Jan 29, 2015
Collaborating on Coverage

As hospitals expand their athletic training staffs, many are looking to partner with high schools to provide athletic team coverage. Here’s a look at two successful and innovative models.

One trend that continues to gain steam at the high school level is school districts outsourcing athletic training coverage rather than hiring an in-house staff. It can be a money-saver for districts in tight financial spots, and hospitals and clinics get to give part- and full-time jobs to their athletic trainers who want to work in schools. But many of these partnerships involve more than just game coverage.

In Indiana, one such arrangement recently expanded to include not only offering the services of athletic trainers to schools in the district, but also those of team physicians and strength and conditioning coaches. Another partnership in Alabama has grown to include a Friday night injury clinic during the football season and an athlete of the year scholarship program. Let’s take a closer look at these two interesting models.

Growing Fast

By Mike Phelps Mike Phelps is a former Assistant Editor at Training & Conditioning.

The Metropolitan School District of Lawrence Township and Community Health Network (CHN), a health system comprising more than 100 care sites in Indianapolis, have only been building their relationship since last spring, but it’s expanded drastically already. In April of 2011, CHN launched a health and wellness center for school district employees and their children. A few months later, CHN hired Lawrence Township’s school nurses and took over in-school nursing care.

And this fall, the partnership is expanding so that CHN will provide not only athletic trainers, but also team physicians and strength and conditioning coaches at high schools and middle schools in the district. For Nichole Wilson, DPT, ATC, Director of Rehab and Sports Medicine at CHN, including physician and strength and conditioning services along with athletic training was a no-brainer.

“They are all part of the sports medicine team,” Wilson says. “The team physician is the leader of a sports medicine program and if you don’t have one, you really don’t have much of a program. They are the go-to person for medical policies and set the direction for the entire program. The athletic trainers work under their guidance. Even though the athletic trainers are at the schools daily, it’s important to have a team physician who can direct care when things get tricky.

“Strength coaches are a major benefit to an athletic program that wants its teams to excel,” she continues. “Not all of our schools have strength coaches, but those that do have someone there every day who can safely direct student-athletes in the weightroom.”

CHN athletic trainers cover home practices and events for all sports, plus away games for football. Team physicians, meanwhile, cover football games, perform weekly injury checks, and attend games for other sports on an as-needed basis. Finally, the strength and conditioning coaches are on campus during the school day to teach weightlifting classes, then provide direction to coaches in the evening regarding the development of their teams.

The sports medicine teams–particularly athletic trainers and strength and conditioning coaches–spend the majority of their time at their respective schools. The physicians do the most traveling back and forth because they also see patients at their own offices during the day or are performing surgery. Wilson believes that for this sort of arrangement to work, it’s important that the athletic trainers and strength coaches are on campus every day.

“Sports medicine is really a relationship business,” she says. “It’s critical that the athletic trainer and strength coach spend as much time at the school as possible. Even though they’re employed by CHN, they are very much a part of the school and its athletic department. They need to be there to get to know the administrators and coaches and develop trust with the athletes and their parents.

“The athletic trainers and strength coaches generally only come back to the CHN facilities for meetings, in-services, orientations, and things like that,” Wilson continues. “I’m often trying to find ways to make sure they still have enough connections within our own network because they’re always at their school.”

Wilson believes that partnerships like the one between CHN and Lawrence Township will become more commonplace in the future because school systems are seeing the benefits that a large network of health services can provide. Lawrence Township is able to receive athletic training coverage from six CHN athletic trainers for less money than if it were to hire six athletic trainers directly. In addition, there are numerous specialty care sites, including physical therapy clinics, that Lawrence Township student-athletes have access to on a fee-for-services basis.

“We have more than 600 primary care physicians,” Wilson says. “A lot of these athletes may not have a primary care physician or insurance. We have programs in place to accommodate everyone and get them all directed to the right place.”

Athletic trainers, team physicians, and strength coaches employed by CHN also have a wealth of resources at their disposal. Without the partnership, some resources might have been difficult to gain access to or not available at all.

“For example, if an athlete is having trouble sleeping, we have an entire sleep center–in fact, we have several–they can call,” Wilson says. “If others are struggling with nutrition, we have an entire health promotions department they can get resources from. Our nutritionists will go to the school and give a presentation or other things like that to assist students and parents.”

And because CHN is also responsible for nursing services in Lawrence Township schools, communication between all healthcare providers in a respective building is seamless. “For example, if an athlete sustains a concussion, the athletic trainer might see the athlete after school,” Wilson says. “But during the day, if that student is suffering from headaches at class, we already have an open line of communication to the nurses there who can assist the student right away.

