Chapter 2: Organizing
and Administering an
Athletic Health Care
Program
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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
►Existing
space or newly designed
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Facility Design
► 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
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Facility Design
► Distinct
areas
 Taping and bandaging
 Injury treatment with rehabilitation
equipment and/or therapeutic modalities
 Wet area (whirlpools, refrigerator, ice
machine)
 Physicians examination room
 Office space
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Facility Design
► Storage
Facilities
 Athletic Training Rooms (ATR) often lack ample
storage space
 Storage in ATR that holds general supplies and
special equipment
 Storage available in the specified areas of the
ATR
 Large walk-in storage cabinet for bulk supplies
 Refrigerator for equipment, ice cups, medicine
and additional supplies
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© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
© 2005 The McGraw-Hill Companies, Inc. All rights reserved.
Rules of Operation for an Athletic
Healthcare Program
► Must
develop policies and procedures
 Delineate daily routine of program
► Define
scope of program
 Who will be served by program?
 Athlete: to what extent and what services
will be rendered?
 Institution: who else can be served
medically and educationally and what are
the legalities?
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Providing Coverage
► Facility
Personnel Coverage
 Budgetary concerns may be a limiting factor
 What personnel are available?
► Sports
Coverage
 Different institutions (including high schools)
have different levels of coverage based on
personnel and risks involved with sports
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Athletic Training Room Policies
► Facility
should be used only for prevention
and care of sports injuries
► Rules must be established in the interest of
sanitation
► Policies regarding environmental conditions
and emergency protocols should also be set
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Hygiene and Sanitation
► Rules
concerning ATR cleanliness and
sanitation must be set and made known
to population using facility
 Examples
►No
equipment/cleats in training room
►Shoes off treatment tables
►Shower prior to treatment
►No roughhousing or profanity
►No food or smokeless tobacco
► Must
adhere to OSHA standards and
guidelines
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Hygiene and Sanitation
 Cleaning responsibilities are divided
between athletic training staff and
maintenance personnel
 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
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Establishing Health status for the
Athlete
► Promotion
of good health
 Is the athlete cleared to participate?
 Is each athlete insured?
 Does the athlete promptly report injury and
illnesses?
 Does the athlete follow good living habits?
 Does the athlete avoid sharing clothes and
towels?
 Does the athlete exhibit good hygiene
practices?
 Does the athlete avoid common drinking
sources?
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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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Developing a Risk Management
Plan
► Security
Issues
 Accessibility to ATR (staff, physicians, student
athletic trainers)
 Supervision issues
► Fire
Safety
 Post evacuation plan in case of fire
 Smoke detectors/alarm system and fire
extinguisher should be tested and in place
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Emergency Injury
Management Plan
►A
plan must exist for accessing
emergency personnel
 Must include transportation of athletes to
emergency facilities
► Meeting
with outside personnel is
necessary to determine roles and rules
regarding athlete and equipment care
► Must have knowledge of local and
community health services and agencies
in the event of referrals
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Record Keeping
► Major
responsibility
► Rule not the exception
- accurate and up-todate
► Medical records, injury
reports, insurance
information, injury
evaluations, progress
notes, equipment
inventories, annual
reports
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Administering Pre-participation
Examinations
► Pre-participation
exam prior to start of
practice is critical
► Purpose:
 Identify athlete that may be at risk
 Establish a baseline
 Reveal condition that may warrant
disqualification
 Satisfy insurance and liability issues
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Administering Pre-participation
Examinations
► 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
► Station
Examination
 Provides athlete with detailed exam in little
time
 Team of nine is ideal (2 physicians, 2 nonphysicians and 5 managers/student athletic
trainers)
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Administering Pre-participation
Examinations
► Medical
History
 Complete prior to exam to identify past and
existing medical conditions
 Update yearly and closely review by medical
personnel
 Collect medical release and insurance info at the
same time
► 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
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Administering Pre-participation
Examinations
► Maturity
Assessment
 Means to protect young physically active athletes
 Methods
► Circumpubertal
(sexual maturity)
► Skeletal
► Dental
 Tanner’s five stage assessment is most expedient
► Orthopedic
Screening
 Part of physical exam or separate
 Various degrees of detail concerning exam
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Administering Pre-participation
Examinations
► 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
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Release of Medical Records
► The
release of medical records can not
occur without written consent
► If the athlete wants records released to
colleges/universities, professional
organizations, insurance companies or news
media, he/she and the parents/guardians
must provide written consent
 Waiver must specify information to be released
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Release of Medical Records
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HIPAA Regulations
► Regulates
how coaches, athletic trainers,
physicians or other members of the sports
medicine team can share health information
concerning an athlete
► Provides athletes with access to their medical
records and control over how their health
information is used and disclosed
► Athlete can provide blanket authorization for
release of specified medical information on a
yearly basis
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Injury Reports
► Injury
reports serve as future reference
► 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
 Filled out in triplicate
►Copy
to school health office, physician and one
copy should be retained
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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
► Subject to HIPAA regulations
Personal Information Card
► Contains
contact information for family,
personal physician, and insurance
information
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Injury Evaluation and Progress
Notes
► Injured
athlete should be evaluated by
an athletic trainer or physician
 Record of the evaluation should be kept
► If
not available, a coach should
encourage athlete and parents to set
appointment with a local physician for
injury assessment, diagnosis and
documentation.
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Supplies and Equipment
Inventory
► Managing
budget and
equipment/supplies is critically
important
► Inventory must be taken yearly in order
to effectively keep track of:
 New equipment that is needed
 Equipment that needs to be replaced
 Equipment needing to be replenished
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Annual Report
► Summary
of athletic training room
functioning
► Can be used to evaluate/recommend
potential changes for program
► Includes number and types of injuries
seen/treated
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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, inventory and
prioritizing is necessary to effectively
manage monetary allocations to meet
programmatic goals
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Ordering Supplies and
Equipment
► Expendable
(supplies that cannot be
reused- first aid and injury prevention
supplies)
► Equipment (items that can be used for
a number of years)
 Fixed (remain in the training room- ice
machine, tables)
 Non-fixed (crutches, coolers, training kits)
► Yearly
inventory and records must be
maintained in both areas
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Additional Budget Considerations
► Other
operating costs
 Telephone and postage expenses
 Contracts for outside services
 Purchases relative to liability insurance and
professional development
Purchasing Systems
► Direct
buy vs. competitive bidding
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Hiring a Certified Athletic
Trainer in Secondary Schools
► Problems
occurring later from
improperly managed injuries could be
avoided with proper management from
an athletic trainer
► According to the NATA
 “…all secondary schools should provide the
services of a full-time, on-site, certified
athletic trainer (ATC) to student athletes.”
► American
Academy of Pediatrics (1998)
adopted a policy recommending
employment of ATC’s in the high school
setting
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Human Resources and Personnel
Issues
► The
sports medicine team is only as good as
the individuals in the group
► 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
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Human Resources and Personnel
Issues
► 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
© 2005 The McGraw-Hill Companies, Inc. All rights reserved.