Creating a Physical
Therapist Assistant
Student Clinic
How to get a PTA Student Clinic Started on Your
Campus
Guide by Whatcom Community College. Funded by the Carl D. Perkins SBCTC Innovation Grant 2015-16
Creating a Physical Therapist Assistant Student Clinic
CONTRIBUTORS
MARGARET ANDERSON, BS, M.Ed., Physical Therapist Assistant Program Coordinator
JILL LUDLOW, PTA, Academic Coordinator of Clinical Education, Physical Therapist Assistant Program
CINDY BURMAN-WOODS, M.Ed., Workforce Special Projects Director
MEGAN THOMAS, PTA, CWcHP, Research
JARRETT MARTIN, Graphic Designer
MARLA BRONSTEIN, Editor
Funded by Carl D. Perkins SBCTC Innovation Grant 2015-2016
Table of Contents
4 ꟷ Table of Contents
Planning and Development									
Convene faculty and community members 								8
Incorporate Institutional Input										10
Budget													10
Recruitment Strategies											11
Industry Partnership											12
Research Student Clinic Models									12
Business Plan												13
Executive Summary											14
Mission/Vision Statement and Goals									14
Business Summary											15
Products and/or Services										16
Market Assessment 											16
Strategic Implementation 										17
Business Policies and Procedures									17
Marketing Plan												18
Monitoring Outcomes											18
Student Clinic Handbook Model									19
Roles and Responsibilities										19
Scope of Treatment											19
Daily Routine												19
Quarterly Project/Research 										19
Outcome Measurements										19
Table of Contents ꟷ 5
Table of Contents
Glossary of Terms											 20
Index													
Draft Business Plan for WCC										 22
Draft Student Clinic Handbook for WCC								 40
Comparison of Student Clinics										 44
Focus Group Questions											 46	
Forms													
		
