© 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 2: Organizing and Administering an Athletic Health Care Program

© 2005 The McGraw-Hill Companies, Inc. All rights reserved.

Chapter 2: Chapter 2: Organizing and Organizing and

Administering an Administering an Athletic Health Athletic Health Care ProgramCare Program


Facility DesignFacility Design►Design will vary drastically based Design will vary drastically based

on number of athletes, teams, and on number of athletes, teams, and various needs of the programvarious needs of the program

►SizeSize Varies between settings Varies between settings Must take advantage and manage Must take advantage and manage

space effectivelyspace effectively Interact with architect relative to Interact with architect relative to

needs of program and athletesneeds of program and athletes►Existing space or newly designedExisting space or newly designed


►LocationLocation Outside entrance (limits doors that Outside entrance (limits doors that

must be accessed when transporting must be accessed when transporting injured athletes)injured athletes)

Double door entrances and ramps are Double door entrances and ramps are idealideal

Proximity to locker rooms and toilet Proximity to locker rooms and toilet facilitiesfacilities

Facility DesignFacility Design


►Distinct areasDistinct areas Taping and bandagingTaping and bandaging Injury treatment with rehabilitation Injury treatment with rehabilitation

equipment and/or therapeutic equipment and/or therapeutic modalitiesmodalities

Wet area (whirlpools, refrigerator, ice Wet area (whirlpools, refrigerator, ice machine)machine)

Physicians examination roomPhysicians examination room Office spaceOffice space




►Storage FacilitiesStorage Facilities Athletic Training Rooms (ATR) often lack Athletic Training Rooms (ATR) often lack

ample storage spaceample storage space Storage in ATR that holds general supplies Storage in ATR that holds general supplies

and special equipmentand special equipment Storage available in the specified areas of Storage available in the specified areas of

the ATRthe ATR Large walk-in storage cabinet for bulk Large walk-in storage cabinet for bulk

suppliessupplies Refrigerator for equipment, ice cups, Refrigerator for equipment, ice cups,

medicine and additional suppliesmedicine and additional supplies






Rules of Operation for an Rules of Operation for an Athletic Healthcare ProgramAthletic Healthcare Program

►Must develop policies and procedures Must develop policies and procedures Delineate daily routine of programDelineate daily routine of program

►Define scope of programDefine scope of program Who will be served by program?Who will be served by program? Athlete: to what extent and what services Athlete: to what extent and what services

will be rendered?will be rendered? Institution: who else can be served Institution: who else can be served

medically and educationally and what are medically and educationally and what are the legalities?the legalities?


Providing CoverageProviding Coverage

►Facility Personnel CoverageFacility Personnel Coverage Budgetary concerns may be a limiting Budgetary concerns may be a limiting

factorfactor What personnel are available?What personnel are available?

►Sports CoverageSports Coverage Different institutions (including high Different institutions (including high

schools) have different levels of schools) have different levels of coverage based on personnel and risks coverage based on personnel and risks involved with sportsinvolved with sports


Athletic Training Room Athletic Training Room PoliciesPolicies

►Facility should be used only for Facility should be used only for prevention and care of sports injuriesprevention and care of sports injuries

►Rules must be established in the Rules must be established in the interest of sanitationinterest of sanitation

►Policies regarding environmental Policies regarding environmental conditions and emergency protocols conditions and emergency protocols should also be setshould also be set


Hygiene and SanitationHygiene and Sanitation►Rules concerning ATR cleanliness and Rules concerning ATR cleanliness and

sanitation must be set and made known to sanitation must be set and made known to population using facilitypopulation using facility ExamplesExamples

►No equipment/cleats in training roomNo equipment/cleats in training room►Shoes off treatment tablesShoes off treatment tables►Shower prior to treatmentShower prior to treatment►No roughhousing or profanityNo roughhousing or profanity►No food or smokeless tobaccoNo food or smokeless tobacco

►Must adhere to OSHA standards and Must adhere to OSHA standards and guidelinesguidelines


Cleaning responsibilities are divided between Cleaning responsibilities are divided between athletic training staff and maintenance athletic training staff and maintenance personnelpersonnel

