1. Health Care Organization Administration in AT Chapter 2 1

2. Developing a Strategic Plan First step in establishing a health care program – Why is the program needed? – What are the goals of the program? 2

3. Developing a Strategic Plan Involve as many people as possible, both within the organization and outside Ongoing evaluation process (WOTS UP) – Weaknesses – Opportunities – Threats – Strengths Underlying planning 3

4. Developing P&P Manual Next step after strategic planning Policies – clear written statements – outline the rules that govern decision making What and why? Procedures – process by which something is done How? 4

5. Issues Specific to the HS and College Setting Scope of the program Coverage Hygiene and Sanitation Emergency Telephones Budgetary Concerns Risk Management Plan Community-Based Health Services Human Resources Facility Design 5

6. Scope of Program Athlete – In season vs. year round – Athletic injuries only vs. total health care Institution – Will the general student population be treated? Community – Is the facility open to the general public? 6

7. Coverage Issues All depends on your staffing Hours of operation for the facility – Rehab vs. pre-practice prep Sports Coverage – Can’t be in 2 places at once – Based on risk of injury 7

8. Hygiene and Sanitation Essential for the prevention of disease transmission – Must address who is responsible for cleaning – Have rules for the facility – Weight rooms and common areas must also have a plan for sanitation Athletes must be educated about skin conditions and encouraged to report any lesions 8

9. Emergency Telephones Most everyone has a cell phone, but must have a backup plan in case of poor reception Emergency phones should be close to each area Walkie-talkies can help as well 9

10. Budgetary Concerns HS’s often have significant restrictions Must prioritize to use available funds wisely Accurate inventory is essential 10

11. Budgetary Concerns Supplies = what we use to carry out daily tasks – Expendable = can’t be reused – Nonexpendable = can be used for a few years Equipment = used in the AT facility – Nonconsumable capital = usually not removed; large pieces of equipment – Capital equipment = crutches, coolers, kits, etc. 11

12. Risk Management Plan Security issues – who has access to the AT facility? Fire Safety – evacuation plan should be posted Electrical equipment safety – GFI’s, yearly maintenance Emergency Action Plans (Ch. 12) 12

13. Accessing Community-Based Health Services Need to communicate with local EMTs, especially if you have football Need to have an established relationship with local hospitals Referral network of specialists 13

14. Human Resources Available personnel Must recruit when hiring Costs a lot of time and $$$$ to hire new people – Want to retain the most qualified in order to be effective 14

15. Designing an AT Facility Essential to be involved in the design process Sufficient size is critical – Depends on the scope of the program Location is another important consideration – Outdoor entrance Illumination – Needs to be well lit, esp in the wound care and taping areas 15

16. Issues Specific to Clinics, Hospitals, Corporate/Industrial Settings Scope of Practice Human Resources Potential Duties Fiscal Management 16

17. Scope of Practice The type of patient and the type of activities the AT can perform are generally specified by the state practice act Varies by state 17

18. Human Resources Written job description for each is essential Will often be working with a variety of different health care providers – Often will use the team approach Refer to Focus Box 2-4 for additional certifications for AT’s working in clinics or hospitals 18

19. Potential AT Duties Ergonomics – looking at efficiency and safety – Important for prevention Work hardening programs – prepares a worker to return to his/her full duty – May be 8 hours a day/5 days a week Wellness Center – wellness screenings, workshops, employee health fairs – Early detection and prevention is the focus 19

20. Potential AT Duties Community Outreach and Marketing – Special events vs. outreach to a HS – Important marketing opportunity Corporate Fitness Program – Fitness evaluations then design and implement a fitness program Drug-testing program for employees 20

21. Fiscal Management Bottom line is generating a profit Depends in billing the patient’s insurance company and getting reimbursed for services Must keep extremely detailed records Must have a billing department 21

22. Record Keeping Keeping accurate records is extremely important, especially in case of lawsuit Must maintain the athlete’s confidentiality 22

23. HIPAA Health Insurance Portability and Accountability Act Regulates how health professionals share private health information (PHI) Must have written authorization to release information Designed to protect the patient 23

24. FERPA Family Educational Rights and Privacy Act protects the privacy of a students education records – At UNCP, medical records are considered education records – If the student is 18, university officials must have written permission to release info to parents – May release info to others who need to info to perform their jobs without a written release 24

25. The Preparticipation Physical Exam (PPE) NCAA as well as many state high school federations have guidelines about what needs to be included NCAA only requires a PPE upon entering college – Must complete yearly “Health Updates” UNCP requires a yearly PPE 25

26. Purpose of the PPE To identify an athlete who may be at risk before he/she participates in a specific sport Different from a general physical exam 26

27. Types of Preparticipation Physicals Personal Physician – Advantage--ideal doctor-patient relationship – Disadvantage--may not be sports oriented Station Exam – Advantage--most thorough and sports-specific – Disadvantage--requires a lot of personnel Mass Exam – Advantage--done quickly – Disadvantage--easy to miss things 27

28. Sport Disqualification All sports involve a risk of injury Certain injuries and conditions might make it dangerous for someone to participate – Certain heart conditions, blood traits, enlarged spleen, Marfan syndrome (Dengeneration of heart valves)- Isaiah Austin Physicians make recommendations not to continue participation – The Americans with Disabilities Act of 1990 gives the athlete the final say 28

29. Additional Records to be Maintained Injury reports and referrals Treatment and Rehabilitation log Insurance Form and Emergency Contact Injury Evaluations and Progress Notes – SOAP format (Subjective, Objective, Assessment and Plan) Supply and Inventory 29

30. Additional Records to be Maintained Annual Reports – # of athletes served by sport, # and type of injuries by sport – Assists in justification of new positions and recommendations for improvement Release of Medical Records – Keep the signed waivers in the athlete’s file 30

31. Injury Surveillance Accident = unplanned event capable of resulting in loss of time, property damage, injury, disablement or even death Injury = damage to the body that restricts activity of causes disability to the extent that the patient is not able to participate 31

32. Catastrophic Injuries Results in death or permanent disability Low incidence, but none are good Direct causes = direct blows – Ground, opponent, sports implement or equipment Indirect causes – Heatstroke causes the most deaths – Next would be congenital defects to heart and/or lungs or the cervical spine 32

33. Epidemiology Study of factors affecting the health and wellness of individuals and populations Problem – can be comparing apples to oranges 33

34. Who is collecting data? National Safety Council Annual Survey of Football Injury Research National Center for Catastrophic Sports Injury Research NCAA Injury Surveillance System National Electronic Injury Surveillance System – Consumer Product Safety Act 34

35. Using Injury Data Modify rules Educate coaches and participants about risks Improvements to protective equipment 35