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Health Care Administration in Athletic Training

Terms in this set (91)

Developing a Strategic Plan
• Strategic planning: involves critical self-examination to bring about organization improvement
o Why is there a need for such a program and what should the function of the program be within the total scope of the athletics program? (answer by administrators, athletic directors, or school boards)
o To determine whether the program is consistent with the overall mission of the institution/organization
o Helps build support for the program (include many people in the planning process)
o Should be a tool for improvement, helping to determine the strengths and weaknesses of the program and
transforming it positively
Vision Statement
a concise statement that describes the ideal state to which an organization aspires
o The provider of the service
o The actual services to be provided
o Target clients
o Quality declaration that identifies aspirations for how audiences will receive the program
Mission Statement
a written expression of an organization's philosophy, purposes & characteristics
o Functions: 1) help the AT direct resources toward accomplishing specific tasks; 2) should inspire ATs to do a good job; 3) should be action oriented and should stimulate a change in behavior
o The particular services to be offered, the primary market for those services, and the technology to be used in delivery of those services
o The goals of the program
o The philosophy of the program & the code of behavior that applies to its organization
o The "self-concept" of the program based on evaluation of strengths & weaknesses
o The desired program image based on feedback from internal and external stakeholders
Accreditation
formal recognition indicating that a program meets certain prescribed quality standards
o JCAHO: Joint Commission on Accreditation of Healthcare Organizations
o CARF: Commission on Accreditation of Rehabilitation Facilities
WOTS UP Analysis
a data collection and appraisal technique designed to determine an organization's
"weaknesses, opportunities, threats, and strengths underlying planning"
Operational Planning
defines organization activities in the short term, usually no longer than 2 years
Policies
expresses an organization's intended behavior relative to a specific program subfunction, not intended to answer detailed questions; intended as road maps (basic rules and principles)
Processes
a collection of steps designed to direct the most important tasks of an organization, i.e. injury prevention, injury rehabilitation, injury recognition, organization & administration, etc.
Procedures
provides specific directions for members of an organization to follow, i.e. procedure for discharge from rehabilitation
Practices
the action that takes place in response to administrative problems, i.e. procedure written that states all machines should be calibrated once a year (which vendor? what time of year? scheduling?)
PERT (Program Evaluation and Review Technique)
a method of graphically depicting the time line for and interrelationships of different stages of a program
Gannt Charts
a graphic planning and control technique that maps discrete tasks on a calander
Agreement-Trust Matrix
high

Agreement

low Trust high
Scope of Athletic Training Program Operations - Athlete
prevention and care for entire year, or just competitive season? All illnesses, or only musculoskeletal?
Scope of Athletic Training Program Operations - Institution
are other persons to receive care? How should they be referred? Clinical setting for students?
Scope of Athletic Training Program Operations - Community
will any outside groups be served by AT staff? (Take legality and insurance into consideration)
Scope of Athletic Training Program Operations - Clinical and Corporate/Industrial Setting Consideration
should only be assigned to work with those physically active; often expected to oversee preventative and rehabilitation programs (additional education)
Facility Personnel Coverage
time of coverage depends on number of staff
Sports Coverage
may be forced to decide where greatest need of coverage is
Hygiene and Sanitation
AT must be aware of OSHA guidelines (Occupational Safety and Health Administration)
Hygiene and Sanitation - The Athletic Training Facility
o No cleated shoes or game equipment
o Keep shoes off of treatment tables
o Athletes should shower before receiving treatment
o Roughhousing and profanity should not be allowed
o No food or smokeless tobacco should be allowed
Hygiene and Sanitation - The Gymnasium
o Facilities cleanliness (floors swept, bathrooms disinfected, lockers sanitized, mats cleaned
o Equipment and clothing (fitted clothing, no swapping, clothing laundered & changed frequently, wet clothing allowed to dry, proper shoe fit, protective clothing during inclement weather, clean & dry towels)
Hygiene and Sanitation - The Athlete
o Medically cleared to participate? Insurance?
o Prompt reporting of injuries, illness, and skin
disorders?
o Proper habits of sleeping, resting, and nutrition?
o Avoid using a common towel or drinking from a common water dispenser?