Division of responsibilitiesDivision of responsibilities Maintenance crewMaintenance crew

►Sweep floors daily, clean and disinfect sinks and Sweep floors daily, clean and disinfect sinks and tubs, mop hydrotherapy room, empty waste tubs, mop hydrotherapy room, empty waste basketsbaskets

Athletic Training staffAthletic Training staff►Clean treatment tables, disinfect hydrotherapy Clean treatment tables, disinfect hydrotherapy

modalities daily, clean equipment regularlymodalities daily, clean equipment regularly

Hygiene and SanitationHygiene and Sanitation


Establishing Health status for Establishing Health status for the Athletethe Athlete

►Promotion of good health Promotion of good health Is the athlete cleared to participate?Is the athlete cleared to participate? Is each athlete insured?Is each athlete insured? Does the athlete promptly report injury and Does the athlete promptly report injury and

illnesses?illnesses? Does the athlete follow good living habits?Does the athlete follow good living habits? Does the athlete avoid sharing clothes and Does the athlete avoid sharing clothes and

towels?towels? Does the athlete exhibit good hygiene practices?Does the athlete exhibit good hygiene practices? Does the athlete avoid common drinking sources?Does the athlete avoid common drinking sources?


Emergency TelephonesEmergency Telephones

►Accessibility to phones in all Accessibility to phones in all major areas of activity is a mustmajor areas of activity is a must

►Should be able to contact outside Should be able to contact outside emergency help and be able to emergency help and be able to call for additional athletic training call for additional athletic training assistanceassistance

►Radios, cell and digital phones Radios, cell and digital phones provide a great deal of flexibility provide a great deal of flexibility


Developing a Risk Developing a Risk Management PlanManagement Plan

►Security IssuesSecurity Issues Accessibility to ATR (staff, physicians, Accessibility to ATR (staff, physicians,

student athletic trainers)student athletic trainers) Supervision issuesSupervision issues

►Fire SafetyFire Safety Post evacuation plan in case of firePost evacuation plan in case of fire Smoke detectors/alarm system and fire Smoke detectors/alarm system and fire

extinguisher should be tested and in placeextinguisher should be tested and in place


Emergency Injury Emergency Injury Management PlanManagement Plan

►A plan must exist for accessing A plan must exist for accessing emergency personnel emergency personnel Must include transportation of athletes to Must include transportation of athletes to

emergency facilitiesemergency facilities►Meeting with outside personnel is Meeting with outside personnel is

necessary to determine roles and rules necessary to determine roles and rules regarding athlete and equipment careregarding athlete and equipment care

►Must have knowledge of local and Must have knowledge of local and community health services and agencies community health services and agencies in the event of referralsin the event of referrals


Record KeepingRecord Keeping

► Major responsibilityMajor responsibility► Rule not the exception Rule not the exception

- accurate and up-to-- accurate and up-to-datedate

► Medical records, injury Medical records, injury reports, insurance reports, insurance information, injury information, injury evaluations, progress evaluations, progress notes, equipment notes, equipment inventories, annual inventories, annual reportsreports


Administering Pre-Administering Pre-participation Examinationsparticipation Examinations

►Pre-participation exam prior to start Pre-participation exam prior to start of practice is criticalof practice is critical

►Purpose:Purpose: Identify athlete that may be at riskIdentify athlete that may be at risk Establish a baselineEstablish a baseline Reveal condition that may warrant Reveal condition that may warrant

disqualificationdisqualification Satisfy insurance and liability issuesSatisfy insurance and liability issues


►Examination by Personal PhysicianExamination by Personal Physician Yields an in-depth history and ideal physician-Yields an in-depth history and ideal physician-

patient relationshippatient relationship May not result in detection of factors that May not result in detection of factors that

predispose the athlete to injurypredispose the athlete to injury

►Station ExaminationStation Examination Provides athlete with detailed exam in little timeProvides athlete with detailed exam in little time Team of nine is ideal (2 physicians, 2 non-Team of nine is ideal (2 physicians, 2 non-

physicians and 5 managers/student athletic physicians and 5 managers/student athletic trainers)trainers)