Clinical Administrator Job Description and Contract						 47
On-site Clinical Education Questions - Mentor							 	
On-site Clinical Education Questions - Student							 49
Consent Form												 50
HIPAA Release Form											 52
Mentor Confidentiality Agreement									 54
On-site Clinic Mentor Job Description								 55
Patient Registration											 56
Patient Satisfaction Survey										 57
Patient Medical History											 58
Patient Attendance Policy Pay-As-You Go								 59
Patient Attendance Policy Pay in Advance								 60
Student Daily Self Assessment									 61
Statistics Tracking											 63
How to start your
PTA Student Clinic
Choose to move your program
forward, to serve students and the
community
Research other student clinics
Identify possible
funding source(s)
Establish student
learning outcomes
Launch Clinic
Meeting or
Exceeding Clinic
Goals
Determine a need for a more robust
PTA Academic Program
Meet with Institution Administrators
to create partnerships
Assess Risk Management &
Liability Concerns
Recruit and identify
volunteer mentors
Present to
College Administration
Hold a focus group
Decide how to run the clinic.
Management, logistics, etc
Create a budget &
business plan
Market to
target audience
(Host Pilot Clinic)
Clinic schedule
is full
Launch Successful!
Clinic schedule isn’t full:
?
Industry Outreach
for marketing advice
Introduction
Introduction ꟷ 7
The general consensus in the Physical Therapist Assistant (PTA) profession is that
it has become increasingly more difficult to place students at clinical internship
sites, and at times, the students have limited opportunities to develop their pro-
fessional qualities prior to entering a clinical site. Students in PTA programs come
from a variety of backgrounds and do not always have experience in professional
setting. Providing them a safe and supportive environment to learn these qualities
will better prepare them for later clinical internship and work experiences.
This guide has been designed to assist any institution whether public or private,
community college or university, in planning, developing and implementing a stu-
dent clinic for Physical Therapist Assistant students. There are a variety of ways
to implement a student clinic to suit an institution’s priorities and accommodate
a range of financial support. Keep in mind that the guide offers several options to
consider and our goal is to lay out the steps to take while designing a student clinic
for your Physical Therapist Assistant program.
Through research gathered from established student clinic programs, outcomes
have consistently shown positive feedback from students, faculty and clinical in-
structors. Students feel supported in their learning process and have a more real-
istic opportunity to practice their clinical skills and professional qualities. Faculty
members appreciate more time to observe and guide the students while working
under their supervision, and clinical instructors in local clinics and hospitals iden-
tify a higher level of competence from the students and greater employee perfor-
mance.
Providing mentorship to students is one of the most effective and worthwhile ways
that an experienced physical therapist and physical therapist assistant can help
the next generation of students become successful and learn beyond standard
curriculum. Being a Clinical Instructor while also carrying a full patient load can be
demanding for some therapists. Providing an opportunity to mentor students a few
hours a week in a student clinic may be more appealing and reasonable.
One of the most difficult issues that health care professionals face is to deny
services to a patient in need due to lack of ability to pay. Despite laws that require
a person to carry health insurance, many policies do not cover physical therapy
treatment. In many cases where coverage does exist, there are limitations and
benefits are exhausted before the patient is fully recovered. For these groups to
have access to treatment, education and self-management techniques, student
clinics are essential to providing care for many people who are low-income and
under-insured. The long term benefits are far reaching not only for the students’
education, but to improve the quality of life of the patients served.
Getting Started: Planning and Development Process
8 ꟷ Getting Started
This section outlines the recommended steps to take while developing the design of
the student clinic as well as preparing information and background for the Business
Plan and Student Handbook. Specifics vary depending on what kind of institution is
creating the program. Draft documents for the Whatcom Community College (WCC)
PTA Student Clinic are included in the Index.
FOCUS GROUP
Convene a group of faculty members, Program Director, Academic Coordinator
of Clinical Education (ACCE) and institution administrator, at minimum. Invite
Physical Therapy (PT) clinicians from the community, asking for their participation
in a focus group, work group, and/or advisory board.
1. The Focus Group should consist of 5-7 industry members for initial
discussion and brainstorming student clinic implementation. See Index - Focus
Group Questions
2. Encourage participants to consider being a clinic volunteer (Mentor), discuss
recruiting potential mentors at their places of employment
3. Identify challenges, opportunities and determine options for implementation
of the student clinic
4. Determine clinic goals and how the Physical Therapist Assistant (PTA)
program would benefit from a student clinic. For the purpose of example, as a
result of WCC’s focus group, the following benefits were determined:
¾¾ Provides students with a period of mentorship while practicing hands-	
on skills and professional behavior with patients
¾¾ Provides additional practical experience early in the students’ training.
¾¾ Highlights unique educational opportunities within the program, which	
may attract more qualified applicants
5. Establish target patient population and physical conditions that will be
served by the clinic. For the purpose of example, WCC’s inclusions and
exclusions determined as a result of the focus group are as follows:
¾¾ Welcome underserved community members that may not have
access to mainstream PT services. “Underserved” includes those	
who are uninsured, low income patients, or insured patients with
exhausted benefits
¾¾ Campus students and faculty members are invited to use services
¾¾ “Excluded “population includes those who present with new injuries,	
or students enrolled in their institution’s athletics program
Getting Started ꟷ 9
6. Identify possible challenges that may interfere with the development of a clinic.
For example, WCC’s challenges determined as a result of the focus group are as
follows:
¾¾ Potential legal ramifications of student clinic operations, such as		
liability and insurance coverage
¾¾ Ensuring compliance with Washington state’s physical therapy		
practice regulations that relate to supervision of PTAs and students
¾¾ Recruiting volunteer mentors (PTs & PTAs) from local businesses, as	
well as institutional faculty
¾¾ Establishing financial solvency to sustain clinic functions in order
to prevent clinic from draining resources from Program and/or 		
institution
7. Gather industry feedback from local physical therapists:
¾¾ Determine ways to recruit potential mentors who have established
history working with students during internships, and who would work
at the clinic to perform patient evaluations
¾¾ Identify benefits to community Mentors, such as:
ŠŠ Local therapists will help educate and shape the next			
generation of therapists
ŠŠ Foster qualities potential employers desire from new graduate	
therapists
ŠŠ Resolves issues of conflicts of interest or potential competition	
between Student Clinic and local businesses
ŠŠ Establishes a cooperative relationship between Student Clinic	
and local businesses to meet the needs of patients
Getting Started: Planning and Development Process
10 ꟷ Getting Started
ADMINISTRATION INPUT
Incorporate Institutional Administration input
¾¾ Include WorkForce Education and Special Projects departments
¾¾ Identify person who will monitor the department’s budget
¾¾ Determine need for Identified Faculty/Clinic Administrator
¾¾ Identify institutional communication and approval processes
necessary to implement the clinic
¾¾ Consider contacting the institution’s Business Department for
assistance on developing a successful business plan
BUDGET
Create Estimated Budget
1. Start-up expenses/needs:
¾¾ Electronic Medical Records (EMR) software
¾¾ If a PTA Student Clinic is being designed at the initial development of
an institution’s PTA program, and a facility for the clinic is required to
be built, part of those costs may be included in the budget. Equipment
costs such as treatment tables, exercise machines, ultrasound,
electrical stimulation, traction units, etc. may also be included. It
is expected that most existing PTA programs already have a lab
site in place. It may be difficult to anticipate until actual patient
demographics can be analyzed
2. Overhead:
¾¾ Utilities may be covered by institution if the student clinic is located in
an established facility on campus, such as the PTA lab space
¾¾ If an off site facility for the clinic is available, building maintenance
and utilities costs will need to be included into the budget.
¾¾ The majority of established student clinics are held within the
designated lab space, which typically include the above listed
equipment.
+$$
Getting Started ꟷ 11
3. Revolving expenses:
99 Linens (laundering and replacement)
99 Miscellaneous PT supplies
99 Printing costs:
ŠŠ Patient forms may be absorbed by institution as part of the
department’s budget
99 Equipment maintenance
4. Salaries/Personnel:
¾¾ Clinical Administrator will be a paid position.
ŠŠ A consistent staff member managing clinic functions is
essential for a well-functioning clinic
¾¾ Identified Faculty-Mentor salaries should be absorbed by institution.
RECRUITMENT STRATEGIES
Connect with local therapists who are interested in supporting a student clinic
through mentorship
1. Targeted Clinicians: Promote participation from established local clinical
sites with current connections to the program	
Key Points:
¾¾ Mentors will garner satisfaction of being associated with Student
Clinic, contributing to professional education and helping underserved
communities
¾¾ Partnerships are essential to coexist in similar market to avoid
conflict and competition with local businesses
¾¾ Recruit clinicians already associated with the PTA program
¾¾ An investment in student success
¾¾ Clinicians may have more flexible schedule than full-time faculty
2. Program alumni:
¾¾ Former students are more familiar with program and curriculum
¾¾ May provide retrospective analysis of program and personal
experiences as a former student
Getting Started: Planning and Development Process
12 ꟷ Getting Started
MARKETING
Create and Maintain Industry Partnerships for the purpose of marketing and
continuing business, while recognizing service boundaries
¾¾ Referral sources:
ŠŠ Local PT clinics refer to clinic when patient exhausts insurance
benefits
ŠŠ Medical clinics serving low-income communities
¾¾ Formal recognition of partnership participation (such as donations of
time and/or materials). Sample recognition options:
ŠŠ Plaque to be displayed in the clinic
ŠŠ Award Certificate presented to participating Mentors each
quarter
RESEARCH STUDENT CLINIC MODELS
For this section, PTA Student Clinics at other institutions were contacted and given
the opportunity to share the methods they use to set up and run their clinic. Topics
discussed are set forth below. A summary of the results of these discussions of
considerations and suggestions follow in the Index. Be advised they are not all-
inclusive. See Index - Comparison of Student Clinic Models
Topics:
¾¾ Clinic scheduling (days/week and hours/day)
¾¾ Student Clinic hours/credits may vary. (Check with your accrediting
body to determine rules for clinical and lab hour requirements)
¾¾ Determine practical skills students learn in clinic that support patient
care
¾¾ Identify PT/PTA supervision requirements which may vary from state
to state
¾¾ Identify examples of successful business models to present to
college administration
¾¾ Develop measurable outcomes for Students, Patients, and Mentors
¾¾ Identify additional expected and unexpected challenges faced
Business Plan Model ꟷ 13
Business Plan Model
This is a standard format that, when completed, will help your program identify
specific details of how you are planning for your clinic to be set up and operate. A draft
business plan for the creation of Whatcom Community College’s PTA Student Clinic can be
found in the Index as an example of a completed formal business plan.
Remember that your business plan should be only as big as you need to run your business.
While every business owner should use planning to help them run their business, not every
business owner needs a complete, formal business plan suitable for submitting to an
institution, potential investor, or bank, or venture capital contest. You may not need to
include outline points just because they are on this list, unless you’re developing a standard
business plan that you’ll be showing to someone who expects to see a standard business plan
TABLE OF CONTENTS
Executive Summary											14
Mission/Vision Statement and Goals								14
Mission/Vision Statement 										14
Goals and Objectives											14
Keys to Success												14
Business Summary											15
Business Background											15
Resources, Facilities and Equipment 									15
Marketing Methods											15
Management and Organization 									15
Products and/or Services										16
Market Assessment 											16
External Analysis												16
Customers													16
Strategic Implementation										17
Marketing Plan												17
Sales Plan													17
Location and Facilities											17
Technology													17
Equipment and Tools											17
Financial Plan												17
Projected Balance Sheet											17
Outcomes													18
14 ꟷ Business Plan Model
Executive Summary
Write this last, the executive summary is a page or two that highlights the points
made elsewhere in your business plan. Summarize the problem you are solving
for customers, your solution, the target market, the founding team, and financial
forecast highlights. Keep things as brief as possible and entice your audience to
learn more about your company.
The Executive summary should summarize the following from the business plan:
•	 Mission/Vision Statement
•	 Company Summary
•	 Products/Services
•	 Market Assessment
•	 Strategic Implementation
•	 Expected Outcomes
Mission/Vision Statement and Goals
1. Mission/Vision Statement
Mission/vision statements are clear summaries of where the business is
headed. It describes what the business produces, for whom the products
are produced, and unique business characteristics. It will reflect the values
of the management team and the type of business culture you are trying to
create.
Mission: Should be short, definitely not longer than two or three sentences.
The mission statement supports the vision and serves to communicate its
purpose and direction.
Vision: The Vision Statement may be a paragraph or a whole page. It should
paint a picture of the future that will come to be as we carry out our mission.
2. Goals and Objectives
What do you want your business to achieve? Be specific in terms of financial
performance, resource commitments (time and money) and risk. When will
various milestones be achieved? Describe the problem that you solve for
your customers and the solution that you are providing.
3. Keys to Success
What do you need, or must happen, for you to succeed?
Business Plan Model
Business Plan Model ꟷ 15
Business Summary
The material in this section is an introduction to the business. Not all sections may
be applicable.
1. Organization Background
What does your business do?
Who were the founders of the business?
What were the important milestones in the development of the business?
2. Resources, Facilities and Equipment
With what do you produce your products or services?
What are the land, equipment, human and financial resources?
Who provides them?
How are resource providers rewarded?
3. Marketing Methods
What is your annual sales volume in dollars and units?
Explain how you work with others to improve returns. This may include a
strategic alliance with suppliers or customers that you can leverage.
How much does it cost to produce and deliver your products and services?
How is contracting used?
4. Management, Organization and Ownership Structure
Who is currently on the management team?
How have management responsibilities been divided among the
management team?
What are the lines of authority?
Who acts as the president/CEO/Spokesperson/Chief Financial Officer?
Who determines employees’ salaries and conducts performance reviews?
What is the educational background of the management team members?
What is the management team’s reputation in the community?
What special skills and abilities does the management team have?
What additional skills does the management team need?
Who are the key people and personnel that make your business run?
Who do you go to for advice and support?
Do management and employees have avenues for personal development?
Sketch a diagram of lines of authority for your operation.
Do you need special permits to operate, or a record for inspections? If you
do, please describe them.
5. Social Responsibility
What environmental practices do you follow?
What procedures do you use for handling chemicals?
What will be the roles of management and employees in community
organizations?
What will be your involvement at the local/state/national level in commodity
organizations?
What training and new employee orientation practices will you offer to insure
proper handling of hazardous materials and safe operation of equipment?
Business Plan Model
16 ꟷ Business Plan Model
6. Internal Analysis
What are the strengths and weaknesses of your business?
What things can you build on? Think only about the things that you can
control.
Suggested areas to consider:
ŠŠ financial position
ŠŠ productivity
ŠŠ location
ŠŠ resources
Products and/or Services
Describe the products and services you plan to sell/provide.
How is your product or service unique?
Are you producing a commodity or a differentiated product?
How does your product or service compare to other products in
Quality? Price? Location?
What experience do you have with this product/service?
Market Assessment
1. Examining the General Market
What important customer need(s) is the market not currently fulfilling?
What is the growth potential for each segment of the market?
What opportunities and threats does your firm face?
What trends, relevant to your business, do you see?
2. Customer Analysis
Who will be your customers?
What do you sell or provide to each of the customers?
How does your product/service solve a key customer problem?
How difficult is it to retain a customer?
How much does it cost to support a customer?
Business Plan Model ꟷ 17
Strategic Implementation
1. Production
What is your competitive advantage?
What technology will you use?
Risk Management/Liability Concerns
2. Resource Needs
In order to effectively organize your business you need to insure the
resources are available. Assess those needs here.
Staffing
¾¾ What skills are needed?
¾¾ How will human resources be acquired?
Financial
¾¾ What level of financial resources will be needed	
¾¾ Financial Projections