[bedfellows I allies ]
[adversaries I opponents]
Spending-ceiling budget model
requires justification only for those expenses that exceed those of the previous budget cycle (also known as incremental model) - often results in falling behind due to prices of supplies rising faster than inflation
Spending-reduction budget model
financial crisis model; requires reallocation of institutional funds, resulting in reduced spending levels for some programs (should identify areas that could be cut w/o serious impact)
Zero-based budgeting
requires justification for every budget line item without reference to previous spending patterns; requires documentation of actual program needs and development of priorities (rank each item)
Fixed Budgeting
expenditures and revenues are projected on a monthly basis, thereby providing an estimate of cash flow; most appropriate for large, well-established sports medicine clinics during economic certainty
Variable budgeting
requires adjustment of monthly expenditures so that they do not exceed revenues; rarely used by school-based programs (very difficult to estimate costs in advance)
Lump sum budgeting
allocates a fixed amount of money for an entire program without specifying how the
money will be spent; gives freedom to spend where it is needed most
Line item budgeting
allocates a fixed amount of money for each subfunction of a program
o Expendable supplies, equipment repair, team physician services, and insurance
o Easy to understand and prepare; the AT has limited flexibility in responding to midyear financial crises
Performance Budgeting
allocates funds for discrete activities; not commonly used due to expense and difficulty of analyzing specific activity costs
o Prepractice and pregame team preparation, rehabilitation, injury treatment, administration, patient
education, emergency first aid.
Needs Assessment
procedure to set organization or programmatic priorities based on identified needs
o Phase 1: exploration (identify needs, decide on info to collect for each need, where/how to collect info)
o Phase 2: information gathering (collect info, prioritize needs, determine causes for needs)
o Phase 3: decision making (develop alternative solutions for needs, determine budgetary implications, prioritize solutions, integrate solutions into the program budget)
Capital Improvements
o Consider pooled buying for a quantity discount
o Tap into booster clubs, alumni, and fundraising groups
o Sponsorships and endorsements
Expendable Supplies/Equipment
cannot be reused (tape, bandages, hydrogen peroxide)
Nonexpendable Supplies/Equipment
can be reused (compression wraps, scissors, neoprene sleeves)
Non-consumable capital
usually not removed from athletic training facility (ice machine, modality unit)
Consumable Capital
crutches, coolers, and kits
Purchasing Process
1) Request for Quotation
2) Negotiations
3) Requisition
4) Purchase Order
5) Receiving
6) Accounts Payable
Request for Quotation
document that provides vendors with the specifications for the bidding on the sale of
goods and services (types of products to be purchased via bidding should be consumable supplies and some types
of durable equipment - don't bid on services because quality may be reflected in lower prices)
Negotiations
the process of bargaining (capital equipment, medium-priced annual rebuys, lower-cost consumable supplies)
a. Price: playing on vendor against another after bids have been returned is frowned upon
b. Supply: many schools' fiscal years begin July 1 (order in May, take possession in June, defer billing until after July 1 - allows time to restock and prepare for fall season while not paying until next fiscal year)
c. Quality:
i. implied warranty (unstated understanding that a vendor will "make good" if product is faulty);
ii. may negotiate for a express warranty (statement specifying the conditions, circumstances, and terms under which a vendor will replace or repair a product if found to be faulty)
d. Shipping: payment of shipping costs and freight-on-board (FOB) point
i. FOB point: point at which the title for shipped goods passes from vendor to purchaser
1. Clarifies cost by factoring cost of shipping into bid
2. Generally, AT should specify institution of clinic as FOB point
e. Support: important for computers and isokinetic testing/rehabilitation devices; becomes an important factor in the overall cost during the life of the equipment
Requisition
formal or informal communication used for requesting authorization to purchase goods/services
Purchase Order
a document that formalizes the terms of purchase and transmits the intentions of the buyer to purchase goods or services from a vendor
a. Should make the award based on the cost for each individual item (rather than on the cost of entire order)
b. Only do for purchase orders over $200 (most vendors have a minimum-order policy)
Receiving
process of accepting delivery of goods; should be immediately checked to make sure packing slip matches contents and to determine whether all goods specified in order were received; inspect for damage
Accounts Payable
a. Educational, professional, or industrial settings: submit invoice to business office ASAP to take advantage of early payment discounts
b. Independent clinics: evaluate terms of early payment discount
Alternative Purchasing Strategies
pooled buying consortia, alumni/booster groups, external funding programs
o Buy or Lease Capital Equipment?
