Health Care Administration in Athletic Training

Britni Racus MS, ATC, LAT, CSCS, PES

Policy and Procedure Development

Creation of policies and procedures for all involved in health care of athletes necessaryPolicies = clear written out statements of basic rules

Procedures = describe the processAbbreviated version of policies and procedures should be provided to athletes and parents (if financially feasible)

Providing Coverage

Facility Personnel CoverageAppropriate coverage of facility and sportsSetup of treatments, rehabilitation, game and practice

coverage varySports Coverage

Certified athletic trainer should attend all practices and games

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

Hygiene and Sanitation

Athletic Training FacilityRules concerning room cleanliness and sanitation must be set

and made known to population using facilityExamples

No equipment/cleats in training roomShoes off treatment tablesNo roughhousing or profanityNo food or smokeless tobacco

Budgetary Concerns

Size of budget??Different settings = different size budgets and space allocationsEquipment 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 Cont.Supplies

Expendable (supplies that cannot be reused- first aid and injury prevention supplies)

Non-expendable (re-useable supplies -ace wraps, scissors…etc)Yearly inventory and records must be maintained in both areas

EquipmentItems that can be used for a number of years

Capital (remain in the training room- ice machine, tables)Non-consumable capital (crutches, coolers, training kits)

Emergency Action Plan

Accessing emergency personnel outside setting in the event of emergency

Include transportation of athletes to emergency facilitiesMeeting 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 physicianParental involvement is necessary when dealing with

psychological and sociological events

Record Keeping

Major responsibilityThe rule not the exception - accurate and up-to-dateMedical records, injury reports, insurance information,

injury evaluations, progress notes, equipment inventories, annual reports

Administering Pre-participation ExaminationsInitial pre-participation exam prior to start of practice is criticalPurpose it to identify athlete that may be at riskShould include

Medical history, physical exam, orthopedic screening, wellness screening

Establishes a baselineSatisfies insurance and liability issue

Types of PPE

Examination by Personal PhysicianYields an in-depth history and ideal physician-patient relationshipMay not result in detection of factors that predispose the athlete to injury

Station ExaminationProvides athlete with detailed exam in little timeTeam of nine is ideal (2 physicians, 2 non-physicians and 5

managers/student athletic trainers)

What’s in a PPE

Medical HistoryComplete prior to exam to identify past and existing medical conditionsUpdate yearly and closely review by medical personnelCollect medical release and insurance info at the same time

Physical ExaminationShould 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

What’s in a PPE Cont.

Wellness ScreeningPurpose is to determine if athlete is engaged in a healthy

lifestyle

Sport DisqualificationCertain injuries and illnesses warrant special concern when

dealing with sportsRecommendations can be madeAmerican with Disabilities Act (1990)

Dictates that athlete makes the final decisionPotential disqualifying factors should be determined during

the pre-participation exam

Injury Reports and Injury Disposition

Injury reports serve as future referencesReports can shed light on events that may be hazy following

an incidentNecessary in case of litigationAll reports should be filed in the athletic training room

Treatment Log/ Emergency Card

Treatment LogSign-in to keep track of servicesDaily treatments can be recordedCan be used as legal documentation in instances of litigation

Emergency CardContains 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 formatS: 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)

Release of Medical

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

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/problemsMost injuries are related to appendages

Strains, sprains, contusions, fractures, abrasions

Using Injury Data

Valid and reliable data can be utilized to decrease injuriesMay allow for:

Rule modificationAssist coaches and players in understanding risksHelp manufacturersEducate parents, athletes and the public on inherent risks associated with

sport