Does the business fall under the institution’s Tax exempt status?
¾¾ Income: Consider how will you fund the business?
¾¾ Expenses
What procedures will be used for monitoring overall business performance?
Physical
¾¾ What type, quantity and quality of physical resources will be required?
Contingency Plan
¾¾ What will you do if you can’t follow through with your primary plan?
¾¾ How are you preparing for an emergency in your business?
¾¾ How will the business function if something happens to one of the key
members of the management team?
3. Business Policies and Procedures (Specific Student Clinic Example)
¾¾ Standard clinic operations
¾¾ Personnel roles and responsibilities
¾¾ Fee structure
¾¾ Scheduling
ŠŠ Service Capacity
ŠŠ Scheduling in Advance
ŠŠ Walk-ins
ŠŠ Cancellation Policy
ŠŠ Late arrival policy
¾¾ Intake and Documentation
¾¾ Discharge and Documentation
¾¾ Staffing
¾¾ Training/Orientation
Business Plan Model
18 ꟷ Business Plan Model
4. Marketing Strategy
What advertising and promotion will be used to increase sales/awareness?
5. Performance Standards
What performance standards will be used to monitor this enterprise or
business unit?
What procedures will be used to monitor performance?
Who is responsible for monitoring performance?
What industry benchmarks will be used to assess performance?
6. Monitoring
What tools will be used to monitor outcomes?
Who and how will changes necessary for business success be decided and
implemented?
Student Clinic Handbook
Student Clinic Handbook ꟷ 19
The intention of creating a student clinic is to develop effective opportunities for
students to grow professionally, as well as academically, and optimally prepare them
for working in the community. Learning goals are closely aligned with expectations
during external clinical internships. By providing a clinical experience within an
academic program, there is greater influence from faculty and mentors to support
student growth earlier in their curriculum. Guiding the students to develop the Core
Values as outlined by the APTA is a primary goal. See Index - WCC Draft Student
Clinic Handbook
The Student Clinic Handbook will:
Define roles and responsibilities
¾¾ Mentor to Student
¾¾ Student to Student support while providing treatment	
¾¾ Clinic Administrator
¾¾ Identified Faculty/ ACCE/Program Coordinator
Set forth scope of treatment techniques and activities
Determine Daily Routine
Review Student Clinic Assessment and Outcomes
¾¾ Perform monthly to allow for continuous updating of program
objectives and implementation (See Index - specific surveys)
ŠŠ Patient satisfaction survey
ŠŠ Student Feedback survey
ŠŠ Mentor feedback survey
¾¾ Statistics Tracking - Essential for continuing support from institution
and local volunteer recruitment.
Glossary of Terms
20 ꟷ Glossary of Terms
ACCE: Academic Coordinator of Clinical Education – Establishes expected
competencies and monitors student performance in clinical settings, gathers
contracts with outside facilities who accept students for clinical internships,
maintains communication with clinical sites and students
APTA: American Physical Therapy Association – Professional association which
establishes standards for care and conduct among PT’s and PTA’s
CLINICAL INSTRUCTOR: A person who is responsible for the direct one-on-
one instruction and supervision of the Physical Therapist Assistant Student
(“Student”.) This person can either be a PT or a PTA. The instruction customarily
takes place at the Clinical Instructor’s work site/clinic.
DSHS: Department of Social and Health Services - State government agency that
supports community members to find and receive resources to improve their
health and safety
EMR: Electronic Medical Records – computer software which documents patient
information, treatment interventions and assessment tools; HIPAA secured
HIPAA: Health Insurance Portability and Accountability Act – Protects patient
privacy by securing access to sensitive health information limited to treating
providers and family members who are explicitly designated to receive health
information
HPEC: WCC’s Health Professions Education Center
INSTITUTION: A public, private or a community/technical college.
MA: Medical Assistant – Healthcare provider who performs intake procedures as
well as patient care such as taking vital signs and other basic tests
MENTOR – A person who is responsible for the direct instruction and supervision
of the Physical Therapist Assistant Student (“Student”) in the clinical education
setting taking place at the institution’s place of instruction, following the
institution’s educational programming. This person can either be a PT or a PTA.
PATIENT: For the purpose of this document, Patients of the PTA Student Clinic are
as follows: A member of the underserved population as defined by those with no
insurance or who have exhausted their insurance benefits. Patients who present
with new injuries, or who are enrolled in an institution’s sports program. No one will
be refused service for lack of ability to pay.
PT: Physical Therapist – Performs initial evaluations, treatments, supervises
PTAs and students in observing and implementing patient treatments. Ultimately
responsible for patient
Getting Started ꟷ 21
PTA: Physical Therapist Assistant – Performs follow-up treatments under the
supervision of a PT, supervises and guides students in observing and implementing
patient treatments
STUDENT: Institution’s Physical Therapist Assistant Student
WCC: Whatcom Community College
Glossary of Terms ꟷ 21
Business Plan
The PTA Student Clinic @Whatcom Community College
475 Stuart Rd., Bellingham, WA 98226
360.383.3258
MARGARET ANDERSON, BS, MEd, Physical Therapist Assistant Program Coordinator
JILL LUDLOW, PTA, Academic Coordinator of Clinical Education, Physical Therapist Assistant Program
MEGAN THOMAS, PTA, CWcHP, Research
CINDY BURMAN-WOODS, Workforce Special Projects Director
JARRETT MARTIN, Graphic Designer
MARLA BRONSTEIN, Editor
22 ꟷ Index
Table of Contents
Executive Summary....................................................................... 1
Mission/Vision Statement and Goals ............................................. 3
Mission/Vision Statement
Goals and Objectives
Keys to Success
Company Summary ....................................................................... 4
Company Background
Resources, Facilities and Equipment
Management and Organization
Ownership Structure
Social Responsibility
Internal Analysis
Products and/or Services............................................................... 6
Market Assessment ....................................................................... 7
Examining the General Market
Customer Analysis
Strategic Implementation ............................................................... 9
Student Clinic Policies and Procedures ......................................... 9
Resource Needs.......................................................................... 11
Risk Management/Liability Concerns........................................... 13
Marketing Strategy....................................................................... 14
Monitoring.................................................................................... 15
Expected Outcomes ..........................................................................15
Monitoring .........................................................................................15
Index ꟷ 23
Page 1 of 16
Physical Therapist Assistant Student Clinic
Business Plan
Executive Summary
Mission/Vision Statement
Mission: To provide quality education and experience to Physical Therapist Assistant
(“PTA”) students while providing quality patient services in an affordable setting.
Vision: The intention of creating a Student Clinic is to provide an opportunity for PTA
students to grow professionally, as well as academically, while providing low-cost
treatment and services to benefit underserved and/or underinsured community
members.
Organization Summary
The PTA Student Clinic (“Clinic”) will provide an on-campus, educational opportunity for
the students in the Physical Therapist Assistant program at Whatcom Community
College (“WCC”). The clinic will allow students to develop their clinical skills and
professional qualities, while also providing services to low-income and under-served
communities in Whatcom County. Clinic will serve as an extension of clinical internships
and offers an alternative setting for therapists interested in providing mentorships to
students.
Products/Services
Clinic will provide an opportunity for patients to receive physical therapy services
performed by supervising Physical Therapists, Physical Therapist Assistants, and
Physical Therapist Assistant Students. The products generated include health
promotion for the community patients and education enhancement for the students.
Market Assessment
There are currently no student clinics in Whatcom County for either PT or PTA
programs. The nearest student clinic is University of Puget Sound for PT students only.
Local industry members support the implementation of the Student Clinic and have
determined there is no competition between the Student Clinic and established physical
therapy businesses based on the proposed business model. Services of the clinic will
be available to the underserved population as defined by those with no insurance or
those who have exhausted their insurance benefits. The Clinic services will not be
available to treat new injuries, or for students enrolled in an institution’s sports program
so as to avoid conflict with currently available services.
24 ꟷ Index
Page 2 of 16
Strategic Implementation
By the second and third quarters of WCC’s five quarter PTA program students will have
received enough information to fully participate in the Student Clinic as part of their lab
requirement, allowing them the opportunity to act as Reporter, Interpreter, Manager and
Student Therapy Assistant, as fully defined in the Student Handbook. Students will be
closely supervised by a licensed Physical Therapist and Physical Therapist Assistant.
Providing services to an otherwise underserved population will enable the students to
obtain additional skills and bring these skills to their clinical experience. Clinicians from
the community will have the opportunity to participate and partner in an important part
of the PTA student education.
Expected Outcomes
Expected outcomes include an increase in student learning and performance, both
clinically and professionally, and an increase in student confidence when performing
patient care. We expect an increase in health benefits to community patients who
participate in Clinic services. Daily feedback reports from students and mentors will be
completed, and weekly statistics will be kept and reviewed monthly in order to inform
the program for continuous improvement.
Index ꟷ 25
Page 3 of 16
Mission/Vision Statement and Goals
Mission/Vision Statement
Mission: To provide quality education and experience to Physical Therapist Assistant
(PTA) students while providing quality patient services in an affordable setting.
Vision: Whatcom Community College has determined there is a need for a Physical
Therapy Assistant Student Clinic. The intention of creating a clinic is to develop
effective opportunities for PTA students to grow professionally, as well as academically,
and optimally prepare them for working in the community. The Student Clinic will
provide an opportunity for PTA students to be mentored while providing low-cost
treatment and services to underserved and/or underinsured community members.
Faculty and volunteers from the physical therapy community will provide positive
mentorship to support students in expanding their knowledge and confidence with
patient interactions. By providing a clinical experience within an academic program,
there is greater opportunity for influence from faculty and mentors to support student
growth earlier in their curriculum.
Goals and Objectives
The Student Clinic intends to achieve financial sustainability by maintaining low
overhead costs and utilizing income from donations to support revolving expenses. The
Student Clinic will partner with current practicing PTs and PTAs as leveraged resources
from community businesses to provide evaluations, mentorship and support to promote
professionalism and enhance knowledge. Local community members who qualify for
services will utilize the Student Clinic for accessible physical therapy services when
they may be unable to obtain services otherwise. Milestones such as an increase in
applicants to the PTA Program, as students seek this unique patient care experience
over other programs, a full patient load and an increase in measurable outcome scores
for student achievement will indicate growth and success.
Keys to Success
For optimal success of the Student Clinic, community members will consistently fill the
available treatment times during both Spring and Summer quarters and operate at a
break-even (self-sustaining). Students will work with supervising therapists and mentors
to observe and implement physical therapy treatments, and will portray professional
behavior while integrating didactic curriculum into the practical clinic setting. For long
term success, the clinic requires continually rotating volunteers to support initial
evaluation and re-assessments every 5th visit, in order to maintain congruency with
Washington State RCW 18.74.170, Section 2(a).
26 ꟷ Index
Page 4 of 16
Company Summary
Company Background
The PTA Student Clinic functions within the non-profit academic institution, Whatcom
Community College, and is beholden to those stakeholders and administrators.
Whatcom Community College is accredited by the Northwest Commission on Colleges
and Universities.
The Student Clinic will be managed by the WCC Physical Therapy Assistant
department, currently led by PTA Program Coordinator Margaret Anderson. The
Student Clinic will provide outpatient physical therapy services, performed by PTA
students under the supervision of licensed PTAs and PTs. The treatment services will
be provided to benefit the patient base consisting of community members as defined in
the Glossary. The Student Clinic will not accept patients for services who present with
new injuries or who may be enrolled in their institution's sports programs.
The collaboration in the development of this business plan included Margaret
Anderson, PTA Program Coordinator; Jill Ludlow, PTA Program Academic Coordinator
of Clinical Education; Cindy Burman-Woods, Health Programs Special Project Director;
and Megan Thomas, Consultant. Gathering research from previously established
student clinics across the United States was essential to the development of this
business plan, followed by connecting with administrators and industry professionals to
provide their input.
Resources, Facilities and Equipment
Services are produced in tandem with volunteer and faculty physical therapists
performing evaluations, and with PTA students participating in implementing
treatments. Services are provided through a combination of manual therapy
techniques, patient education and physical assessments.
Space and equipment resources are already established in the existing lab for PTA
students in WCC’s Health Professions Education Center (HPEC) building. Human
resources in terms of staffing include HPEC’s Program Assistant, current PTA faculty,
PTA Clinic Administrator, volunteer PT/PTA supervisors/mentors, and PTA students.
Fees provided by Student Lab fees, community patients and donations from local
businesses who seek to support the Student Clinic will contribute to revolving
expenses.
WCC provides the space, equipment, faculty and students. Volunteer Mentors will be
recruited through community outreach.
WCC faculty are compensated by standard negotiated contract salary agreements.
Volunteer Mentors will receive a certificate of participation at the end of each quarter.
Local businesses providing support and/or donations to the program will receive a
certificate and/or plaque to be displayed in their business office and at the Student
Clinic to indicate support.
Index ꟷ 27
Page 5 of 16
Management and Organization
The management team includes a Clinic Administrator to assume administrative
responsibility of the Student Clinic. The PTA Program Coordinator and Academic
Coordinator of Clinical Education (“ACCE”) will be available for supervisory needs as
well as decision making regarding changes to the format, policies or procedures of the
Student Clinic. The Clinic Administrator will maintain management of daily Student
Clinic activities which include intake of patients, communicating with students,
scheduling appointments, monitoring supplies, taking payments for appointments and
communication with PTA Program Coordinator. Any changes to Student Clinic functions
may be discussed and determined by Program Coordinator and ACCE.
Lines of Authority are as such: Student → Mentor → ACCE /or Program Coordinator
→Dean for Workforce Education → Vice Presidents for Instruction and Administration→
President.
All staff and faculty salaries are determined by WCC Human Resources in conjunction
with negotiated contracts and/or WCC administration.
Ownership Structure
As noted above, the PTA Student Clinic functions within the non-profit academic
institution, Whatcom Community College, and is beholden to those stakeholders and
administrators. There are no specific owners of the Student Clinic, as it is connected
and a part of an academic program. As an educational focused entity, CAPTE
(Commission on Accreditation in Physical Therapy Education) inspects and evaluates
the PTA program every 5 to 10 years and will assess the clinic from the perspective of
its success as a clinical component of the academic program. WCC will assess the
clinic’s viability as a program of the college.
Social Responsibility
Environmental practices and safe equipment handling will be followed according to the
policies and procedures outlined by Whatcom Community College. During Mentor
training, policies regarding hazardous materials and equipment operation will be
addressed to ensure the safety of all participants.
Internal Analysis
The primary strength of this Student Clinic is the unique educational opportunity being
provided to the students, who will gain exposure to direct patient care and integrate
didactic curriculum into practical treatment interventions, while being guided and
supported by local therapists. The primary weaknesses of the Student Clinic include
limited financial support, which is contingent upon donations and participation in the
Student Clinic by community members, and potential limitations of available volunteers
to provide mentorship and supervision.
Additional weaknesses may include the undetermined impact of a lack of clinic
schedule continuity (only offered initially two quarters per year) and unpredictable
28 ꟷ Index
Page 6 of 16
workforce needs for PTAs in the region, should local demand decline in coming years
and impact enrollments.
Products and/or Services
The Student Clinic will provide outpatient physical therapy services, including, but not
limited to: manual therapy techniques, therapeutic exercises, posture and body
mechanics training, use of therapeutic modalities (i.e. ultrasound, traction) and
symptom management techniques. The PTA Student Clinic is unique in that PTA
students will be provided opportunities to implement a portion of the treatments, under
the supervision of a licensed PT or PTA. Underserved and underinsured community
members will gain access to physical therapy services, where they otherwise have
limited or no access to such services.
