© 2009 McGraw-Hill Higher Education. All rights reserved Chapter 2: Health Care Organization and Administration in Athletic Training

© 2009 McGraw-Hill Higher Education. All rights reserved

Chapter 2: Health Care Organization and Administration in Athletic Training


What should one do to organize and operate an athletic training room?

• Facility Design• Policies & Procedures• Budget• Personal Management• Record Keeping• Doing all the Roles & Responsibilities

of an Athletic Trainer


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

involved in health care – Policies = clear and accurate written out

statements of basic rules• That What and Why

– Procedures = describe the process• The How


Issues Specific to Athletic Training Program

Operations 1. Scope of Program: Who will be served by

program?– Athlete: to what extent and what services will

be rendered (systemic illness, musculoskeletal injuries, in season, out-of-season, club sports)

– 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


2. Providing Coverage• Facility Personnel Coverage

– Dependant upon when the Athletic Trainer is there (All day, weekends, just during games, practices etc)

• Sports Coverage– Certified athletic trainer should attend

all practices and games dependant on personnel


3. Hygiene and Sanitation• Athletic Training Facility

– Operation should abide by policies set forth by OSHA (Occupational Safety & Health Administration) due to blood and bacteria; Cleaning both custodial and athletic trainer

– Examples• No equipment/cleats in training room• Shoes off treatment tables• Shower prior to treatment• No roughhousing or profanity• No food or smokeless tobacco


• 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


4. Emergency Telephones

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

• Landline in case wireless isinterupted

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


Assignment: What would your policies be in your athletic training room?

• Get into groups.• Decide on 5 policies you would

have in your athletic training room?

• Make a classroom policy list.


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)


• 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 clinic (including ice machine, tables)

– Non-consumable capital: reusable but leaves the athletic training room (crutches, coolers, training kits)


• Purchasing Systems– Direct buy: going straight to a vendor and

making an order– vs. Competitive bidding: usually for more

expensive purchases, getting multiple bids and buying the least expensive

– Lease alternative

• Additional Budget Considerations– Telephone, Utilities, Contracts for outside

services, Insurance and professional development


Developing a Risk Management Plan

1. Security Issues– Accessibility to 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

settings2. Fire Safety

– Post evacuation plan in case of fire– Smoke detectors/alarm system and fire

extinguisher should be tested and in place


3. Electrical and Equipment Safety– Major concern (GFIs)– Be aware of power distribution system to avoid

accidents

4. 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


Athletic Training Clinic Design

• Multipurpose area for first aid, therapy/ rehabilitation, injury prevention, medical procedures and administration

1. Size– Varies between settings – Must take advantage and manage

space effectively


2. Location– Outside entrance (limits doors that must

be accessed when transporting injured athletes)

– Double door entrances and ramps are ideal- getting athletes in and out

– Proximity to locker rooms and toilet facilities

– Light, heat and water source should be independent from rest of facility


3. Special Service AreasA. Treatment Area: area that accommodates

4-6 adjustable treatment tables, 3-4 stools, and hydrocollator and ice machine accessibility

B. Electrotherapy Area: area that houses ultrasound, diathermy, electrical stim units, storage units, grounded outlets, treatment tables and wooden chairs, under constant supervision


C. 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

D. Exercise Rehabilitation Area: area that provides adequate space and equipment to perform reconditioning of injuries

E. Taping, Bandaging & Orthotics Area: 3-4 taping tables and storage cabinets to treat athletes with proximity to a sink


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

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


4. Storage Facilities– Athletic training clinics 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


5. Athletic Trainer’s Office– Space at least 10x12 feet is ample– All areas of training room 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


6. 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


When designing an athletic training room what are the 6 main parts one must have in

their design?• Size• Location• Special Service Areas• Storage Facilities• Athletic Trainer’s Office• Others




Assignment: Design your own athletic training room

• Get into small groups of 4-5• Using construction paper, markers and

magazines, design your own athletic training room

• Needs to have all parts including the different special service areas. (One area can be used multiple ways.)

