Chapter 2: Health Care Administration in Athletic Training

Jennifer L. Doherty, MS, LAT, ATC Academic Program Director, Entry-Level ATEP Florida International University Acute Care and Injury Prevention

Policies and Procedures Manual

• Policies = clear, written-out statements of basic rules • Procedures = describe the process • To be covered throughout presentation • Abbreviated version – Should be provided to athletes and parents (if financially feasible)

Components of a P&P Manual

• Scope of the AT program – Who will it serve?

• Use of equipment and supplies – Budgetary concerns • Facility use and maintenance – Design, access, etc… • Risk management plans • Job descriptions – Chains of command and supervision

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/digital phones provide a great deal of flexibility

Budgetary Concerns

• Different settings – Different size budgets & 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

Budgetary Concerns: Supplies

• Expendable Supplies – Cannot be reused • First aid and injury prevention supplies • Non-expendable Supplies – Re-useable supplies • Ace wraps, scissors, etc… – Yearly inventory and records must be maintained in both areas

Budgetary Concerns: Equipment

• Equipment = items that can be used for a number of years • Capital Equipment – Remain in the training room • Ice machine, tables, etc… • Non-consumable Capital Equipment – Crutches, coolers, training kits, etc…

Budget Considerations

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

Developing a Risk Management Plan

• Emergency Action Plan – Accessing emergency personnel outside setting in the event of emergency – Include transportation of athletes to emergency facilities – Meeting with outside personnel is necessary to determine roles and rules regarding athlete and equipment care

Human Resources and Personnel Issues

• Specific policies are established relative to hiring, firing, performance evaluations and promotions • Roles and responsibilities must be established – Job descriptions - job specifications, accountability, code of conduct, and scope

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

• Location – Outside entrance • Limits doors that must be accessed when transporting injured athletes – Proximity to locker rooms and toilet facilities • Illumination – Well lighted throughout – Natural lighting is a plus

• Storage Facilities – 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

• Office Space – All areas of athletic training room should be supervised without having to leave the office space (glass partitions) – Equipment should include, desk, chair, tack board, telephone, computer (if necessary) and independent locking system

Pre-participation Examinations

• Purpose = identify “at risk” athletes • Should include – Medical history, physical exam, orthopedic screening, wellness screening • Establishes a baseline • Satisfies insurance and liability issues

• Medical History – Complete prior to exam to identify past and existing medical conditions – Update yearly and closely review by medical personnel – 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 • 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 pre-participation exam

Injury Reports

• 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

Annual Report

• Summary of athletic training room functions • Can be used to evaluate recommend potential changes for program • Includes number and types of injuries seen/treated

Release of Medical Records

• Written consent is required • Waiver must be signed for any release (include specifics of information to be released and to whom)

Computer as Tool for Athletic Trainer

• Indispensable tool • Can make the job more efficient with appropriate software • Must maintain security and confidentiality

Components of a P&P Manual

• Scope of the AT program – Who will it serve?

• Use of equipment and supplies – Budgetary concerns • Facility use and maintenance – Design, access, etc… • Risk management plans • Job descriptions – Chains of command and supervision