The Student Clinic produces a differentiated product, as many other companies provide
physical therapy services, however this Student Clinic provides services to community
members who are unable to access services at other businesses due to a variety of
factors including exhausted benefits. The significant price reduction in physical therapy
services as compared with a for-profit clinic allows for the same services to be provided
by the student clinic at a reduced rate, due to low overhead and utilizing skills of
student PTAs to implement aspects of treatment. There are approximately a dozen
other community college based student PTA clinics currently functioning across the
United States. The nearest student clinic to WCC is part of University of Puget Sound’s
Doctor of Physical Therapy Program in Tacoma, WA, 128 miles away, which is
exclusively for student Physical Therapists.
Index ꟷ 29
Page 7 of 16
Market Assessment
Examining the General Market
The primary customer base targeted for the Student Clinic is one that is currently
unable to access physical therapy services due to a lack of insurance, exhaustion of
current insurance benefits or insurance that is not accepted at many established
business locations. Based on discussion with local physical therapy business members,
the customer base this Student Clinic is seeking is not desired due to reduced, or lack
of, reimbursement.
The PTA Student Clinic may be a positive drawing factor in a future student choosing
the program at WCC over another institution.
The Student Clinic will promote health and education in the local community to
members who do not otherwise have access to standard physical therapy services.
Local businesses will have the opportunity to refer patients who they are unable to
treat, or who are undesired to be treated, and simultaneously support the education of
PTA students.
There are no comparable businesses in northwest Washington, and the customer base
of the PTA Student Clinic is unique. There is no expectation that local businesses would
claim that patients who choose to take advantage of the low-cost student PTA clinic
would otherwise be able to utilize their services. The nearest community college PTA
program is 86 miles away at Lake Washington Institute of Technology, which does not
have a student clinic, therefore there is no direct threat of another student clinic
competing with this business.
Anticipated trends include having the same patient population attending treatment
sessions weekly, or every other week, for the duration of Winter and Spring quarters.
Some community patients may continue to be treated in the following academic year
with a new cohort. There may be some inconsistency in attendance due to the target
population's anticipated challenges with transportation, time management, or child care
concerns and the lack of continuity of the clinic offering services throughout the year.
The primary legal issue faced by the PTA Student Clinic is ensuring that initial
evaluations are performed by a licensed physical therapist, and follow up treatments
are supervised by a licensed physical therapist or physical therapist assistant, with the
appropriate ratio of students to licensed staff, as per Washington State Law RCW
18.74.180, Section 3(c) (i) “The physical therapist may supervise a total of two assistive
personnel at any one time.” and (ii): “In addition to the two assistive personnel
authorized in (c)(i) of this subsection, the physical therapist may supervise a total of two
persons who are pursuing a course of study leading to a degree as a physical therapist
or a physical therapist assistant.”
30 ꟷ Index
Page 8 of 16
Customer Analysis
Target customers include community members from Whatcom County who are not
currently insured, have exhausted eligible insurance benefits or who have been denied
access to treatment by local businesses. Physical therapy services address movement
dysfunctions, pain due to injuries which can lead to loss of work or ability to perform
activities of daily living, and educate the community on how to live with, and manage
chronic pain or disabilities. Target customers are limited in access to such services,
therefore the Student Clinic is solving a major barrier in their ability to benefit from
these services, which may improve their quality of life, ability to work, or care for their
children or other family members.
When a customer receiving physical therapy services acknowledges improvement in
their condition, they are very likely to continue participating in their treatment. When
community patients receive enough treatment to resolve their impairment, they will
cease to require our services and will not be appropriate to be retained as patients.
Customer retention is likely to be high if they are benefiting from the Student Clinic
services. The costs associated with customer support primarily include the salary of the
Student Clinic Administrator and associated faculty, with a small amount of resources
used for supplies and equipment.
There are currently no student clinics in Whatcom County for either PT or PTA
programs. The nearest student clinic is University of Puget Sound for PT students only.
Local industry members support the implantation of the Student Clinic and have
determined there is no competition between the Student Clinic and established physical
therapy businesses. Services of the Student Clinic will be available to the underserved
population as defined by those with no insurance or who may have exhausted their
insurance benefits. The Student Clinic services will not be available to treat new
injuries, or for students enrolled in an institution's sports program.
Index ꟷ 31
Page 9 of 16
Strategic Implementation
Production
The Student Clinic has a competitive advantage by providing affordable physical
therapy services to people who do not otherwise have access to such services.
Technology such as Electronic Medical Records (EMR) will be used to document each
treatment and assist with scheduling, as well as review of documentation by
supervising therapists.
Student Clinic Policies and Procedures
Standard Student Clinic Operations
Student Clinic Schedule
 First year of operation, Student Clinic will run Spring and Summer
Quarters, 2017, and students participating will be 1st year students. They
will have completed enough coursework to begin limited treatment
interventions. After that, Student Clinic will operate one day a week for
Winter and Spring Quarters.
Scheduling Appointments
 Appointments will be made via a direct phone number for scheduling that
includes an answering system that will be monitored by the Clinic
Administrator.
 Patients will be seen for one hour appointments from 1 p.m. until 4 p.m.
 There will be expected variation due to students and supervising PTs and
PTAs availability, as well as patients not showing up for their
appointments, not returning after evaluation or not fulfilling complete cycle
of visits.
 Appointment Scheduling Options - See Index - Patient Attendance Policy
 1 patient per hour per 4 students per team
 Scheduling in advance - allows for better planning of staffing
 Reminder calls will be made on the business day prior to
appointment.
 Walk-in appointments as available on first come, first served.
 Cancellation Policy See Index - Patient Attendance Policy
 Late arrival policy See Index - Patient Attendance Policy
Fees for Service – Pilot Year
 Pay in Advance- $15 for three appointments, $20 for five. Not
Refundable.
 Pay as You Go- $5.00 per appointment
Volunteer Mentors (Physical Therapists and Physical Therapist Assistants)
 Training/orientation
 PT/PTA volunteers must complete training to prepare and
understand expectations and responsibilities of being a mentor.
 Volunteer PTs and PTAs must have individual malpractice
insurance coverage.
32 ꟷ Index
Page 10 of 16
Students providing non-treatment roles and observing
 Modified Reporter, Interpreter, Manager, Educator (RIME) framework for
development of medical professionals See Index - Student Handbook for
clarification
Clinic Administrator Job Description and contract- See Index
Consent
 All staff and volunteers must sign consent to participate in student clinic
which includes behavior and mentorship expectations, parameters for
excusal of participation.
Student Handbook – See Index
 Student orientation/training
 Roles and Responsibilities
 Scope of Treatment
 Student Daily Routine
 Outcome Measurements
 Statistics Tracking
 Code of Conduct
 Disciplinary Actions for violations of Code of Conduct
 Behavioral expectations (professional attire, behavior, arrive at
determined time, respect for socioeconomic factions, ethical standards,
comply with letter and spirit of the law, report inappropriate/non-compliant
actions to supervisor)
 How to find a replacement in case of absence (applies to students and
mentors)
 Lines of communication: Who to report to for questions
 Direct supervisor (PT or PTA)
 Identified faculty/Program Director
 Program Director or ACCE
 How and where to report child, domestic or elder abuse
 Responsibilities during treatment
Documentation training - EMR vs. paper
 Supervising PT/PTA to review notes prior to next treatment
 Forms (All samples attached at index)
 Patient intake/registration
 Contact info, demographics, emergency contact
 Consent to Treatment-Adult/ Consent to Treatment-
Minors/Waivers/HIPAA
 Medical History/ Wellness goals
 Treatment Log (via EMR)
 Surveys
 Patient Satisfaction Surveys
 Student Surveys
 Faculty/Mentor Surveys
 Patient Evaluations
Completed by faculty members or volunteer mentors
Index ꟷ 33
Page 11 of 16
 Collaboration with Doctor of Physical Therapy (DPT) programs in regional
areas.
 Washington State is a direct access state that allows the
patient to self-refer for physical therapy services and does not
require a prescription from a medical provider.
 A patient’s 5th visit re-evaluation is required regardless of
insurance coverage, per Washington State law RCW
18.74.170, Section 2(a)
Intake and Documentation
 PTA students initially process intake forms
 PT evaluates patient; from there student follows treatment plan under
supervision of PT or PTA
 Student clinic can utilize EMR vs. paper charts depending on Student
Clinic’s ability to access EMR
Discharges
Patients will be discharged when goals are met or if patient is not benefitting
from services
 Patients must be reevaluated by PT or discharged at 5th visit.
 Anticipate scarcity of formal discharges due to nature of Student
Clinic only being opened during select quarters
 High potential for chronic conditions being treated, so patients will
most likely return each quarter and not require discharges
 There is no legal obligation to create discharge documentation due
to no insurance or referring Medical Doctor (MD) to inform
Resource Needs
Staffing
Paid position: Clinic Administrator
 Provides support to program by scheduling appointments and handling patient
payments.
 Communicates any changes in Student Clinic needs including supplies and
equipment
 Communicates about Mentor involvement and possible concerns
Unpaid Position(s)
 Mentors: provide supervision and treatment assistance; volunteers Quarterly
contracts acknowledging their commitment to participate as a mentor, which
provides the opportunity to rotate with other therapists and prevent exhaustion
of volunteers
 Student PTAs: assist with treatments as outlined by supervising therapists.
Students expected to participate during 2 quarters of their program.
Contingency
If staff members or students have a personal emergency, or are unable to
uphold their duties in the Student Clinic for a period of time, they must take
action to find a replacement for their position. An alternate will be identified (in
34 ꟷ Index
Page 12 of 16
advance) to take over Clinic Administrator duties if the designated staff member
is unable to fulfill their duties. If either the Program Director or ACCE become
unable to maintain their position, their replacement will be trained in the Student
Clinic functions and needs.
Financial
Financial Requirements
 Tax exempt - Student Clinic is on campus and considered an additional
clinical education experience, it is considered to be part of the institution’s
business.
 Create means to accept donations
 Establish an independent budget code and account through Business
Office that can handle deposits from evaluation and treatment fees, as
well as donations
 Recurring expenses to be paid from this account
 May be the only source of funds to be used for any Student Clinic needs
Expenses
 Salary for Clinic Administrator
 Potential cost to do evaluations of patients if not pro-bono (est. $180-
$200/patient)
 Supplies/Laundry
Income See attached Income/Expense Forecast
 Donations/grants from local clinics/hospitals/foundations or agencies can
add to resources
 Fees for service for evaluations and treatments by those with capacity to
pay. This fee structure will be re-evaluated after the first year. First Year: $5
per appointment (2 unexcused no-shows will result in patient dismissal); $15
for three appointments paid in advance (no-show penalty waived,
appointment fee withdrawn from balance); $20 for five appointments paid in
advance (no-show penalty waived, appointment fee withdrawn from balance)
 Contingency
 Donations to be solicited from local businesses, foundations or
individuals to cover unaccounted for costs and expenses. If the
Student Clinic is unable to be sustained according to this plan,
then further efforts towards fundraising and gaining administrative
support will be sought out to provide greater financial stability.
 Excess funds that are not needed for supplies, may potentially be
used for equipment purchases or continuing education courses or
workshops for faculty participating in the clinic.
Physical needs
Equipment Needs
 HPEC is set up and fully equipped for needs of Student Clinic except for
EMR software, a cloud-based software.
 Lab equipment typically present in PT/PTA lab
Index ꟷ 35
Page 13 of 16
 If needed, Student Clinic will purchase additional equipment with
institution funds depending on available funds/donations
Parking
 Parking spaces are sufficient for patients during Student Clinic
hours. The parking lot is compliant with American Disabilities Act
(ADA).
Emergency Procedures
 In case of emergency, existing procedures for HPEC outlined by WCC are
to be utilized.
Risk Management/Liability Concerns
Responsibility for the patient’s treatment
 As determined by the Physical Therapist Practice Act, the most recent
physical therapist to evaluate or treat a patient is the responsible party in
case of negligence or injury.
Malpractice Insurance
 Supervising Physical Therapist/Physical Therapist Assistants will be
required to pay for and maintain their own individual malpractice
insurance. Most policies cover the policyholder regardless of what venue
they are treating patients in which will be verified for WCC Clinic.
Facility Coverage
 Provide Insurance Policy Rider with Business Plan
 College institutions maintain a standard level of liability insurance in case
of an accidental injury on campus grounds. This covers students, faculty
and visitors. Insurance documentation available through WCC
Administrative Offices.
Student Coverage
 Students are covered by their institution for injury to a patient that occurs
during, or as a result of, clinical experience during treatment
 Students are required to have individual health insurance in case of self-
injury.
HIPAA regulations
 The PTA Student Clinic will uphold all HIPAA policies in order to protect
the privacy of the community patients who under treatment.
 Students are educated in HIPAA regulations
 Patients will sign HIPAA acknowledgement form
36 ꟷ Index
Page 14 of 16
Marketing Strategy
For the launch of the Student Clinic, a Health and Wellness Fair will be planned for the
Winter Quarter 2017 to serve as an opportunity for students to meet and educate local
community members regarding the availability of affordable physical therapy services,
as well as schedule patients for the first week(s) of the Student Clinic in Spring Quarter
2017. Fliers and marketing materials will be distributed in strategic locations to our
target population. Local businesses will be informed of the Student Clinic as a resource
to refer appropriate patient population. Future sessions of the Student Clinic are
anticipated to run Winter and Spring Quarters. Facilities that offer shuttles to transport
potential patients will also be contacted. Possible other means of marketing include use
of social media, public service announcements, flyers and press releases.
Index ꟷ 37
Page 15 of 16
Monitoring
Expected Outcomes
Evaluations and surveys are established to assess performance of the overall Student
Clinic, student performance, Mentor performance and patient satisfaction. Feedback
will inform continuous improvement of the clinic’s processes, services, student
experience and operations. See forms in the Index.
Monitoring
 Utilization of evaluations and surveys will monitor performance and any changes
required will be implemented by the ACCE and/or Program Coordinator.
 Student clinical assessments, which are consistent with established clinical
guidelines, will be used to ensure students are progressing professionally and
academically.
 Reviews for Mentors are completed by students and will be reviewed by
Program Coordinator and ACCE.
38 ꟷ Index
Page 16 of 16
Income and Expense Fall 2016 Winter 2017 Spring 2017 Summer 2017 Annual NOTES
Income
Income based on academic quarter with
a total of 10 weeks of service
Week 1- clinic open / client fees 90.00$ 90.00$ 180.00$
Week 2- clinic open / client fees 90.00$ 90.00$ 180.00$ Fee $ per appointment $5.00
Week 3- clinic open / client fees 90.00$ 90.00$ 180.00$ Appointments per day 18
Week 4- clinic open / client fees 90.00$ 90.00$ 180.00$ Clients may be paying a reduced
Week 5- clinic open / client fees 90.00$ 90.00$ 180.00$ rate, based on $15 for 3 visits
Week 6- clinic open / client fees 90.00$ 90.00$ 180.00$ or $20 for 5 visits, paid in advance.
Week 7- clinic open / client fees 90.00$ 90.00$ 180.00$
Week 8- clinic open / client fees 90.00$ 90.00$ 180.00$
Week 9- clinic open / client fees 90.00$ n/a 90.00$ Summer is only 8 weeks
Week 10- clinic open / client fees 90.00$ n/a 90.00$
TOTAL CLIENT FEE INCOME 900.00$ 720.00$ 1,620.00$ Income from appointment fees
% of clients show and pay 85% 85% 85% estimated client show rate
Income based upon % 765.00$ 612.00$ 1,377.00$ Appointment fees less 15% no show
Income from PTA Department
and other sources
$108.75 per unit tuition cost per WCC’s 
website
PTA program adjunct instructor 2,850.00$ 2,285.00$ 5,135.00$ Foundation or Grant Funds
2 Units of lab fee per student (24) 600.00$ 600.00$ 1,200.00$ $25 lab fee per student
Other Sources 3,615.00$ 3,615.00$ Foundation or Grant Funds
TOTAL INCOME 3,615.00$ 4,215.00$ 3,650.00$ 11,480.00$
Student lab fees, 85% client fees,
program budget
Expenses
Clinic Administrator ($12/hr – 5 
hours week, salary and benefits) 315.00$ 660.00$ 500.00$ 1,475.00$
Health Fair-marketing and supplies 300.00$ 300.00$
supplies 150.00$ 150.00$ 300.00$
gel 100.00$ 80.00$ 180.00$
Thera bands 400.00$ 300.00$ 700.00$
laundry 100.00$ 80.00$ 180.00$
software (purchased once) 3,000.00$ 3,000.00$ EMR software estimate
adjunct faculty salary and benefits 2,850.00$ 2,285.00$ 5,135.00$ May require 1 adjunct faculty
TOTAL EXPENSES 3,615.00$ 4,260.00$ 3,395.00$ 11,270.00$
NET -$ (45.00)$ 255.00$ 210.00$
PILOT YEAR MAY HAVE
REDUCED INCOME AS THE
STUDENT CLINIC GEARS UP
FOR FULL OPERATION AND
COMMUNITY AWARENESS
BUILDS
Index ꟷ 39
 
