></ul><ul><li>Rule not the exception - accurate and up-to-date </li></ul><ul><li>Medical records, injury reports, insurance information, injury evaluations, progress notes, equipment inventories, annual reports </li></ul>
  • 30. Administering Preparticipation Examinations <ul><li>Initial pre-participation exam prior to start of practice is critical </li></ul><ul><li>Purpose it to identify athlete that may be at risk </li></ul><ul><li>Should include </li></ul><ul><ul><li>Medical history, physical exam, orthopedic screening, wellness screening </li></ul></ul><ul><li>Establishes a baseline </li></ul><ul><li>Satisfies insurance and liability issue </li></ul>
  • 31. <ul><li>Examination by Personal Physician </li></ul><ul><ul><li>Yields an in-depth history and ideal physician-patient relationship </li></ul></ul><ul><ul><li>May not result in detection of factors that predispose the athlete to injury </li></ul></ul><ul><li>Station Examination </li></ul><ul><ul><li>Provides athlete with detailed exam in little time </li></ul></ul><ul><ul><li>Team of nine is ideal (2 physicians, 2 non-physicians and 5 managers/student athletic trainers) </li></ul></ul>
  • 32. <ul><li>Medical History </li></ul><ul><ul><li>Complete prior to exam to identify past and existing medical conditions </li></ul></ul><ul><ul><li>Update yearly and closely review by medical personnel </li></ul></ul><ul><ul><li>Collect medical release and insurance info at the same time </li></ul></ul><ul><li>Physical Examination </li></ul><ul><ul><li>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 </li></ul></ul>
  • 33. <ul><li>Maturity Assessment </li></ul><ul><ul><li>Means to protect young physically active athletes </li></ul></ul><ul><ul><li>Methods </li></ul></ul><ul><ul><ul><li>Circumpubertal (sexual maturity) </li></ul></ul></ul><ul><ul><ul><li>Skeletal </li></ul></ul></ul><ul><ul><ul><li>Dental </li></ul></ul></ul><ul><ul><li>Tanner’s five stage assessment is most expedient </li></ul></ul><ul><li>Orthopedic Screening </li></ul><ul><ul><li>Part of physical exam or separate </li></ul></ul><ul><ul><li>Various degrees of detail concerning exam </li></ul></ul>
  • 34. <ul><li>Wellness Screening </li></ul><ul><ul><li>Purpose is to determine if athlete is engaged in a healthy lifestyle </li></ul></ul><ul><li>Sport Disqualification </li></ul><ul><ul><li>Certain injuries and illnesses warrant special concern when dealing with sports </li></ul></ul><ul><ul><li>Recommendations can be made </li></ul></ul><ul><ul><li>American with Disabilities Act (1990) </li></ul></ul><ul><ul><ul><li>Dictates that athlete makes the final decision </li></ul></ul></ul><ul><ul><li>Potential disqualifying factors should be determined during the preparticipation exam </li></ul></ul>
  • 35. Injury Reports and Injury Disposition <ul><li>Injury reports serve as future references </li></ul><ul><li>Reports can shed light on events that may be hazy following an incident </li></ul><ul><li>Necessary in case of litigation </li></ul><ul><li>All reports should be filed in the athletic training room </li></ul>
  • 36. Treatment Log <ul><li>Sign-in to keep track of services </li></ul><ul><li>Daily treatments can be recorded </li></ul><ul><li>Can be used as legal documentation in instances of litigation </li></ul><ul><li>Personal Information Card </li></ul><ul><li>Contains contact information for family, personal physician, and insurance information </li></ul>
  • 37. Injury Evaluation and Progress Notes <ul><li>Injuries and progress should be monitored by athletic trainer and recorded </li></ul><ul><li>SOAP note format </li></ul><ul><ul><li>S: Subjective (history of injury/illness) </li></ul></ul><ul><ul><li>O: Objective (information gathered during eval) </li></ul></ul><ul><ul><li>A: Assessment (opinion of injury based on information gained during evaluation) </li></ul></ul><ul><ul><li>P: Plan (short and long term goals of rehabilitation) </li></ul></ul>
  • 38. Supplies and Equipment Inventory <ul><li>Managing budget and equipment/supplies is critically important </li></ul><ul><li>Inventory must be taken yearly in order to effectively replenish supplies </li></ul>
  • 39. <ul><li>Annual Report </li></ul><ul><li>Summary of athletic training room functioning </li></ul><ul><li>Can be used to evaluate recommend potential changes for program </li></ul><ul><li>Includes number and types of injuries seen/treated </li></ul><ul><li>Release of Medical Records </li></ul><ul><li>Written consent is required </li></ul><ul><li>Waiver must be signed for any release (include specifics of information to be released and to whom) </li></ul>
  • 40. Computer as Tool for Athletic Trainer <ul><li>Indispensable tool </li></ul><ul><li>Can make the job more efficient with appropriate software </li></ul><ul><li>Must maintain security </li></ul><ul><li>Can also be used for other administrative tasks </li></ul>
  • 41. Collecting Injury Data <ul><li>Accident - unplanned event resulting in loss of time, property damage, injury or death </li></ul><ul><li>Injury- damage to the body restricting activity </li></ul><ul><li>Case study- looks at specific incident of injury </li></ul><ul><li>Injury study falls under numerous categories </li></ul><ul><ul><li>Age, gender, body part, occurrence in different sports </li></ul></ul><ul><ul><li>Contact vs. non-contact sports </li></ul></ul>
  • 42. <ul><li>Catastrophic Injuries </li></ul><ul><ul><li>98% of injuries requiring hospital emergencies are treat and release relative to sport </li></ul></ul><ul><ul><li>Sports deaths (struck with object, heat stroke) </li></ul></ul><ul><ul><li>Catastrophic injuries also include spinal cord trauma, cardiorespiratory injuries/problems </li></ul></ul><ul><ul><li>Most injuries are related to appendages </li></ul></ul><ul><ul><ul><li>Strains, sprains, contusions, fractures, abrasions </li></ul></ul></ul>
  • 43. <ul><li>Current National Injury Data-Gathering Systems </li></ul><ul><ul><li>State of the art injury surveillance is still developing </li></ul></ul><ul><ul><li>Ideal situation </li></ul></ul><ul><ul><ul><li>Epidemiological approach that studies relationship of various factors that influence frequency and distribution of injury in sport </li></ul></ul></ul><ul><ul><ul><li>Extrinsic factors (activity, exposure, equipement) </li></ul></ul></ul><ul><ul><ul><li>Intrinsic factors (age, gender, neuromuscular aspects, structural aspects….etc) </li></ul></ul></ul><ul><ul><li>Number of different surveillance systems in place </li></ul></ul>
  • 44. <ul><li>Surveillance Systems </li></ul><ul><ul><li>National Safety Council (general sports injury data) </li></ul></ul><ul><ul><li>Annual Survey of Football Injury Research (public school, college, professional, sandlot football injury data) </li></ul></ul><ul><ul><li>National Center of Catastrophic Sport Injury Research (Tracks catastrophic injuries in all levels of sports) </li></ul></ul><ul><ul><li>NCAA Injury Surveillance System (data collected on most major sports- ATC data collection) </li></ul></ul>
  • 45. <ul><ul><li>National Electronic Injury Surveillance System (Monitor injuries relative to different products --consumer safety, determine if products are hazardous or defective) </li></ul></ul><ul><ul><li>National High School Sports Injury Registry (tracks injuries in specific sports at 150-200 high schools) </li></ul></ul>

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