Health Care Organization and Administration in Athletic Training

System of Healthcare Management

• Strategic Plan Development– Determine why there is need for such a program– Determine function of program and what the goals

should be– Decision of administrators will determine extent of

health care program in athletic training– Develop written mission statement to focus

direction of program

• Strategic Plan Development (cont.)– Strategic plan development must include

administrators, other allied healthcare providers, student-athletes, coaches, physicians, athletic trainers, parents and community health leaders

• Development of Policy & Procedures Manual– Creation of policies and procedures for all

involved in health care – Policies = clear written out statements of basic

rules• Critical element for operation of athletic training clinic

– Procedures = describe the process

Issues Specific to 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 injuries)

– 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

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 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 Clinic– Rules concerning room cleanliness and

sanitation must be set and made known to population using facility

– Operation should abide by policies set forth by OSHA

– Examples• No equipment/cleats in the athletic training

room• Shoes off treatment tables• Shower prior to treatment• No roughhousing or profanity• No food or smokeless tobacco

– Cleaning responsibilities should be addressed appropriately by athletic training staff and custodial staff

– 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

disinfecting• Mats cleaned daily (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• Prompt injury and illness reporting• Follow good living habits• Showering after practice• Avoid sharing clothes and towels• Exhibit good hygiene practices• Avoid common drinking sources• Avoid contact with athletes with contagious

disease or infection• Understand the role exercise can play in maintaining a healthy

lifestyle

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. secondary school)

• Continuous planning and prioritizing is necessary to effectively manage monetary allocations to meet programmatic goals

• Supplies– Expendable • Involves 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

• Equipment– Items that can be used for a number of

years– Capital (remain in the athletic training

facility including ice machine, tables)– Non-consumable capital (crutches,

coolers, athletic training kits)

• 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

• Security Issues– Accessibility to athletic training clinic

(staff, physicians, athletic training students)

– Athletic training students must be supervised when in the clinical setting

– Coaches may have access in secondary school settings

• 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 accidents• 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

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 physician

• Parental involvement is necessary when dealing with psychological and sociological events

Human Resources and Personnel Issues

• Assembling appropriate personnel to achieve program goals and objectives is critical to success.

• Recruitment, hiring and retaining qualified personnel is necessary to be effective

• Specific policies are established relative to hiring, firing, performance evaluations and promotions–Must adhere to these principles

• 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 staff

• Performance evaluations should take place routinely

Athletic Training 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 located 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 & Orthotics Area: 3-4 taping tables and storage cabinets to treat athletes with proximity to a sink

– Physician’s Exam Room: space for physician to work which may hold exam table, lockable storage, sink, telephone

– Records Area: space devoted to record keeping which may include filing system or computer based database, that allows access only to medical personnel

• Storage Facilities– Athletic training facilities often lack

ample storage space– Storage in athletic 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

– Space should be designated for storage of patient belongings

• Athletic Trainer’s Office– Space at least 10x12 feet is ample– All areas of athletic training facility

should be able to be supervised without leaving office space (glass partitions)

– Equipment should include, desk, chair, tack board, telephone, computer and independent locking system

• Additional Areas– Pharmacy Area: separate room that can

be secured for storing and administrating medications (records must be maintained concerning administration)

– Rehabilitation Pool: if space permits, must be accessible to individuals with various injuries, with graduated depth and non-slip surface

– Restrooms: Should be at least one available within the facility