-Purchasing: cost, program owns equipment (may be bad if technology becomes obsolete)
-Leasing: possible tax advantages, lower initial cost, use capital on other things
Purchasing Services
• Different from purchasing supplies/equipment because quality is more difficult to assess
• Try to get service free of charge: volunteer physicians; donate time in exchange for an advertisement
• OR: try to employ cost sharing whenever possible: physician may accept only what insurance will pay
• Evaluate what each provider is willing to provide and at what price: ex) response time of ambulances
• Investigate provider's reputation with other ATs: ask whom they use and why
• Develop a contract of understanding, specifying expectations: helps improve communication & prevent
problems; should specify a period for which contract will be in effect
Developing a Risk Management Plan - Security Issues
who has access/keys to ATR (college: staff, students; HS: staff, coaches)
Developing a Risk Management Plan - Fire Safety
evacuation plan; smoke detectors and fire alarm system should be periodically tested
Developing a Risk Management Plan - Electrical and Equipment Safety
o Ground fault interrupters (especially in areas of water) - interrupts electricity if a surge of ≥5 milliamps
o Three-pronged hospital-grade plugs and electrical outlets (green dot)
o Electrical outlets should be spaced every 4 feet throughout and at least 3 feet from the floor
o A single circuit should service a limited number of modality outlets (to prevent overload)
Strategies for Managing Risk - Avoidance
avoid a risky activity (especially when negative consequences of activity have high costs)
Strategies for Managing Risk - Transference
activities associated with high financial risk but low frequency (catastrophic sports injury) or lower financial risk but high frequency (fractures, joint injuries requiring surgery)
-Purchase insurance designed to cover financial loss associated with certain risks
-Exculpatory waivers signed by athletes and parents (this method has many flaws)
Strategies for Managing Risk - Retention
activities with an acceptable level of risk that are viewed as part of the cost of doing business
-Program must account for risks in the program budget and ideally establish a reserve fund to cover costs that rise above predicted levels
Strategies for Managing Risk - Reduction
careful development, implementation, monitoring & evaluation of policies & procedures can reduce risks
Real-World observation
making inferences regarding the risk of certain activities based on clinical practice and experience (can often lead to spurious conclusions)
Inference from controlled experiments
method is difficult to implement (time intensive, costly, and frequently impractical)
-practical method is using an epidemiological approach- track incidence of injuries & all their associated factors (athlete characteristics, playing surface, weather, type of activity)
-NCAA Injury Surveillance Study
Emergency Action Plan (EAP)
o Failure to have an EAP could constitute a breach of the institution's legal responsibility to conduct safe programs; plan should cover practices, games, and conditioning sessions; should be reviewed annually
o List of personnel involved (roles, responsibilities, chain of command for decision making)
o Procedures to be followed in event of an emergency (communication and transportation procedures)
o Phone numbers (911, athletic trainers, physician)
o Make sure keys to gates are accessible, inform members of sports medicine team of EAP, assign roles, carry contact information for athletes, EAP should include procedures for spectator injury/illness
o Form a good relationship with local EMTs and also establish guidelines and procedures
o Try to obtain consent from parents if athlete is a minor (should have a signed consent form anyway)
Emergency Call info
1) Type of emergency situation; 2) Type of suspected injury; 3) Present condition of athlete; 4) Current assistance being given [i.e. CPR]; 5) Location of telephone being
used; 6) Exact location of emergency
Recruitment
the process of planning for human resource needs and identifying potential candidates to meet those needs
Validity (in staff selection)
criteria that predict how well a candidate will perform in a role
Reliability (in staff selection)
consistency of staff selection procedures
Position description
a formal document that describes the qualifications, work content, accountability, and scope of a job
Job description
a written description of the specific responsibilities a position holder will be accountable for in an organization
Job specification
a written description of the requirements or qualifications a person should have to fill a particular role in an organization
Clinical Supervision
the process of direct observation of an employee's work, with emphasis on