► Medical HistoryMedical History Complete prior to exam to identify past and existing Complete prior to exam to identify past and existing

medical conditionsmedical conditions Update yearly and closely review by medical Update yearly and closely review by medical

personnelpersonnel Collect medical release and insurance info at the Collect medical release and insurance info at the

same timesame time

► Physical ExaminationPhysical Examination Should include assessment of height, weight, body Should include assessment of height, weight, body

composition, blood pressure, pulse, vision, skin, composition, blood pressure, pulse, vision, skin, dental, ear, nose, throat, heart, lungs, abdomen, dental, ear, nose, throat, heart, lungs, abdomen, lymphatic, genitalia, maturation index, urinalysis and lymphatic, genitalia, maturation index, urinalysis and blood workblood work



► Maturity AssessmentMaturity Assessment Means to protect young physically active athletesMeans to protect young physically active athletes MethodsMethods

► Circumpubertal (sexual maturity)Circumpubertal (sexual maturity)► SkeletalSkeletal► DentalDental

Tanner’s five stage assessment is most expedientTanner’s five stage assessment is most expedient

► Orthopedic ScreeningOrthopedic Screening Part of physical exam or separatePart of physical exam or separate Various degrees of detail concerning examVarious degrees of detail concerning exam



►Sport DisqualificationSport Disqualification Certain injuries and illnesses warrant Certain injuries and illnesses warrant

special concern when dealing with sportsspecial concern when dealing with sports Recommendations can be madeRecommendations can be made American with Disabilities Act (1990) American with Disabilities Act (1990)

►Dictates that athlete makes the final decisionDictates that athlete makes the final decision

Potential disqualifying factors should be Potential disqualifying factors should be determined during the pre-participation determined during the pre-participation examexam



Release of Medical RecordsRelease of Medical Records

►The release of medical records can not The release of medical records can not occur without written consent occur without written consent

► If the athlete wants records released to If the athlete wants records released to colleges/universities, professional colleges/universities, professional organizations, insurance companies or organizations, insurance companies or news media, he/she and the news media, he/she and the parents/guardians must provide written parents/guardians must provide written consentconsent Waiver must specify information to be Waiver must specify information to be

releasedreleased


Release of Medical RecordsRelease of Medical Records


HIPAA RegulationsHIPAA Regulations► Regulates how coaches, athletic trainers, Regulates how coaches, athletic trainers,

physicians or other members of the sports physicians or other members of the sports medicine team can share health information medicine team can share health information concerning an athleteconcerning an athlete

► Provides athletes with access to their Provides athletes with access to their medical records and control over how their medical records and control over how their health information is used and disclosedhealth information is used and disclosed

► Athlete can provide blanket authorization for Athlete can provide blanket authorization for release of specified medical information on a release of specified medical information on a yearly basisyearly basis


Injury ReportsInjury Reports

► Injury reports serve as future referenceInjury reports serve as future reference►Reports can shed light on events that Reports can shed light on events that

may be hazy following an incidentmay be hazy following an incident►Necessary in case of litigationNecessary in case of litigation►All reports should be filed in the athletic All reports should be filed in the athletic

training roomtraining room Filled out in triplicateFilled out in triplicate

►Copy to school health office, physician and one Copy to school health office, physician and one copy should be retainedcopy should be retained


Treatment LogTreatment Log►Sign-in to keep track of servicesSign-in to keep track of services►Daily treatments can be recordedDaily treatments can be recorded►Can be used as legal documentation in Can be used as legal documentation in

instances of litigationinstances of litigation►Subject to HIPAA regulationsSubject to HIPAA regulations

Personal Information CardPersonal Information Card►Contains contact information for family, Contains contact information for family,

personal physician, and insurance personal physician, and insurance informationinformation


Injury Evaluation and Injury Evaluation and Progress NotesProgress Notes

► Injured athlete should be evaluated Injured athlete should be evaluated by an athletic trainer or physicianby an athletic trainer or physician Record of the evaluation should be keptRecord of the evaluation should be kept

► If not available, a coach should If not available, a coach should encourage athlete and parents to set encourage athlete and parents to set appointment with a local physician appointment with a local physician for injury assessment, diagnosis and for injury assessment, diagnosis and documentation.documentation.