Physical Therapist Assistant Student Clinic  
Student/Mentor Handbook 
Clinic Policies and Procedures 
This document has not yet received final approval from AAG  
● 1. Roles and Responsibilities 
o Clinic Administrator 
▪ Schedules appointments by phone and in person 
▪ Time of appointment 
▪ Gives directions to clinic, and room number to report to 
▪ Request they arrive 15 minutes early to fill out paperwork 
▪ Collects payment for appointment $5.00, per treatment, or $20 for 
five treatments paid in advance, cash or checks accepted. 
▪ Communicates scheduling changes to students/Mentors 
o Identified Faculty and ACCE/Program Coordinator 
▪ Communicate any changes in clinic needs including supplies 
and equipment  
▪ Communicate regarding student progress or concerns 
▪ Communicate about Mentor involvement and possible 
concerns 
▪ Faculty to review student’s Daily Self­Assessment to provide 
feedback and planning for next treatment 
▪ Once per month hold a large group mentoring session 
o Student  
▪ Students are required to be on time to each clinic session and to 
dress professionally for Student Clinic. (see pg 47 of the PTA 
Program Student Handbook) 
▪  Attempts will be made to fill all treatment appointment times. If 
either of the treatment appointment times assigned to a student is 
unfilled or cancelled, he/she will be assigned duties by the 
instructor. 
▪ Appointment Reminder Calls 
● On the Thursday before clinic, the student will receive the 
names and phone numbers of the clients for that week to 
confirm. Student will inform Clinic Administrator of 
cancellations. 
● Each Student Physical Therapist Assistant will give his/her 
clients a reminder call of the upcoming appointment. This 
message must include: 
o Time of appointment 
o Directions to clinic, and room number to report to 
o Request they arrive 15 minutes early to fill out 
paperwork 
PAGE 1 OF 4 
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40 ꟷ Index
 
