Risk Management

1. Risk Management • Injury is damage to the body that restricts activity and/or causes disability. • Those who participate in sports and other physical activities, risk sustaining an injury. • Sports Medicine professionals should try to minimize the risk of injury as much as possible. Objective 3: Explain legal issues and legal terminology.

2. COLLISION Risk Management: Types of Sports • Athletes use their body to deter or punish opponents. (Intent of the sport.) • Risk of injury relatively high. Ice Hockey Football Rugby

3. CONTACT Risk Management: Types of Sports • Contact occurs, but is not the intent of the sport and discouraged by rules. • Traumatic and overuse injuries are common. Basketball Baseball Field Hockey Lacrosse Rodeo Soccer Softball Water Polo Wrestling

4. NON-CONTACT Risk Management: Types of Sports • Sports where players are separated such that contact is unlikely without violation. • Acute, traumatic injuries still occur, but the incidence of chronic, overuse related injury is greater. Archery Badmiton Bowling Crew/rowing Cross country running Curling Fencing Golf Gymnastics Skiing/Snowboarding Squash Swimming Diving Tennis Track & Field Volleyball

5. Assumption of Risk Legal Terminology It is assumed that an individual who participates in an activity and is injured as a result of the ordinary risk associated at the activity will not have grounds for negligence.

6. Battery Legal Terminology Touching someone without their permission.

7. Commission & Omission Legal Terminology Doing something (commission) or failing to do something (omission) that a reasonable person would or would not do under similar circumstances.

8. Failure to Warn Legal Terminology Failing to inform a participant of potential risks and dangers. When dealing with minors, failing to warn parents or obtaining consent.

9. HIPAA Legal Terminology Health Insurance Portability and Accountability Act Law that mandated four main areas of change for business in the health care industry. • Privacy of health information • Standards for electronic transactions of health information and claims. • Security of electronic health information. • National identifiers for providers.

10. Informed Consent Legal Terminology Being informed of all procedures and the potential risks and benefits of each.

11. Liability Legal Terminology The legal responsibility to act in a reasonable and prudent manner. Failure to perform in such a manner makes you legally liable.

12. Malpractice Legal Terminology When an individual commits a negligent act while providing care.

13. Negligence Legal Terminology Failure to use ordinary or reasonable care. In order to prove, four basic elements must be shown: • Duty of care – an individual has the responsibility to provide care. • Breach of duty – conduct of provider falls short of that duty. Usually commission or omission. • Injury or damage – results of the breach of duty. • Proximate cause – the injury or damage directly related to the breach of duty.

14. Standard of Care Legal Terminology Provides reasonable and prudent care expected as compared to someone with similar education and experience.

15. Ethical Conduct and Associated Issues Sports medicine professionals must act at all times with the highest standards of conduct and integrity. Ethics can be defined as a system of moral principles or standards governing conduct and knowledge of right and wrong.

16. Americans with Disabilities Act (ADA) Ethical Conduct and Associated Issues Federal legislation that opens up services, facilities, and opportunities to people with disabilities.

17. Fair Play and Sportsmanship Ethical Conduct and Associated Issues Many people believe fair play and sportsmanship to be the “golden rule” of the sports world. Some ethical issues related to fair play/sportsmanship include: • Cheating • Performance Enhancing Drugs • Drug Testing

18. Cheating Ethical Conduct and Associated Issues: Fair Play and Sportsmanship Manifests itself in several ways in the world of athletics. Is victory due to training and talent, or cheating? The pressure of failing is too much to deal with. No one wants to be a failure.

19. Performance Enhancing Drugs Ethical Conduct and Associated Issues: Fair Play and Sportsmanship Substances used for the express purpose to perform better athletically.

20. Drug Testing Ethical Conduct and Associated Issues: Fair Play and Sportsmanship A common tool used to try to deter the use of performance enhancing drugs.

21. Scope of Practice Ethical Conduct and Associated Issues Each career area has guideline regarding what you can and cannot do. Make sure you are staying within the boundaries of your training and complying with local and federal laws.

22. Title IX - Gender Equity Ethical Conduct and Associated Issues An addition to the 14th Amendment in 1972. No person shall be excluded on the basis of gender or be denied the benefit of any education program or activity receiving Federal financial assistance.

23. Winning At All Costs Ethical Conduct and Associated Issues • Our cultural traditions value winning, and why not since it is part of the reason sports exist.  • What we fail to teach our children, students, athletes, and society in general is that the honest pursuit of anything carries with it the responsibility to do it right.

24. Clinician Risk Reduction Ethical Conduct and Associated Issues • Be familiar with medical histories of athletes, clients, or patients. • Carry liability insurance. • Be informed and current in changes in the standard of care through continuing education.

25. Clinician Risk Reduction (con’t) Ethical Conduct and Associated Issues Demonstrate appropriate documentation. • Implement a comprehensive record-keeping system. • Critical in litigation, as well as with communication between members of sports medicine team. • Pre-participation exams, insurance forms, personal data, rehab programs, progress charts, etc. • In a legal situation, “if it wasn’t written down, it didn’t happen”! • Injury reporting forms and injury tracking software are available online.

26. Clinician Risk Reduction (con’t) Ethical Conduct and Associated Issues SOAP Format – a medical documentation method • S = Subjective: Information that the patient reports. • O= Objective: Information that can be measured and expressed in a standard format. • A= Assessment: What decisions are made with the information gathered. • P = Plan: Course of treatment to be carried out.

27. Clinician Risk Reduction (con’t) Ethical Conduct and Associated Issues • Follow physician’s orders and recommendations. • Have an Emergency Action Plan: • Develop separate EAP for each field, gym, court, etc. • Include policies for removal of protective equipment. • Emergency communication needed. • Have keys to doors, gates or padlocks easily accessible. • Hold an annual meeting with all involved to review EAP. • Carry contact information for athletes and coaches at all times.

28. Clinician Risk Reduction (con’t) Ethical Conduct and Associated Issues • Always stay within your scope of practice. • Maintain qualified and adequate supervision of facilities, employees, and equipment. • Maintain good rapport with athletes, parents, coaches, physicians, clients and colleagues. (Sports Medicine Team)