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Sample Policy and Procedures: Operation of the Athletic Training Facility

Proper operation of health care facilities and programs, specifically the athletic training room operation, is the responsibility of every institution.    Policies should exist that clearly establish the overriding authority and supervision of medical doctors as well control of the involvement of other health care professionals such as athletic trainers, masseurs, chiropractors, strength and conditioning personnel, student trainers and other employees and third parties who may be involved in the care or treatment of student-athletes.  Policies related to the operation of and safety in the athletic training facility are also required.  These program authority and facility operating policies should exist in addition to standard operating procedures related to medical screening, drug testing, and other programs administered by athletic trainers.
The following policy and procedure is a sample and should not be used verbatim.  Policies and procedures should always be submitted  to the institution’s legal counsel for review to be sure all provisions conform to both institutional policy and applicable local, state and federal laws. 
Policies and Procedures Regarding Athletic Training Program Authority and Athletic Training Facility Operations

The Athletics Director or designee shall be responsible for the administering the following policies and procedures pertaining to Athletic Training program authority and oversight and training room facility operations.

1.0    Athletic Training Program Scope of Responsibilities.  The Institution athletic training program (ATP) shall be led by a NATA certified and licensed Athletic Trainer and shall be responsible for delivering the following student-athlete health care services:

1.1    Individualized Student-Athlete Care.  ATP shall provide individualized student-athlete care that includes (a) performing assessments of health status, (b) making physician referrals for diagnosis and health care strategy instructions, (c) developing health care plans based on physician diagnosis and instructions, (d) implementing health care treatment and (e) evaluating the success of health care interventions.

1.2    Health Care Intervention.  ATP shall implement health care interventions targeted at returning student-athletes to pre-injury performance levels as quickly and as safely as possible with maximum attention to prevention of reoccurrence resulting from incomplete rehabilitation.

1.3    Documentation.  ATP shall be responsible for maintaining complete documentation of student-athlete health care screening, history and the treatment of injuries, including symptoms, responses and progress and physician diagnosis and consultation.

1.4    Privacy.  ATP shall respect the student-athlete’s right to privacy by protecting confidential information unless obligated or allowed by law to disclose such information.

1.5    Student-Athlete Education.  ATP shall be committed to the highest levels of student-athlete communication, education and counseling in all health care situations.

1.6    Collaboration and Coordination with Other Health Care Professionals and Agencies.  The ATP is responsible for insuring collaboration and coordination of student-athlete treatment with physicians, rehabilitation specialists, and other resources and agencies collaborating on producing the highest levels of student-athlete health care.  In particular, ATP is responsible for consultation with appropriate licensed medical practitioners in the design of treatment strategies and the clarification of any instructions or treatment regimens that the NATA certified athletic trainer has reason to believe to be inaccurate or contraindicated.

1.7    Health Care Staff Supervision.  The NATA certified athletic trainer in charge of the ATP shall be responsible for supervising and evaluating the performance of the athletic training staff of the institution and ensuring that assignments of staff are made with full consideration of the professional training and experience of each employee.

1.8    Professional Development.  The NATA certified athletic training in charge of the ATP shall be responsible for ensuring the continued professional development of himself/herself and all other ATP employees.

2.0    Medical Physician Supervision and Authority

2.1    Institution Health Center Authority.  The Director of [name of institution or school district] Health Services (DHS) is responsible for all health programs within the [institution or district], including the ATP. 

2.2    Team Physician.  The DHS, in consultation with the Head Athletic Trainer and Director of Athletics shall select and appoint a Team Physician who shall be responsible for the following:
a.    Recruiting all consulting physicians
b.    Arranging for appropriate emergency medical, pharmaceutical and other services
c.    Providing for adequate medical care of all student-athletes
d.    Approving the use of physicians for second opinions
e.    Supervising and evaluating the performance of the ATP staff and making recommendations for the improvement of the ATP
f.    Advising on development, implementation and progression of rehabilitation protocols
g.    Making final decision on return to limited or full participation of injured or ill student-athletes
h.    Attendance at home athletics events in sports requiring attendance of a physician or arranging for consulting physician coverage of such event

2.2.1    Student-Athlete Use of Private Physicians.  Any student-athlete may use the services of any physician at her own expense and without the approval of the Team Physician.  If prior approval is obtained, the physician expenses is reimbursable by the Institution.

