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Q&A Transcript: Accountability and Education of Non-Healthcare Personnel Webinar

The following is a transcript of the Q&A section of the webinar entitled Accountability and Education of Non-Healthcare Personnel (Sept. 21, 2021). The questions and answers are posted as they were originally entered and are listed in the order that they were answered.

What are some resources for educating these non-healthcare personnel? Tracking compliance?
Thanks for the question.  For those in the NCAA environment, the NCAA SSI has best practices and consensus guidelines of things that must be covered. USCAH has educational modules geared specifically for coaches, administrators, athletes, and medical personnel to specifically address this.  These modules also allow healthcare administrators to track compliance with this education through Athletics Healthspace. Would be happy to share more information with you or you could email info@uscah.com.  Thanks!

While having an AT onsite is beneficial, it’s not possible for all organizations due to budget limitations or AT human resource accessibility. What are some alternatives for rural organizations that focus on athlete/employee health and safety?
It is important to educate those personnel that are on site with the athletes. USCAH and the AHAA have educational modules that are online and designed to educate people of different backgrounds (Coaches, administrators, athletes, medical personnel).  Use of technology can also help reach out in the rural space.

When it comes to high school and youth sports there’s always a lot of talk about educating coaches, administrators, and their support staff- are these educational resources available for parents as well so that everyone can be on the same page?  Sometimes there is a gap in understanding between each of these groups.
These educational modalities should absolutely be available to athletes and to parents.  Those are areas that are often under reached, but are very important.  Many youth sports organizations rely on online education for these requirements.

I think that is a great point…how do you get those individuals (coaches, etc) to “care” about things that are not their focus?
If people are going to be responsible for the performance of young people (or even adults) in an organized athletics setting, everyone is responsible.  I think it comes from the top and getting your AD or key administrators engaged and then engaging coaches in what they need to know is essential.

How can we quantify the number of qualified individuals needed for administration/risk management? We know there is always more work to do, athletes to evaluate and treat, more “things a new coach” wants to do.
NATA has a model to use to quantify the # of ATs needed per sport based on risk.  I think a lot of it is also dependent on local standard of care.  If other schools/organizations in the area have  x# ATs (personnel) per athlete, then other schools in that area would be held to a similar standard.  Also, engaging with your legal counsel, risk mitigation or even insurers can help come up with this number

Is it true that independent medical care is only legislated for NCAA Div 1? is there any word on it trickling down to Div 2 and 3?
It is required for all NCAA programs, D1, D2 and D3.  It is in the NCAA Interassociation document on prevention of catastrophic injury that came out in 2019 initially as recommendations.  Passage of the concussion requirements in 2020 also mandated all parts of the Interassociation guidance on preventing catastrophic injury and death

At the heart of "independent medical care" is preventing non-medical personnel from providing influence over the provision of medical care. Structurally that looks like running the reporting line for medical personnel outside of the athletics reporting line (ie. have ATs report to head AT or head team physician, or Assoc AD for Sports Medicine)

For non NCAA entities where independent medical care is not "required," striving towards keeping undue outside influence out of medical decisions should be viewed as best practice

This would be such a great idea for coaches and admin to hop onto a zoom call just like this to hear from professional panel as yourselves. Is this something possible to make available to coaches and admin? I was not sure if this type of zoom call was even available to them or just health care providers
This will be recorded and available for those in the Athletics Healthcare Administrators Association.  We would love to address coaches and admin join the upcoming calls - we want to reach those involved in athlete health and safety!

How does this impact student-run rec sports and club sports?
Rec and club sports are high risk areas for universities that are under-reached with education on health and safety.  We are working with several universities to help them with this.  But there needs to be a responsible party for the health and safety of those students and athletes involved in organized sports.

What are yall's thoughts on making EKG/Echos a requirement before athletes can be eligible to play. With covid going on we are required to get an EKG to be able to return from covid but we have caught things that are not covid related.
EKG and echo are controversial in the pre-participation screening for athletes. Many entities (colleges, universities, pro teams) with resources perform them. They are not recommended for wide spread use unless the infrastructure is in place to accurately assess an athlete ECG, the infrastructure for follow-up should someone need follow-on testing exists. Also, there is no evidence to show that doing ECG or echo’s save lives. They may be good at identifying conditions possibly associated with sudden death, but unclear at this time if holding someone from sport because of what you found on ECG really saves lives. 

https://www.choosingwisely.org/clinician-lists/aapccs2-do-not-routinely-order-a-screening-ecg-as-part-of-a-sports-preparticipation-examination-in-asymptomatic-otherwise-healthy-patients-with-no-personal-or-family-history-of-cardiac-disease/

As far as post covid goes, we updated the algorithm: https://www.amssm.org/Content/pdf-files/COVID19/NCAA_COVID-18-AUG-2021.pdf

Based on large scale studies through the NCAA and European club sports for those athletes with no or very mild symptoms, cardiac clearance should not be required.   It should only be needed if people have moderate or severe symptoms, or they fail their progression back to sport.

How do you share mental health crisis issues with non-medical personnel?
This is a complex question, much of which depends on your environment.  FERPA (college) and HIPAA (non college and medical environment) are in place to protect health information and patient privacy/confidentiality.  It is very important to educate coaches, administrators, athletes and medical personnel on your mental health EAP. 

NATA has a good guideline for mental health EAP: https://www.nata.org/sites/default/files/mental_health_eap_guidelines.pdf

Here is a good link to a mental health emergency education which was done at George Mason University: https://achieves.gmu.edu/assets/docs/achieves/plan-athlete-psychological-

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