Jan 29, 2015Group Think
What do you get when you bring athletic trainers, strength coaches, administrators, medical personnel, and sport coaches together for regular meetings? The University of California-Berkeley got a better way to assess the present and plan the future of athletic medicine on campus.
By Ryan Cobb
Ryan Cobb, MS, ATC, is Head Athletic Trainer at the University of California-Berkeley. He can be reached at: [email protected]
More than a decade ago, the University of California-Berkeley formed a committee whose mission was to focus on the “big picture” of athletic medicine on our campus: helping set priorities, allocate resources, and solve problems that arise in all aspects of athlete care and treatment. I’ve been a part of that committee since I took over as Head Athletic Trainer in 2003, and it has been both challenging and rewarding to watch the project grow and evolve.
Originally called the Sports Medicine Steering Committee, our group comprises athletic trainers, medical administrators (including our Campus Medical Director and our Head Team Physician), athletic administrators, and coaches. Two years ago, we changed the name to the Sports Medicine Working Group to better reflect our permanent, forward-looking role in the athletic department.
In this article, I’ll describe how the working group has improved many aspects of our sports medicine offerings and ultimately helped us provide better care for the athletes we serve. In addition, I’ll share some pointers on how you can put a similar arrangement into place in your own setting.
CREATION PROCESS
Have you ever wondered whether your sports medicine department’s day-to-day operations are running as smoothly as they could be and providing the utmost support to the athletes? If you’re like most athletic trainers, you have so many daily tasks to juggle that it’s hard to find time to think about long-term goals, program-wide efficiency, and new ways of coordinating with others on campus. It’s a classic case of not seeing the forest for the trees.
When the committee was formed, seeing the forest was exactly what we had in mind. Like at many NCAA institutions, the supervision and leadership for our medical staff comes from two places–an ultimate medical authority on campus supervises medical care delivery, and the athletic department pays for the services, sets our budget, and helps assign our priorities. With so many stakeholders, we decided to form a group that would oversee the functioning of all facets of sports healthcare.
The committee was also charged with helping make important decisions on things like financial resources and medical and safety protocols. Since the choices made in these areas affect several departments inside and outside athletics, we felt it was important to discuss them in a group setting, with everyone represented.
For example, when making final decisions on insurance renewal, annual budgeting, and clinical or quality assurance issues, it’s critical to avoid miscommunication. Those decisions used to be made after multiple phone calls, e-mails, and scattered conversations that didn’t involve all the necessary parties or provide an orderly, logical process for sharing information. With our committee, the sports medicine staff and administrators have a forum to discuss all sorts of issues, hear each other’s opinions and concerns, and work together to solve problems.
We decided to meet once a month, which would be frequent enough to achieve our objectives but not too much of a burden on anyone. We scheduled the meetings over lunch, as this was the best way to get people from so many different departments together at one time with everyone’s busy schedules. What began as sessions to talk primarily about big-picture present-day issues quickly morphed into a platform for planning the long-term future.
SETUP & BENEFITS
As our athletic program has grown over the years, the committee has evolved along with it. In 2005, our athletic department adopted what we call the High Performance Initiative, a comprehensive new mission based on providing the best opportunities for optimum performance for each student-athlete. It also means creating a learning- and growth-centered environment for the staff, emphasizing ongoing education and collaboration between all areas of athletics, from strength and conditioning to athletic training to coaching to psychological services.
We set an agenda for each meeting that lists the items to be discussed, and we assign each item a time block. While it’s sometimes hard to cut off good conversation on a particular topic, everyone understands the schedule, and when something requires further exploration or discussion, the involved parties make arrangements to continue the dialogue later. Our main objective is producing recommendations for senior administrators to implement, and that’s impossible if we can’t get past the first few items on the schedule.