2.3    Consulting Physicians.  Consulting physicians appointed by the Team Physicians shall be identified in the areas of orthopedics, gynecology, dentistry, internal medicine, allergies and immunology, dermatology, cardiology, ophthalmology and other specialty areas as determined by student-athlete health care needs.  The responsibilities of the Consulting Physician are:
a.    Immediately examine, diagnose and recommend treatment for an ill or injured student-athlete in his or her respective specialty area when contacted by the Team Physician or Head Athletic Trainer
b.    Advise the Team Physician and Head Athletic Trainer of desirable injury prevention measures that should be utilized in the ATP
c.    Be available for telephone consultation when contacted by the Team Physician or Head Athletic Trainer

2.4    Head Athletic Trainer and ATP Staff.  The Head Athletic Trainer (and all full-time professional athletic training staff members) shall hold a National Athletic Trainers Association certification, a [state] license to practice athletic training and shall serve directly under the direction and supervision of the Team Physician and Consulting Physicians in all matters of a medical nature.  In administrative and non-medical matters, the Head Athletic Trainer shall report to and be supervised by the Athletics Director or designee.  The Head Athletic trainer shall be responsible for providing exemplary programs in health care delivery, care, prevention and treatment of athletics injuries, rehabilitation and sports nutrition.  The Head Athletic Trainer shall also be responsible for supervising all employees and student trainers, coordinating the involvement of all health care professionals and agencies, maintaining a state-of-the-art athletic training facility and completing all administrative duties as assigned by the Athletic Director or designee.  Athletic training program standards of care shall conform to the requirements contained in the most recent issue of the NCAA Sports Medicine Handbook.

2.5    Allied Health Care Professionals.  The employment and/or association on a paid or voluntary basis of allied health care professionals (i.e. chiropractors, massage therapists, nutritionists, etc.) requires the approval of the Team Physician and Head Athletic Trainer according to the following required procedures.

2.5.1     Provision of Service in a Professional Setting.  Coaches and ATP staff are responsible for ensuring that allied health care personnel provide their services in professional settings (i.e., training room, locker room, etc.) as opposed to home, dormitory or hotel rooms.  The work of such personnel must occur under the direct supervision of a full-time member of the coaching or ATP staff.

2.5.2    Documentation.  Allied health care professionals are required to document all treatments rendered.

3.0    Athletic Trainer Coverage of Practice, Competition and Other Activities

3.1    Determination.  The Head Athletic Trainer shall be responsible for determining assignments of all ATP personnel.

3.2    Practice Coverage.  ATP NATA-certified personnel shall provide coverage of all practices in contact sports or sports with elevated injury risks:  football, basketball, volleyball, softball, baseball, soccer, track and field and rugby.

3.3    Competition Coverage.  ATP NATA-certified personnel shall provide coverage at all home competitive events in all sports.

3.4    Student-Trainers.  A student athletic trainer shall be assigned to each sport depending on availability and such assignments shall be rotated to ensure exposure to a variety of sports.

3.5    Special Events, Camps and Clinics.  The assignment of ATP personnel to special events shall be made on a “request only/dependent on availability” basis.  Athletic trainer fees and the cost of all expendable supplies shall be charged to the event budget.  Such services shall be requested at least one month in advance.

3.6    Pre-Participation Screening.  ATP personnel shall be assigned to all required pre-participation screening programs.
4.0    Home Event Planning.  It is the responsibility of the facility manager to provide for the safety of student-athletes, officials and spectators at each home event.  ATP personnel shall participate in pre-event planning, assist in the provision of health care services as determined in such planning meetings, follow all established emergency medical procedures and provide consumable first aid supplies as determined in the planning meeting.

5.0    Athletic Training Facility

5.1    Standards.  The Head Athletic Trainer is responsible for maintaining a state-of-the-art athletic training room that contains all required modalities for treatment, sufficient consumable supplies to meet the needs of the ATP and that such facility is operated with the highest standard of care and cleanliness that diminishes the possibility of contamination by blood-borne pathogens or infectious diseases. 

5.2    Storage of Drugs and Supplements.  All prescription and non-prescription drugs and supplements shall be kept in locked cabinets and procedures shall be in place to adequately supervise their distribution and use.

5.3    Training Room Dress and Conduct.  The Head Athletic Training shall be responsible for establishing standards of dress for treatments and conduct of student-athletes in the training room and enforcing such standards to ensure the health and safety of training room occupants.

5.4    Student-Athlete Records.  All student-athlete medical and treatment records shall be stored in locked file cabinets.

5.5    Safety Signage.  Safety procedure signage is posted on all modalities, the training room code of conduct and other safety related signage is prominently displayed in appropriate areas of the training room.

5.6    Supervision.  Athletic training facilities shall be locked at all times when they are not under the supervision of an assigned ATP staff member.

-- Sports Management Resources with thanks to the University of Texas Women’s Athletics sports medicine program for contributing to its development.