o Reminder that payment for  treatment is paid in 
advance, cash or checks accepted. 
● Check and initial confirm box after call 
▪ Modified RIME system: ​R​eporter, ​I​nterpreter, ​M​anager, 
E​ducator, will identify the role of each student in treatment 
group.  
● Reporter​: Gather and communicate clinical information 
on patient; Distinguish important information from 
unimportant information; Communicate relevant 
subjective information; Identify opportunities for data 
collection 
● Interpreter​: Identify potential problems or challenges in 
treatment; offer possible solutions to identified 
problems; develop support for individual treatment 
interventions 
● Manager​: Monitor treatment time during each 
intervention; Communicate with Identified 
Faculty/Clinic Adminstrator regarding supplies or 
equipment needs; Document objective data measures; 
Determine questions to ask Mentor regarding treatment 
interventions or diagnosis 
● Treatment​: Perform treatment intervention as outlined 
by supervising physical therapist; Monitor patient’s 
response to treatment; Communicate objective data 
measures to Manager for documentation 
● Educator​: Mentor serves this role to provide clinical 
problem solving, critical thinking and treatment 
strategies 
o Mentor 
▪ Support critical thinking and clinical problem solving pre­ and 
post­treatment 
▪ Demonstrate and integrate therapeutic techniques 
▪ Teach students how to be a good caregiver 
▪ Promote effective communication techniques 
▪ Model and encourage professional behavior and positive 
interactions with patients 
o Limits on Physical Therapy Practice 
▪ The student clinic is legally required to refuse service to anyone 
with a communicable disease or under the influence of an 
intoxicant. 
2 
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Index ꟷ 41
▪ A WCC student athlete enrolled in the institution’s sports program 
is not eligible for treatment. 
▪ A Patient who present with a new injury is not eligible for 
treatment unless referred by their PT. 
o Noise levels 
▪ During intake interview keep voices low to protect your Patient’s 
privacy while going over the health intake form. 
● 2. Scope of Treatment may include: 
o Body mechanics training 
o Therapeutic exercise  
o Modalities 
o Balance training 
o Patient Education 
o Any treatment deemed necessary by PT 
o Patient referrals 
▪ Identify patients who may benefit from other services such as 
CareNav, support groups or other community services 
▪ Discuss appropriateness of referrals with supervising 
therapist/mentor 
● 3. Student Daily Routine 
o PT evaluation  
▪ Greet the patient and escort to treatment area 
▪ Introduce all members of treating team (RIME) 
▪ Gather equipment needed for the PT 
▪ Document relevant information from the evaluation into EMR 
▪ PT to review documention at end of evaluation. 
o Daily Treatment 
▪ Review of patient chart for 30 minutes prior to clinic opening 
▪ Prepare treatment area 
▪ Record Subjective information on chart. Review goals of treatment 
Note any possible changes to patients current level of function. 
Consult with Mentor if you have any questions.  
o Treatment (45 minutes)  
▪ Wash your hands. 
▪ If you leave a treatment area announce your presence to your 
patient before you enter the area and only enter after the client 
consents. 
▪ You may use treatment techniques learned in 1​st​
 through 3​rd 
quarter. 
▪ You must complete the treatment in the time allotted.  
▪ Wash your hands after the treatment  
3 
DRAFT
o
DRAFT
or
DRAFT
r
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.
e
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vi
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u
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up
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pp
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ou
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up
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ps
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t/
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to
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or
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v
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al
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lu
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ua
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at
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ti
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io
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on
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▪
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▪
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DRAFTuc
DRAFTce
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DRAFTrs
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DRAFTof
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DRAFTre
DRAFTea
DRAFTat
DRAFTti
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▪
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DRAFTGa
DRAFTat
DRAFTth
DRAFThe
DRAFTer
DRAFTr e
DRAFTeq
DRAFTqu
DRAFTui
DRAFTip
DRAFTpm
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DRAFTen
DRAFTnt
DRAFTt n
DRAFTne
DRAFTee
DRAFTed
DRAFTde
DRAFTed
DRAFTd f
DRAFTf
▪
DRAFT▪ D
DRAFTDo
DRAFToc
DRAFTcu
DRAFTum
DRAFTme
DRAFTen
DRAFTnt
DRAFTt r
DRAFTre
DRAFTel
DRAFTle
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DRAFTva
DRAFTan
DRAFTnt
DRAFTt i
DRAFTin
DRAFTnf
DRAFTfo
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DRAFTfof r
DRAFTr
▪
DRAFT▪ P
DRAFTPT
DRAFTT t
DRAFTto
DRAFTo r
DRAFTre
DRAFTev
DRAFTvi
DRAFTie
DRAFTew
DRAFTw d
DRAFTdo
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DRAFTcu
DRAFTum
DRAFTme
DRAFTe
o
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DRAFTDa
DRAFTai
DRAFTil
DRAFTly
DRAFTy T
DRAFTTr
DRAFTre
DRAFTea
DRAFTat
DRAFTtm
DRAFTme
DRAFTen
DRAFTnt
DRAFTt
▪
DRAFT▪ R
DRAFTRe
DRAFTev
DRAFTvi
DRAFTie
DRAFTew
DRAFTw o
DRAFTof
DRAFTf p
DRAFTpa
DRAFTat
DRAFTti
DRAFTi
▪
DRAFT▪ P
DRAFTPr
DRAFTre
DRAFTep
DRAFTpa
DRAFTar
DRAFTre
DRAFTe t
DRAFTtr
DRAFTre
DRAFTe
▪
DRAFT▪ R
DRAFTRe
DRAFTec
DRAFTco
DRAFTor
DRAFTrd
DRAFTd S
DRAFTS
N
DRAFTNo
DRAFTot
DRAFTte
DRAFTe
C
DRAFTCo
DRAFTo
o
DRAFTo T
DRAFTTr
DRAFTre
DRAFTea
DRAFTat
DRAFTtm
DRAFTm
42 ꟷ Index
o Completing the visit 
▪ Walk patient back to the waiting area and give them evaluation 
form to fill out and schedule next visit 
▪ Complete documentation for patient’s treatment. 
▪ Documentation notes are property of Whatcom Community 
College and MAY NOT BE TAKEN OUT OF THE CLINIC 
AREA. 
o Clean treatment area and prepare area for next patient 
o Debriefing period for 30 minutes after clinic closing 
o Fill out Daily Self Assessment Form 
● 4.  Outcome Measurements ­ The goal is to maintain a full appointment 
schedule, allowing students to participate fully each week of the Student Clinic. 
o Perform monthly to allow for continuous updating of student clinic 
outcomes. 
▪ Patient satisfaction surveys 
● Comfort level during treatment 
● Student professionalism rating 
● Effectiveness of treatment ­ Compare to initial 
treatment using visual scale Global Rating of Change 
(GROC) assessment (or other applicable assessment 
rating scale) 
▪ Student Feedback Surveys 
1. Student clinic specific 
2. Mentor specific 
3. Daily Self Assessment Form 
▪ Mentor feedback surveys 
● Interest in future participation with student clinic 
● Assessment of learning goals: were they appropriate 
and practical for students and did the students progress 
in specified areas 
● Student clinic organization: how well did the clinic run 
as compared to a private clinic 
● 5. Statistics Tracking See Index ­ Forms ­ Statistics Tracking 
o Number of student hours in clinic 
o Number of patients per week 
o Evaluations vs. Treatments 
o Mentor Hours PT vs. PTA 
o Average patient satisfaction rating 
o Essential for continuing support from institution and local volunteer 
recruitment 
4 
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CDRAFT
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DRAFT
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DRAFT
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▪
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DRAFTSt
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DRAFTnt
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DRAFTFe
DRAFTee
DRAFTed
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scsc
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N
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N
Index ꟷ 43
PHYSICAL THERAPIST ASSISTANT PROGRAM COMPARISON SUMMARY
Institutions have been consistently running a Student Clinic such as this as early as 1977.
Clinics overall may not run year round due to curriculum and stafÞng constraints.
a. Student Clinic Hours Student Clinics may be considered part of a laboratory class.
Check with your accrediting body to determine rules for clinical and lab hour requirements. The
majority of programs reported running their clinics two days a week for a limited number of
hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are
included in the second and third quarters of the student’s program. Only one clinic has available
treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis.
b. Practical Skills/Patient Care Where the patient pain/injury base varies from Chronic
pain to high trauma, many serve the low income and underinsured population that may also be
low compliance. Even though many appointment times may be available each day, the students
may not see more than one or two patients. Students are expected to help with collecting
patient health histories. Only one clinic allowed students to run the initial patient evaluation, the
others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they
treated pediatric patients. Only one conÞrmed that Neurological patients were seen.
c. PTA Student Clinic Existence There are currently many established PT student clinics,
however it is less common for community college PTA programs. Students and staff from each
program conÞrmed that the educational and empowerment opportunities are priceless. Teaching
students how to have rapport with patients and working side by side with PTs Òhelps to foster
strong, innovative clinical decision making skills.Ó One programÕs students reported that they felt
Òsafe to failÓ in a campus clinic setting.
d. PT/PTA supervision requirements For all but one program initial evaluations were
done by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3. Even thought the PTs
and PTAs are required to carry insurance, the need for concerted Risk Managment was brought
up by a few programs. The cost of additional liability insurance was covered by the institutions.
e. Examples of Business Models Successful, revenue generating examples of business
models vary from charging $50 for Þrst time patients, to free access for low income and
underinsured patient population. Only one program stated they participated in research. The
majority of the institutions already had lab facility and equipment in place. Partnerships and
referrals from the PT community were keys for success.
f. How to Measure Outcomes Student, patient and mentor surveys are used to help
programs develop and measure outcomes for Students, Patients and Mentors.
g. Expected and Unexpected Challenges If the clinic is dependent upon community PTs
and PTAs to step up and volunteer, the task of recruitment is ongoing. For the initial year of the
WCC program, there are plans in place to host a Health Fair in partnership with the other on-
campus health programs prior to the Student Clinic open to spread the word. All Student Clinics
must be sensitive to competition in the industry, and keep communications lines open to make
sure that the clinic is being consistent and mindful of self-referring patients who are or are not
eligible for treatment. Expenses of the clinic should be closely monitored to determine if fees
need to be raised or lowered.
DRAFT
Institutions have been consistently running a Student Clinic such as this as early as 1977.
DRAFT
Institutions have been consistently running a Student Clinic such as this as early as 1977.
Clinics overall may not run year round due to curriculum and stafÞng constraints
DRAFT
Clinics overall may not run year round due to curriculum and stafÞng constraints.
DRAFT
.
Student Clinics may be considered part of a laboratory class.
DRAFT
Student Clinics may be considered part of a laboratory class.
Check with your accrediting body to determine rules for clinical and lab hour requirements. TheDRAFT
Check with your accrediting body to determine rules for clinical and lab hour requirements. The
majority of programs reported running their clinics two days a week for a limited number of
DRAFT
majority of programs reported running their clinics two days a week for a limited number of
hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are
DRAFT
hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are
included in the second and third quarters of the student’s program.
DRAFT
included in the second and third quarters of the student’s program. Only one clinic has available
DRAFT
Only one clinic has available
treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis.
DRAFT
treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis.
Where the patient pain/injury base varies from Chronic
DRAFT
Where the patient pain/injury base varies from Chronic
pain to high trauma, many serve the low income and underinsured population that may also be
DRAFT
pain to high trauma, many serve the low income and underinsured population that may also be
low compliance. Even though many appointment times may be available each day, the students
DRAFT
low compliance. Even though many appointment times may be available each day, the students
may not see more than one or two patients. Students are expected to help with collecting
DRAFT
may not see more than one or two patients. Students are expected to help with collecting
patient health histories. Only one clinic allowed students to run the initial patient evaluation, the
DRAFT
patient health histories. Only one clinic allowed students to run the initial patient evaluation, the
others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they
DRAFT
others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they
treated pediatric patients. Only one conÞrmed that Neurological patients were seen.
DRAFT
treated pediatric patients. Only one conÞrmed that Neurological patients were seen.
c. PTA Student Clinic Existence
DRAFT
c. PTA Student Clinic Existence There are currently many established PT student clinics,
DRAFT
There are currently many established PT student clinics,
however it is less common for community college PTA programs. Students and staff from each
DRAFT
however it is less common for community college PTA programs. Students and staff from each
program conÞrmed that the educational and empowerment opportunities are priceless. Teaching
DRAFT
program conÞrmed that the educational and empowerment opportunities are priceless. Teaching
students how to have rapport with patients and working side by side with PTs Òhelps to foster
DRAFT
students how to have rapport with patients and working side by side with PTs Òhelps to foster
strong, innovative clinical decision making skills
DRAFT
strong, innovative clinical decision making skills.Ó One programÕs students reported that they felt
DRAFT
.Ó One programÕs students reported that they felt
Òsafe to failÓ in a campus clinic setting.
DRAFT
Òsafe to failÓ in a campus clinic setting.
d. PT/PTA supervision requirements
DRAFTd. PT/PTA supervision requirements For all but one program initial evaluations were
DRAFTFor all but one program initial evaluations were
done by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3.
DRAFTdone by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3.
and PTAs are required to carry insurance, the need for concerted Risk Managment was brought
DRAFTand PTAs are required to carry insurance, the need for concerted Risk Managment was brought
up by a few programs. The cost of additional liability insurance was covered by the institutions.
DRAFTup by a few programs. The cost of additional liability insurance was covered by the institutions.
Examples of Business Models
DRAFTExamples of Business Models Successful, revenue generating examples of business
DRAFTSuccessful, revenue generating examples of business
models
DRAFTmodels vary from charging $50 for Þrst time patients, to free access for low income and
DRAFTvary from charging $50 for Þrst time patients, to free access for low income and
underinsured patient population. Only one program stated they participated in research. The
DRAFTunderinsured patient population. Only one program stated they participated in research. The
majority of the institutions already had lab facility and equipment in place. Partnerships and
DRAFTmajority of the institutions already had lab facility and equipment in place. Partnerships and
referrals from the PT community were keys for success.
DRAFTreferrals from the PT community were keys for success.
How to Measure Outcomes
DRAFTHow to Measure Outcomes
programs develop and measure outcomes for Students, Patients and Mentors.
DRAFTprograms develop and measure outcomes for Students, Patients and Mentors.
44 ꟷ Index
Facilities contacted:
Drexel University (DPT)
Sarah Wegner
Assistant Clinical Professor, Coordinator of Experiential Learning
sbw28@drexel.edu
http://drexel.edu/cnhp/practices/11th-street/
Tulsa Community College
Suzanne Reese
Program Director: oversees clinic, no teaching
suzanne.reese@tulsacc.edu
http://ptc.tulsacc.edu/index.html
Univ. of Puget Sound
Ann M Wilson
Clinical Associate Professor and Director of Clinical Education
awilson@pugetsound.edu
http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical-
therapy/our-program/clinical-education/on-site-clinic/
Gateway Community College
Jessica Goodman, Malka Stromer
goodman@gatewaycc.edu, stromer@gatewaycc.edu
http://www.gatewaycc.edu/hug-clinic
Salt Lake Community College
Diana Ploeger
Program Coordinator
diana.ploeger@slcc.edu 
http://www.slcc.edu/ptassistant/
El Paso Community College
Debra L Tomacelli-Brock
Program Coordinator
https://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx
Lake Superior College
Brenda Martin
b.martin@lsc.edu
http://www.lsc.edu/current-students/physical-therapy-clinic/
DRAFT
Clinical Associate Professor and Director of Clinical Education
DRAFT
Clinical Associate Professor and Director of Clinical Education
http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical-
DRAFT
http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical-
DRAFT
therapy/our-program/clinical-education/on-site-clinic/
DRAFT
therapy/our-program/clinical-education/on-site-clinic/
DRAFT
Gateway Community College
DRAFT
Gateway Community College
Jessica Goodman, Malka Stromer
DRAFT
Jessica Goodman, Malka Stromer
goodman@gatewaycc.edu,
DRAFTgoodman@gatewaycc.edu, stromer@gatewaycc.edu
DRAFTstromer@gatewaycc.edu
http://www.gatewaycc.edu/hug-clinic
DRAFThttp://www.gatewaycc.edu/hug-clinic
DRAFTSalt Lake Community College
DRAFTSalt Lake Community College
Diana Ploeger
DRAFTDiana Ploeger
Program Coordinator
DRAFTProgram Coordinator
diana.ploeger@slcc.edu
DRAFTdiana.ploeger@slcc.edu
http://www.slcc.edu/ptassistant/
DRAFThttp://www.slcc.edu/ptassistant/
DRAFTEl Paso Community College
DRAFTEl Paso Community College
Debra L Tomacelli-Brock
DRAFTDebra L Tomacelli-Brock
Program Coordinator
DRAFTProgram Coordinator
https://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx
DRAFThttps://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx
DRAFT
Lake Superior College
DRAFT
Lake Superior College
IndexIndex ꟷꟷ 4545
PTA Student Clinic Focus Group
Date of focus group:
(Materials: pre-or post-survey, sign-up sheet for involvement-work groups, evaluation,
supervision)
Goals:
• To identify challenges in creating and implementing a PTA student clinic from the
industry perspective
• Identify opportunities for industry to participate in the development of the clinic
• Obtain suggestions from industry regarding ways to provide evaluations and supervision
at the clinic
1. What is the first word that comes to your mind when you think of a PTA student clinic?
2. In what ways do you think a PTA student clinic will benefit the healthcare industry and
our community?
3. Who do you envision receiving services at the PTA student clinic?
4. What are 2-3 challenges you anticipate in the implementation of the PTA student
clinic? (Use index cards: take 1 minute to write your answers/thoughts on the index
card)
5. In what ways will a PTA student clinic impact the local industry?
6. What do you like best about the proposed student clinic concept?
7. In what ways could industry be involved in the development of the clinic?
8. What do we need to consider regarding evaluations and supervision at the clinic? (be
prepared to answer to law here, have a copy of the law for handouts)
9. How is your malpractice insurance covered, personally or by your organization? If
personally, would it cover service provided in a student clinic at the college?
10. How can the college attract local PT’s willing to provide their time and mentorship?
(how will this benefit the PT?)
11. What types of risk management issues might we encounter?
12. If you could create the ideal PTA student clinic, what would it look like?
13. Of all the things we discussed this evening, what to you is most important?