As chairperson of the group, I maintain the agenda, as well as a list of our action items, proposals, and accomplishments. I discuss the agenda with our Deputy Athletic Director and a representative from our campus’s Health Service Administration in advance, and distribute it to all working group members at least a week before each meeting. This gives everyone time to collect materials, formulate questions and ideas, and prepare to get the most out of our limited time together. I also e-mail out materials related to agenda items, so that members can review relevant documents before we meet.
In recent years, the Sports Medicine Working Group has tackled issues both large and small–everything from writing a new mission statement to discussing the best ways to assist coaches and student-athletes with mental health issues, and much in between. We have settled important budget questions and made recommendations on our model for staffing in the future.
The only prerequisite for committee members when we begin discussions is a willingness to question why things are done a certain way. Sometimes this has to do with basics, like why we choose to cover one team’s practice session over another’s. Or it may involve more complex issues, such as how we set up our staff schedule, or how we handle medical records to ensure that we’re complying with medical privacy laws. Whatever the topic, we want to challenge the status quo and explore whether our current practices or ways of thinking need to be revised.
For example, at one of our recent working group sessions, we discussed the advantages and disadvantages of having sports medicine staff members present on the practice field, court, course, or pool deck. Athletic trainers sometimes feel that being there for practices is part of our responsibility to the athletes, but it can be a major time drain. When we talked about it, we learned that coaches generally feel this level of on-site coverage isn’t truly necessary as long as an athletic trainer can be quickly summoned if needed. Our athletic trainers talked about how their time could usually be better spent in the sports medicine facility, providing treatments and meeting with athletes.
This in turn led to a healthy dialogue about improving communication between the practice field and the athletic training room, and how the athletic training staff can better coordinate with coaches to determine when “high impact” practice sessions might warrant in-person coverage. We concluded that one way to increase efficiency was for athletic trainers to schedule their practice field time well in advance, and plan on using those occasions whenever possible to put athletes through on-field rehab exercises.
Another way we’ve used the committee to determine how best to use our limited resources is by defining and refining the job description for each position in our department. By bringing everyone together and discussing exactly what we need and want from each contributor on the sports medicine team, everyone better understands what is expected of them. In addition, when it’s time to hire a new staff member, we know exactly what roles need to be filled and what skills and attributes we’re looking for in an ideal candidate.
Sometimes, this process reveals inefficiencies that seem obvious but had been overlooked because no one saw the big picture. For instance, members of our athletic training staff used to deliver water to the field every afternoon for practices. When we took inventory of job duties, we realized this was an unnecessary waste of a skilled worker’s time. Team managers could perform that simple task, freeing our athletic trainers to spend more time working with athletes. Not every team has a manager at this point, but that’s one area where the coaches and administrators are helping us in the interest of maximizing efficiency.
An ongoing goal of our working group has been to help the athletic department shift from a reactive model of sports medicine to a proactive model. With the time saved by addressing inefficiencies, we’ve been able to devote more of our professional resources toward examining injury prevention programs. With a spirit of cooperation sparked by the working group meetings, our athletic trainers and strength and conditioning coaches have started to screen student-athletes before they begin weightlifting and conditioning programs, evaluating important areas like flexibility and functional movement patterns. The results are used to create customized programs that correct deficits and address weaknesses.
Another area of operation that’s improved through leadership from the working group is our use of technology to manage and analyze information. Through our meetings, we concluded that a modern computer database could bring us closer to achieving many of our short- and long-term goals for athletic medicine, and while it has taken a lot of time and effort to implement, we’re starting to see results.
For example, by tracking the diet, exercise level, rehabilitation progress, and weightlifting of an injured athlete in one place, our sports nutritionist, strength and conditioning coaches, medical staff, and coaching staff can all work together to make any needed tweaks to maximize results. This computerized tracking also allows us to identify trends regarding the effectiveness of our programs and our allocation of time and resources, which helps us make informed decisions when planning for the future. And it fits perfectly into the High Performance Initiative, giving us an evidence-based foundation for the regimens we prescribe to optimize the performance of healthy athletes and get injured ones back into action as soon as possible.