Supplies and Equipment Supplies and Equipment InventoryInventory

►Managing budget and Managing budget and equipment/supplies is critically equipment/supplies is critically importantimportant

► Inventory must be taken yearly in Inventory must be taken yearly in order to effectively keep track of: order to effectively keep track of: New equipment that is neededNew equipment that is needed Equipment that needs to be replaced Equipment that needs to be replaced Equipment needing to be replenishedEquipment needing to be replenished


►Summary of athletic training room Summary of athletic training room functioningfunctioning

►Can be used to Can be used to evaluate/recommend potential evaluate/recommend potential changes for program changes for program

► Includes number and types of Includes number and types of injuries seen/treatedinjuries seen/treated

Annual ReportAnnual Report


Budgetary ConcernsBudgetary Concerns►Size of budget??Size of budget??►Different settings = different size budgets Different settings = different size budgets

and space allocationsand space allocations►Equipment needs and supplies vary Equipment needs and supplies vary

depending on the setting (college vs. high depending on the setting (college vs. high school)school)

►Continuous planning, inventory and Continuous planning, inventory and prioritizing is necessary to effectively prioritizing is necessary to effectively manage monetary allocations to meet manage monetary allocations to meet programmatic goalsprogrammatic goals


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

►Equipment (items that can be used for Equipment (items that can be used for a number of years)a number of years) Fixed (remain in the training room- ice Fixed (remain in the training room- ice

machine, tables)machine, tables) Non-fixed (crutches, coolers, training kits)Non-fixed (crutches, coolers, training kits)

►Yearly inventory and records must be Yearly inventory and records must be maintained in both areasmaintained in both areas

Ordering Supplies and Ordering Supplies and EquipmentEquipment


Additional Budget Additional Budget ConsiderationsConsiderations

►Other operating costsOther operating costs Telephone and postage expensesTelephone and postage expenses Contracts for outside servicesContracts for outside services Purchases relative to liability insurance Purchases relative to liability insurance

and professional developmentand professional development

Purchasing SystemsPurchasing Systems►Direct buy vs. competitive biddingDirect buy vs. competitive bidding


Hiring a Certified Athletic Hiring a Certified Athletic Trainer in Secondary Trainer in Secondary

SchoolsSchools►Problems occurring later from improperly Problems occurring later from improperly

managed injuries could be avoided with managed injuries could be avoided with proper management from an athletic trainerproper management from an athletic trainer

►According to the NATAAccording to the NATA “…“…all secondary schools should provide the all secondary schools should provide the

services of a full-time, on-site, certified athletic services of a full-time, on-site, certified athletic trainer (ATC) to student athletes.”trainer (ATC) to student athletes.”

►American Academy of Pediatrics (1998) American Academy of Pediatrics (1998) adopted a policy recommending adopted a policy recommending employment of ATC’s in the high school employment of ATC’s in the high school settingsetting


Human Resources and Human Resources and Personnel IssuesPersonnel Issues

►The sports medicine team is only as The sports medicine team is only as good as the individuals in the groupgood as the individuals in the group

►Recruitment, hiring and retaining Recruitment, hiring and retaining qualified personnel is necessary to be qualified personnel is necessary to be effectiveeffective

►Specific policies are established Specific policies are established relative to hiring, firing, performance relative to hiring, firing, performance evaluations and promotionsevaluations and promotions Must adhere to these principlesMust adhere to these principles


►Roles and responsibilities must be Roles and responsibilities must be established established (job descriptions - job specifications, (job descriptions - job specifications,

accountability, code of conduct, and scope)accountability, code of conduct, and scope)

►Head athletic trainer must serve as a Head athletic trainer must serve as a supervisor and work to enhance supervisor and work to enhance professional development of staffprofessional development of staff

►Performance evaluations should take Performance evaluations should take place routinelyplace routinely

Human Resources and Human Resources and Personnel IssuesPersonnel Issues

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© 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter 2: Organizing and Administering an Athletic Health Care Program