14. What are we missing?
DRAFT
work groups, evaluation,
DRAFT
work groups, evaluation,
To identify challenges in creating and implementing a PTA student clinic from theDRAFT
To identify challenges in creating and implementing a PTA student clinic from the
Identify opportunities for industry to participate in the development of the clinic
DRAFT
Identify opportunities for industry to participate in the development of the clinic
Obtain suggestions from industry regarding ways to provide evaluations and supervision
DRAFT
Obtain suggestions from industry regarding ways to provide evaluations and supervision
What is the first word that comes to your mind when you think of a PTA student clinic?
DRAFT
What is the first word that comes to your mind when you think of a PTA student clinic?
DRAFT
what ways do you think a PTA student clinic will benefit the healthcare industry and
DRAFT
what ways do you think a PTA student clinic will benefit the healthcare industry and
Who do you envision receiving services at the PTA student clinic?
DRAFT
Who do you envision receiving services at the PTA student clinic?
What are 2-3 challenges you anticipate in the implementation of the PTA student
DRAFT
What are 2-3 challenges you anticipate in the implementation of the PTA student
(Use index cards: take 1 minute to write your answers/thoughts on the index
DRAFT
(Use index cards: take 1 minute to write your answers/thoughts on the index
In what ways will a PTA student clinic impact the local industry?
DRAFT
In what ways will a PTA student clinic impact the local industry?
What do you like best about the proposed student clinic concept?
DRAFT
What do you like best about the proposed student clinic concept?
In what ways could industry be involved in the development of the clinic?
DRAFTIn what ways could industry be involved in the development of the clinic?
What do we need to consider regarding evaluations and supervision at the clinic?
DRAFTWhat do we need to consider regarding evaluations and supervision at the clinic?
prepared to answer to law here, have a copy of the law for handouts)
DRAFTprepared to answer to law here, have a copy of the law for handouts)
9.
DRAFT9. How is your malpractice insurance covered, personally or by your organization? If
DRAFTHow is your malpractice insurance covered, personally or by your organization? If
personally, would it cover service provided in a student clinic at the college?
DRAFTpersonally, would it cover service provided in a student clinic at the college?
10.
DRAFT10. How can the college attract local PT’s willing to provide their time and mentorship?
DRAFTHow can the college attract local PT’s willing to provide their time and mentorship?
(how will this benefit the PT?)
DRAFT(how will this benefit the PT?)
What types of risk management issues might we encounter?
DRAFTWhat types of risk management issues might we encounter?
46 ꟷ Index
PTA Student Clinic @ Whatcom Community College
Clinic Administrator Job Description and Contract
This document has not yet received final approval from AAG
Qualifications:
● No history of disciplinary actions
● Preferably 2-3 years of Clinical Administration experience
Duties include, and are not limited to:
● Uphold the Mission and Vision of the PTA Student Clinic
● Schedule patient treatments from incoming phone calls
● Maintain a positive and supportive influence in the learning process of PTA students
● Act as a liaison between patients, students, faculty and volunteer mentors
● Monitor and document income from patient evaluations and follow up treatments
● Provide customer service, and administration of other duties as assigned for the
Student Clinic
By signing below, I agree to adhere to the performance expectations listed above.
________________________________________ _______________________
Name Date
PTA Student Clinic @ Whatcom Community College
DRAFT
This document has not yet received final approval from AAG
DRAFT
This document has not yet received final approval from AAG
Preferably 2-3 years of Clinical Administration experience
DRAFT
Preferably 2-3 years of Clinical Administration experience
Uphold the Mission and Vision of the PTA Student Clinic
DRAFT
Uphold the Mission and Vision of the PTA Student Clinic
Schedule patient treatments from incoming phone calls
DRAFT
Schedule patient treatments from incoming phone calls
Maintain a positive and supportive influence in the learning process of PTA students
DRAFT
Maintain a positive and supportive influence in the learning process of PTA students
Act as a liaison between patients, students, faculty and volunteer mentors
DRAFT
Act as a liaison between patients, students, faculty and volunteer mentors
Monitor and document income from patient evaluations and follow up treatments
DRAFT
Monitor and document income from patient evaluations and follow up treatments
Provide customer service, and administration of other duties as assigned for the
DRAFT
Provide customer service, and administration of other duties as assigned for the
By signing below, I agree to adhere to the performance expectations listed above.
DRAFT
By signing below, I agree to adhere to the performance expectations listed above.
________________________________________ _______________________
DRAFT________________________________________ _______________________
Name Date
DRAFTName Date
Forms – 47
Education Questions
This document has not yet received final approval from AAG
Mentor
Do you feel your student has the background to understand what is expected of him/her in this
setting and to perform at a level necessary to meet the expected skills?
What kind of teaching methods seem to work best with this student (demonstration, practice,
research, case studies, observation, other)
What strengths have you observed during this student’s performance?
What areas of performance have you observed that need improvement?
What format have you established for communicating your feedback, expectations, and goals to
your student?
How would you describe your student’s performance so far.
What changes would you like to see in your student’s behavior before this quarter is over?
PTA Student Clinic @ Whatcom Community College
DRAFT
This document has not yet received final approval from AAG
DRAFT
This document has not yet received final approval from AAG
to understand what is expected of him/her in this
DRAFT
to understand what is expected of him/her in this
setting and to perform at a level necessary to meet the expected skills?
DRAFT
setting and to perform at a level necessary to meet the expected skills?
seem to work best with this student (demonstration, practice,
DRAFT
seem to work best with this student (demonstration, practice,
have you observed during this student’s performance?
DRAFT
have you observed during this student’s performance?
What areas of performance have you observed that
DRAFT
What areas of performance have you observed that need improvement
DRAFT
need improvement?
DRAFT
?
What format have you established for
DRAFT
What format have you established for communicating
DRAFT
communicating your feedback, expectations, and goals to
DRAFT
your feedback, expectations, and goals to
How would you describe your student’s
DRAFT
How would you describe your student’s performance
DRAFT
performance so far.
DRAFT
so far.
would you like to see in your student’s behavior before this quarter is over?
DRAFTwould you like to see in your student’s behavior before this quarter is over?
48 – Forms
PTA Student Clinic @ Whatcom Community College
Education Questions
This document has not yet received final approval from AAG
Student
Describe how you have been challenged in this setting.
Describe what you see as your strengths in this setting.
What areas of your performance do you think need improvement?
Describe the most effective constructive feedback you’ve received from your Mentor.
Describe how you have incorporated this constructive feedback into your performance.
How would you summarize your learning experience so far?
What changes would you like to see in this learning environment?
PTA Student Clinic @ Whatcom Community College
DRAFT
This document has not yet received final approval from AAG
DRAFT
This document has not yet received final approval from AAG
improvement
DRAFT
improvement?
DRAFT
?
effective constructive feedback
DRAFT
effective constructive feedback you’ve received from your Mentor.
DRAFT
you’ve received from your Mentor.effective constructive feedback you’ve received from your Mentor.effective constructive feedback
DRAFT
effective constructive feedback you’ve received from your Mentor.effective constructive feedback
have incorporated this constructive feedback
DRAFT
have incorporated this constructive feedback into your performance.
DRAFT
into your performance.have incorporated this constructive feedback into your performance.have incorporated this constructive feedback
DRAFT
have incorporated this constructive feedback into your performance.have incorporated this constructive feedback
your learning experience so far?
DRAFT
your learning experience so far?
would you like to see in this learning environment?
DRAFT
would you like to see in this learning environment?
Forms – 49
PTA Student Clinic @ Whatcom Community College
Consent & Liability Waiver
This document has not yet received final approval from AAG
By initialing the following statements I am acknowledging that I have fully read and understand each statement:
DISCLAIMERS
You are consenting to undergo physical therapy treatment for your condition, including initial evaluation
and limited plan of care. Treatment will be provided by a student in training to become a licensed
physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of
care in: scope of treatment due to students performing treatments, treatment times within traditional
school hours and number of treatment days. __________
You understand that responding to a specific treatment can vary widely from person to person. It is not
always possible to accurately predict your response to a certain therapy modality or procedure. We
cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is
also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions.
Services may include techniques that involve bodily contact, touching and/or direct contact, however
your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged
to discuss them with the supervising physical therapist. __________
You have the right to ask your physical therapist or physical therapist assistant (a licensed professional
or Whatcom Community College PTA program faculty) what type of treatment he or she is planning
based on your history, diagnosis, symptoms and testing results. Treatments may include but are not
limited to therapeutic exercises, massage, functional activities and physical modalities. You may also
discuss the potential risks and benefits of a specific treatment at any time during the treatment. You have
the right to decline any portion of your treatment at any time before or during your treatment session.
__________
CONSENT TO TREATMENT
I consent to evaluation and treatment by the authorized personnel of Whatcom Community College as
may be dictated by prudent medical practice because of my illness, injury, or condition. I understand that
I will receive a portion of my treatment from a student with an educational objective, under the direct
supervision of Whatcom Community College personnel. I understand that information about my case
may be used without personal identifiers for educational purposes. I understand that I may be refused
treatment if I appear obviously intoxicated, under the influence of drugs or the physical therapist deems
my treatment medically unnecessary or outside the scope of this clinic’s practice. I reserve the right to
refuse and withdraw from participation in physical therapy services at any time. This consent is intended
as a waiver of liability of such treatment except for acts of negligence. __________
TREATMENT OF MINORS
PTA Student Clinic @ Whatcom Community College
DRAFT
By initialing the following statements I am acknowledging that I have fully read and understand each statement:
DRAFT
By initialing the following statements I am acknowledging that I have fully read and understand each statement:
You are consenting to undergo physical therapy treatment for your condition, including initial evaluation
DRAFT
You are consenting to undergo physical therapy treatment for your condition, including initial evaluation
and limited plan of care. Treatment will be provided by a student in training to become a licensed
DRAFT
and limited plan of care. Treatment will be provided by a student in training to become a licensed
physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of
DRAFT
physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of
care in: scope of treatment due to students performing treatments, treatment times within traditional
DRAFT
care in: scope of treatment due to students performing treatments, treatment times within traditional
school hours and number of treatment days. __________
DRAFT
school hours and number of treatment days. __________
You understand that responding to a specific treatment can vary widely from person to person. It is not
DRAFT
You understand that responding to a specific treatment can vary widely from person to person. It is not
always possible to accurately predict your response to a certain therapy modality or procedure. We
DRAFT
always possible to accurately predict your response to a certain therapy modality or procedure. We
cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is
DRAFT
cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is
also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions.
DRAFT
also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions.
Services may include techniques that involve bodily contact, touching and/or direct contact, however
DRAFT
Services may include techniques that involve bodily contact, touching and/or direct contact, however
your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged
DRAFT
your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged
to discuss them with the supervising physical therapist. __________
DRAFT
to discuss them with the supervising physical therapist. __________
You have the right to ask your physical therapist or physical therapist assistant (a licensed professional
DRAFT
You have the right to ask your physical therapist or physical therapist assistant (a licensed professional
or Whatcom Community College PTA program faculty) what type of treatment he or she is planning
DRAFTor Whatcom Community College PTA program faculty) what type of treatment he or she is planning
based on your history, diagnosis, symptoms and testing results. Treatments may include but are not
DRAFTbased on your history, diagnosis, symptoms and testing results. Treatments may include but are not
limited to therapeutic exercises, massage, functional activities and physical modalities. You may also
DRAFTlimited to therapeutic exercises, massage, functional activities and physical modalities. You may also
discuss the potential risks and benefits of a specific treatment at any time during the treatment. You have
DRAFTdiscuss the potential risks and benefits of a specific treatment at any time during the treatment. You have
the right to decline any portion of your treatment at any time before or during your treatment session.
DRAFTthe right to decline any portion of your treatment at any time before or during your treatment session.
__________
DRAFT__________
CONSENT TO TREATMENT
DRAFTCONSENT TO TREATMENT
I consent to evaluation and treatment by the authorized personnel of Whatcom Community College as
DRAFTI consent to evaluation and treatment by the authorized personnel of Whatcom Community College as
may be dictated by prudent medical practice because of my illness, injury, or condition. I understand that
DRAFTmay be dictated by prudent medical practice because of my illness, injury, or condition. I understand that
I will receive a portion of my treatment from a student with an educational objective, under the direct
DRAFTI will receive a portion of my treatment from a student with an educational objective, under the direct
supervision of Whatcom Community College personnel. I understand that information about my case
DRAFTsupervision of Whatcom Community College personnel. I understand that information about my case
may be used without personal identifiers for educational purposes. I understand that I may be refused
DRAFT
may be used without personal identifiers for educational purposes. I understand that I may be refused
50 – Forms
I, __________________________________, as a parent or legal guardian of
_________________________________, give consent to services as directed by the Physical Therapist
upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at
all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student
Clinic. __________
NON-DISCRIMINATION: Admission to our clinic is non-discriminatory for services rendered,
regardless of race, color, national origin, disability, economic status or age. All clients who come to our
clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of
1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
WAIVER AND RELEASE
I hereby release, discharge and acquit Whatcom Community College, its agents, representatives,
affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of
action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow
emergency and or medical services, including but not limited to ambulance service, Emergency Medical
Technician, physician or urgent care services. __________
NOTICE OF PRIVACY PRACTICES
I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant
Student Clinic and authorize release of any medical records necessary to facilitate my treatment
process. I have read a Notice of Patient Information Practices from Whatcom Community College
regarding confidentiality and use of my personal health information and understand I may contact the
supervising physical therapist at any time that I have questions. _____
By signing below, I acknowledge and agree to all terms stated above.
Name of Patient (Please print)
Signature of Patient
Signature of Legal Guardian for patient under 18 years old Date
PTA Student Clinic @ Whatcom Community College
DRAFT
upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at
DRAFT
upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at
all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student
DRAFT
all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student
Admission to our clinic is non-discriminatory for services rendered,
DRAFT
Admission to our clinic is non-discriminatory for services rendered,
regardless of race, color, national origin, disability, economic status or age. All clients who come to our
DRAFT
regardless of race, color, national origin, disability, economic status or age. All clients who come to our
clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of
DRAFT
clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of
1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
DRAFT
1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975.
I hereby release, discharge and acquit Whatcom Community College, its agents, representatives,
DRAFT
I hereby release, discharge and acquit Whatcom Community College, its agents, representatives,
affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of
DRAFT
affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of
action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow
DRAFT
action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow
emergency and or medical services, including but not limited to ambulance service, Emergency Medical
DRAFT
emergency and or medical services, including but not limited to ambulance service, Emergency Medical
Technician, physician or urgent care services. __________
DRAFT
Technician, physician or urgent care services. __________
NOTICE OF PRIVACY PRACTICES
DRAFT
NOTICE OF PRIVACY PRACTICES
I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant
DRAFT
I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant
Student Clinic and authorize release of any medical records necessary to facilitate my treatment
DRAFT
Student Clinic and authorize release of any medical records necessary to facilitate my treatment
process. I have read a Notice of Patient Information Practices from Whatcom Community College
DRAFTprocess. I have read a Notice of Patient Information Practices from Whatcom Community College
regarding confidentiality and use of my personal health information and understand I may contact the
DRAFTregarding confidentiality and use of my personal health information and understand I may contact the
supervising physical therapist at any time that I have questions. _____
DRAFTsupervising physical therapist at any time that I have questions. _____
By signing below, I acknowledge and agree to all terms stated above.
DRAFTBy signing below, I acknowledge and agree to all terms stated above.
Name of Patient (Please print)
DRAFTName of Patient (Please print)
Signature of Patient
DRAFTSignature of Patient
Signature of Legal Guardian for patient under 18 years old
DRAFT
Signature of Legal Guardian for patient under 18 years old
DRAFT
DRAFT
DRAFT
Forms – 51
DRAFT
HIPAA Privacy Authorization Form
**Authorization for Use or Disclosure of Protected Health Information
(Required by the Health Insurance Portability and Accountability Act, 45 C.F.R.
Parts 160 and 164)**
**1.
Authorization**

