Chapter 2: Health Care Administration in Athletic Training

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Chapter 2 Health Care Administration in Athletic
Training
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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

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• 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

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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
• Different institutions have different levels of
  coverage based on personnel and risks involved
  with sports

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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

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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

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• Supplies
• Expendable (supplies that cannot be reused- first
  aid and injury prevention supplies)
• Non-expendable (re-useable supplies -ace wraps,
  scissorsetc)
• Yearly inventory and records must be maintained
  in both areas

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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

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• 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

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• 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

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• 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

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• 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

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Record Keeping

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

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Administering Pre-participation Examinations

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

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• 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

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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

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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

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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
  evaluation)
• A Assessment (opinion of injury based on
  information gained during evaluation)
• P Plan (short and long term goals of rehab)

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Chapter 3 Legal Concerns and Related Issues
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Liability

• State of being legally responsible for the harm
  one causes to another person.

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Standard of Reasonable Care

• Negligence
• the failure to use ordinary or reasonable care.
• Standards of reasonable care
• Assumes that a person is of ordinary and
  reasonable prudence
• Bring commonsense approach to the situation
• Must operate within the appropriate limitations
  of ones educational background

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Torts

• Legal wrongs committed against a person
  (liability results)
• May emanate from
• Nonfeasance
• Fail to perform legal duty (i.e. fail to refer)
• Malfeasance
• Performs action that is not his/hers to legally
  perform (i.e. perform advanced treatment leading
  to complications)

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Proving Negligence

• Care giver does something a reasonably prudent
  individual would not.
• Care giver fails to do something a reasonably
  prudent individual would not.
• Athletic trainer has a duty to provide coverage
  to athletes (obligation)

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• Individual possessing higher level of training
  will possess higher level of competence
• Once coach or athletic trainer assumes duty of
  caring for athlete that person has an obligation
  to provide appropriate care
• Obligation to provide services vs. Scope of
  employment

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• Good Samaritan Law
• Provides limited protection against legal
  liability to one that provides care should
  something go wrong

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Assumption of Risk

• Athlete is made aware of inherent risks involved
  in sport and voluntarily decides to continue
  participating
• Expressed in written waiver or implied from
  conduct of athlete once participation begins
• Can be used as defense against an athletes
  negligence suit

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• Does not excuse overseers from exhibiting
  reasonable care and prudence in regards to
  conduct of activities or foreseeing potential
  hazards
• Many and varied interpretations (particularly
  with minors)
• Often a waiver will stand in court except in
  incidents of fraud, misrepresentation or duress

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Reducing the Risk of Litigation
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Athletic Trainer

• Work to establish good working relationships
  with athletes, parents and coworkers
• Establish policies regarding athletic training
  facility and coverage
• Develop emergency action plan
• Know the medical history of athletes
• Maintain adequate records

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• Detailed job description
• Obtain written consent relative to providing
  health care
• Maintain confidentiality
• Exercise caution with regards to medication
  distribution and modality use
• Ensure safe equipment and facilities

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• Follow physicians orders, particularly when
  dealing with participation of athlete
• Purchase liability insurance
• Know scope of practice
• Use common sense