measurement of specific behaviors, and the subsequent development of plans to remediate deficiencies in performance
-Supervisor observes work, evaluates strengths and weaknesses, & develops a structure for improvement - Very appropriate for student interns
- Work sampling: identifies the type of work that ATs do & the amount of time they spend doing it
• Logging activities of ATs at randomly selected times and analyzing the nature & quality of work they are doing
Clinical Supervision Advantages
emphasis on collegial working relationships and cooperative planning
Clinical Supervision Disadvantages
supervising AT must devote large blocks of time to supervising individual employees (most supervising ATs have significant responsibilities in treatment of clients)
Developmental Supervision
emphasizes collaboration between supervisors and supervisees to help them
solve problems and develop professionally
-Theme of participative management - employees discuss problems suggest creative solutions
Developmental Supervision Advantages
emphasis on personal growth & integration of ATs & Sports medicine program goals
Developmental Supervision Disadvantage
heavy emphasis on collaboration can delay problem solving because of the need to perserve the collegial organizational climate
Inspection production supervision
emphasizes the use of formal authority and managerial prerogatives to improve employee efficiency and efficacy (focus on achieving goals & attainment of program mission)
-Every employee required to make a list of goals
- Usually used in formalistic bureaucratic organizations/industrial settings
Inspection production supervision advantages
sets well-defined limits on job-related behavior and clearly defines employee roles
Inspection production supervision disadvantages
measures of inputs and outputs in AT settings is difficult; not all jobs that ATs performed are easily observed or quantified; can cause ATs to feel unappreciated & unfulfilled
Performance Evaluation Method - Management by objectives - Weakness
tends to emphasize job characteristics that can be measured over those that cannot
Performance Evaluation Method - Management by objectives - Strengths
employee is able to have input into the standards by which he/she is evaluated
Performance Evaluation Method - Written Essay - Weakness
dependent on subjective data, validity depended on writer's skill and judgement
Performance Evaluation Method - Written Essay - Strengths
Evaluator can write a detailed profile of the employee's work
Performance Evaluation Method - Critical Incident Report - Weakness
can be subject to writer bias, often based on subjective data, negative incidents usually receive more notice than positive ones
Performance Evaluation Method - Critical Incident Report - Strengths
More detail regarding the employee's work can be provided
Performance Evaluation Method - Graphic rating scale - Weakness
scale elements are often not valid or job-related
Performance Evaluation Method - Graphic Rating Scale - Strengths
Simple to administer, low cost
Performance Evaluation Method - Forced-Choice ranking - Weakness
fails to provide specific feedback, not useful in human resource planning, does not relate job performance to selection criteria
Performance Evaluation Method - Forced-Choice ranking - Strengths
Simple to administer, low cost
Performance Evaluation Method - Ranking - Weakness
Difficult to discriminate performance levels on multitask jobs, discourages cooperation among work-group members
Performance Evaluation Method - Ranking - Strengths
Simplifies the task of allocating rewards
Performance Evaluation Method - Behaviorally anchored ranking scales - Weakness
Most useful for employees with identical job responsibilities, expensive and time consuming to develop, difficult to update as job responsibilities change
Performance Evaluation Method - Behaviorally anchored ranking scales - Strengths
evaluates behaviors rather than traits, specific to single job category
4 categories of Joint Committee on Standards for Evaluation
1) Propriety
2) Utility
3) Feasibility
4) Accuracy
Propriety
standards intended to help ensure that process is legal and fair
- Service orientation
- Formal evaluation guidelines
- Conflict of interest
- Access to personnel evaluation reports
- Interactions with evaluatees
Utility
standards intended to ensure usefulness of appraisal to workers, employers, & others
- Constructive orientation
- Defined uses
- Evaluator credibility
- Functional reporting
- Follow-up
Feasibility
standards intended to help foster practicality in the evaluation process
- Practical procedures
- Political viability
- Fiscal viability
Accuracy
standards intended to improve the validity & reliability of the process
- Defined role
- Work environment
- Documentation of procedures
- Valid measurement
- Reliable measurement
- Systematic data control
- Bias control
- Monitoring evaluation systems
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