“In order to do a better job and be a good organization that is truly accountable for the population we’re giving care to, it’s just easier to facilitate better outcomes when all the healthcare providers are on the same page,” she continues. “This partnership is a unique opportunity to provide care in an innovative way and impact the lives and health of those in our community.”

Test of Time

By Michael Stevenson Michael Stevenson, ATC, is Program Manager of the Hunstville (Ala.) Hospital SportsCenter. He can be reached at: [email protected].

When partnerships multiply, you know they’re working well. That’s the case here in Huntsville, Ala., where the Huntsville Hospital SportsCenter (HHSC) provides athletic training services to 18 high schools and seven middle schools in the area–not to mention a host of universities, professional teams, and club organizations–with a staff of almost 30 athletic trainers. To give you an idea of our growth, the HHSC started providing coverage to just four high schools with two athletic trainers in 1999.

HHSC is a sports medicine outreach program and a division of not-for-profit Huntsville Hospital–the second largest hospital in the state and sixth largest publicly owned health system in the nation. HHSC operates under the direction of sports medicine physicians at The Orthopaedic Center (TOC), which Huntsville Hospital has partnered with in order to have medical oversight of the HHSC.

HHSC athletic trainers are stationed at their assigned schools for the entire athletic period after school every day and cover all home practices and games. They travel with teams as much as possible, and when a school requests treatment and evaluation time before the school day begins, the athletic trainers meet those requests. All in all, the HHSC athletic trainers work afternoons and evenings and some weekends with the scholastic athletes, and they spend a lot of their weekends covering the club organizations the HHSC also partner with.

Our schools do a great job of helping our athletic trainers integrate themselves into the athletic department. For example, coaches often purchase team clothing for the athletic trainer and include them in staff outings. They help the athletic trainer feel as if they are truly part of the school.

By the same token, we encourage our athletic trainers to take ownership of their school and show school spirit. Our schools’ teams are competitive across a number of classifications and sports in the state, with numerous teams competing for a state championship every season. A little friendly rivalry among athletic trainers who work at competing schools is fun and inclusive.

In addition to great athletic training coverage, there are several advantages for the schools and school systems that use the HHSC. First, school administrators have peace of mind knowing their athletes have a certified, licensed athletic trainer present on campus to help ensure safe participation. We have also worked with the administrators and coaches at some of our schools to help shape emergency action plans, heat guidelines, and concussion recommendations.

The partnership helps lower athletic training coverage costs because the schools we partner with get athletic training coverage for free–they don’t pay athletic trainer salaries or give them any benefits. And by allowing Huntsville Hospital to have such a large presence in the community, we are able to show our dedication to providing a safe, healthy environment in which the young athletes in our area compete.

Should an athlete sustain an injury that needs more specialized or longer-term treatment, the athlete and his or her parents can choose to employ Huntsville Hospital’s services. Doing so means that the healthcare of the athlete never leaves the hospital’s health system. This is a great advantage because it means increased communication among doctors, athletic trainers, physical therapists, and others about the athlete and their progress in returning to action.

Our schools also have access to the entire sports medicine team, which, in addition to athletic trainers, includes sports medicine physicians, physical therapists, exercise physiologists, and registered dietitians. Not all of these services are free to our schools like the athletic training coverage is, but financial assistance is available. The comprehensive sports medicine services the hospital is able to provide makes the HHSC an invaluable service to the schools and organizations we serve.

Finally, over the years, we have offered our schools several unique “bonuses.” Since 2002, the walk-in Friday Night Injury Clinic has been in operation during the football season and allows an injured athlete to be seen quickly by an athletic trainer and/or physician. We use Huntsville Hospital’s pediatric emergency room, which has 16 beds, and staff it with one athletic trainer and one sports medicine physician every Friday night from 8 to 11 p.m.

In the event of an injury, the Friday Night Injury Clinic is a convenient way for athletes to have their medical needs addressed that night. Every athlete and parent knows that injuries are part of playing sports, and a lot of them have experienced the emergency room. The clinic offers a quicker, easier, and less hectic option.

Another fantastic program that helps serve the needs of all student-athletes is the Athlete of the Year scholarship program. In conjunction with the TOC, and D1 Sports Training, a sports performance facility, HHSC recognizes area high school seniors for outstanding athletic, academic, and community accomplishments throughout the school year.

Anyone can nominate a student-athlete for our Athlete of the Week award throughout the year, then from this group of nearly 40 athletes, one male and one female are recognized as the Athletes of the Year and awarded a $1,000 college scholarship. The scholarship is presented at the annual Athlete of the Year banquet at the end of the school year, which is humbling to attend. We see how committed our student-athletes are to helping their communities, providing volunteer services, and setting higher standards in the classroom.

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