Athletic Trainers' Effect on Population Health: Improving Access to and Quality of Care

Abstract

Context: The scope of athletic training practice combined with the magnitude of scholastic athletic injuries means that the scholastic athletic trainer (AT) is uniquely positioned to positively affect the overall health care of this population. The AT is equipped to serve in the prevention and primary management of injuries and return to activity of scholastic athletes. However, to optimize the musculoskeletal health of all athletes within a given setting, the gaps in clinical care must be continuously evaluated. Quality improvement (QI) approaches are often used to establish a framework for delivering care that promotes the best health status of the targeted population.

Objective: To describe the creation, implementation, and early results of a QI initiative aimed at advancing the health of the scholastic athletes served in the Greenville County, South Carolina, school district.

Design: Cohort study.

Patients or other participants: A total of 49 793 athletes.

Main outcome measure(s): The QI framework consisted of a process that documented the magnitude of athletic injuries, established risk factors for injury, defined intervention steps for at-risk athletes, and evaluated the QI process before and after implementation. The results were regularly reported to participating stakeholders, including ATs, athletic directors, coaches, parents, and athletes.

Results: After the QI process, injury rates decreased (absolute risk difference between the 2011-2012 and 2016-2017 academic years = 22%) and resources were more strategically allocated, which resulted in a decrease in health care costs of more than 50%.

Conclusions: Collectively, the QI framework as described provides a systematic process for empowering the AT as the foundation of the scholastic sports medicine team.

Keywords: injury prevention; scholastic athletic injuries; tertiary care.

Figure 1

Steps of the quality improvement process to inform practice.

Figure 2

Injuries by sex. ^a Denotes within-comparison difference of P < .05.

Figure 3

Health care use.

Figure 4

High school sports functional warm-up program. A–D, Dynamic warm-up. Two sets of 10 yd (9 m). E–G, Function. Three sets of 30 repetitions or 30 s. H–J, Balance and agility. Three sets of 15 repetitions or 2 sets of 10 yd (9 m).