• Give presentation on your athletic training room


Issues Specific to Athletic Training Program Operations in Clinic,

Hospital Corporate of Industrial Settings

• Staff must be prepared to provide care to a wide range of patients– Pediatrics– Adolescents– Young adults and adults– Geriatric patients

• May also involve additional duties in management, marketing, outreach, along with fiscal and financial responsibilities


• Scope of Practice– Diverse patient population– In hospital settings time may be spent with in-

patient, out-patient and/or ambulatory care– Owner of out-patient facility will dictate patient

population seen at clinic– The ATC may be involved with patient care, onsite

employee fitness, ergonomics, work hardening programs, outreach programs, athletic event coverage

– Limitations and restrictions will be dictated by state regulatory statutes


Potential Athletic Training Duties Outside the Scope of

Athletics• Ergonomic Assessment– Ergonomics is the science of designing

products, machines and systems to maximize comfort, efficiency and safety

– Primary goal often involves injury and accident prevention in workplace by minimizing risk factors


• Work Hardening/Conditioning Programs– Intensive outpatient therapy for

individuals injured on the job• Work conditioning = treatment 3

hours/day, 3 days/week• Work hardening = 8 hours of treatment

daily, 5 days/week


• Wellness Center– ATC may be involved in organizing wellness

screenings and workshops for:• Asthma & diabetes• Hypertension & stroke• Cholesterol• Osteoporosis• Prostate/skin cancer


• Community Outreach and Marketing– Some athletic trainers may be clinic

or hospital based in the morning and may provide athletic training coverage in afternoons and evenings• Outreach may occur in the collegiate

setting, secondary schools or for single athletic events


• Corporate Fitness Programs– Involves in-house fitness

programming for employees


• Drug Testing Programs– Athletic trainers may be asked to

oversee drug testing programs– Program may act as a deterrent to

employees coming in unfit for duty


What are the 6 potential duties an athletic trainer

maybe asked to do?• Ergonomic Assessment• Work Hardening/Conditioning

Programs• Wellness Center• Community Outreach and Marketing• Corporate Fitness Programs• Drug Testing Programs


Record Keeping

• Major responsibility• The rule not the exception -

accurate and up-to-date• Records Include: Medical records,

injury reports, insurance information, injury evaluations, progress notes, equipment inventories, annual reports


Maintaining Confidentiality in Record Keeping

1. 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 including colleges, professional organizations)


2. Health Insurance Portability and Accountability Act (HIPAA)– Regulates release of Personal History

Information (PHI) by coaches, ATC’s, physicians or other members of sports medicine team

– Guarantees athlete access to information and control over disclosure

– Athlete may provide written authorization for release of information


3. Family Educational Rights and Privacy Act– FERPA = law protecting privacy of

student education records, may contain medical

– When child turns 18 rights are transferred to student

– School must have written permission prior to releasing information


Administering Pre-participation Examinations• Initial pre-participation exam prior to

start of practice is critical, gives baseline

• Purpose it to identify athlete that may be at risk

• Should include– Medical history, physical exam, orthopedic

screening, wellness screening, cardiovascular screening & maturity assessment


• Examination by Personal Physician– Yields an in-depth history and ideal

physician-patient relationship– May not result in detection of factors that

predispose the athlete to injury

VS.• Station Examination

– Provides athlete with detailed exam in little time


1. Medical History– Complete prior to exam to identify past and

existing medical conditions– Update yearly and closely review by medical

personnel

2. 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





3. Cardiovascular Screening- 1996 American Heart Association recommended in

order to recognize abnormal heart sounds and other signs

4. Maturity Assessment– Means to protect young physically active athletes– Tanner’s five stage assessment is most expedient;

matched by maturity not age

5. Orthopedic Screening– Part of physical exam or separate– Various degrees of detail concerning exam


6. Wellness Screening– Purpose is to determine if athlete is

engaged in a healthy lifestyle



What are the 6 parts of a pre-participation exam?

Medical HistoryPhysical ExaminationCardiovascular ScreeningMaturity AssessmentScreeningWellness Screening


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


Personal Information Card• Contains contact information for family,

personal physician, and insurance information

Injury Reports and Injury Disposition• Injury reports serve as future references,

Necessary in case of litigation

• 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)



Supplies and Equipment Inventory

• Managing budget and equipment/supplies is critically important

• Inventory must be taken yearly in order to effectively replenish supplies


Collecting Injury Data

• Accident - unplanned event resulting in loss of time, property damage, injury or death

• Injury- damage to the body restricting activity

• Case study- looks at specific incident of injury


Using Injury Data

• Valid and reliable data can be utilized to decrease injuries

• May allow for:– Rule modification– Assist coaches and players in

understanding risks– Help manufacturers– Educate parents, athletes and the public

on inherent risks associated with sport

Documents

© 2009 McGraw-Hill Higher Education. All rights reserved Chapter 2: Health Care Organization and Administration in Athletic Training