One major reason why our group succeeds is that we focus on education, with particular attention given to coaching staffs, since they have the most frequent and direct contact with athletes. Our coaches have an obvious vested interest in knowing how the sports medicine unit functions, what services we offer, and how to take advantage of them. So, for example, our psychological services staff has used the working group meetings to provide an overview of mental health issues in the college athlete population.
Coaches at those meetings asked questions and related their own experiences dealing with mental health situations among athletes, and talked about times they felt the current system did or didn’t work for them. We also covered all the resources athletes could be referred to for counseling. Based on the discussions that followed, we have improved the working relationship between our coaches and our counselors. While counselors are bound by confidentiality rules and must be careful about their contacts with coaches, they now have a much better understanding of how coaches interact with student-athletes. Coaches learned that they can share information with counselors at will (which some did not know) and were told about the critical role they can play in assisting an athlete with mental health issues.
Continuing education efforts like these give coaches the tools they need to understand and utilize all the services our sports medicine team has to offer. Whether it’s a better understanding of massage therapy or postgame recovery, or a new familiarity with the services available from our chiropractor, sports nutritionist, acupuncturist, and other allied healthcare professionals, giving coaches this information effectively improves the quality of care athletes receive.
LOOKING FORWARD
At present, the Sports Medicine Working Group has several exciting projects on the horizon. For one, we’re helping to plan our campus’s new Student Athlete High Performance Center, a hybrid sports science and training center that will put all the resources a student-athlete needs to train, rehabilitate, study, and get fed under one roof. In addition to the design work, we’re also figuring out exactly what types of professionals will be needed to staff the facility.
At the same time, we’re looking to revamp our sports nutrition offerings, strengthen the partnerships between athletics and other departments on campus, and incorporate the latest knowledge and strategies to improve our drug and alcohol abuse prevention programs.
As we continue to evolve and refine our mission and methods, we’re constantly trying to anticipate the future. We bring in perspectives and voices from a wide range of roles and backgrounds to see what our goals should be, what obstacles stand in the way, and how we can overcome them. The over-arching objective of everything we do is to provide this year’s student-athletes with a higher level of care and support than last year’s student-athletes had–and ensure that next year’s student-athletes have even better.
The Sports Medicine Working Group is an investment in time and effort that has more than paid itself back in terms of efficiency, collaboration, and continuing education. It has been and continues to be a vital part of our success in sports medicine. I believe every athletic program can benefit from this type of arrangement, and I’m proud to say that our group at Cal sets a shining example for others to follow.
Sidebar: WANT YOUR OWN?
Every athletic department is different, so the best way to build momentum for a new Sports Medicine Steering Committee or Working Group like the one we have at the University of California-Berkeley is to identify your program’s specific needs and start conversations about how a committee can help address them. Here are some key points that we’ve learned can help the process along:
• Convince decision-making administrators that bringing together all parties involved in sports medicine for regular meetings can save more time than it takes up.
• Explain how more global planning can boost efficiency to save time and money while improving the quality of care athletes receive.
• Emphasize that a steering committee helps the athletic department create a progressive, forward-thinking work environment that will bring out the best in current employees and attract top talent in the future.
• By fostering teamwork between various entities in the athletic department and thereby improving sports medicine services, this approach can lead to increased success on the fields and courts.
Once a group has been formed, here are a few tips on making the first meetings as successful and productive as possible:
• Start small, with a project you can accomplish through teamwork, like writing a mission statement.
• At every meeting, have a focused agenda with time limits for each item–and include both current “hot button” issues and “big picture” planning.
• Maintain a list at the bottom of the agenda showing both short- and long-term goals.
• Periodically compile a summary of what the group has accomplished (such as producing policies, plans, and recommendations). Share this summary, along with current items on the agenda, with the athletic department as a whole to demonstrate the group’s value and increase program-wide support.