I
authorize
________________________________________
(healthcare
provider)
to
use

and
disclose
the
protected
health
information
described
below
to

______________________________________________
(individual
seeking
the
information).

**2.
Effective
Period**

This
authorization
for
release
of
information
covers
the
period
of
healthcare

from:

a. □ ______________ to ______________.
**OR**
b. □ all past, present, and future periods.
**3.
Extent
of
Authorization**

a.
□
I
authorize
the
release
of
my
complete
health
record
(including
records

relating
to
mental
healthcare,
communicable
diseases,
HIV
or
AIDS,
and
treatment
of

alcohol
or
drug
abuse).


**OR**
b.
□
I
authorize
the
release
of
my
complete
health
record
with
the
exception

of
the
following
information:



□
Mental
health
records




□
Communicable
diseases
(including
HIV
and
AIDS)




□
Alcohol/drug
abuse
treatment



□
Other
(please
specify):
_______________________________________________


52 – Forms
Sheet1
Page1
IncomeandExpenseFall2016Winter2017Spring2017Summer2017AnnualNOTES
Income
Week1-clinicopen/clientfees$90.00$90.00$180.00
Week2-clinicopen/clientfees$90.00$90.00$180.00Fee$perappointment$5.00
Week3-clinicopen/clientfees$90.00$90.00$180.00Appointmentsperday18
Week4-clinicopen/clientfees$90.00$90.00$180.00Clientsmaybepayingareduced
Week5-clinicopen/clientfees$90.00$90.00$180.00rate,basedon$15for3visits
Week6-clinicopen/clientfees$90.00$90.00$180.00or$20for5visits,paidinadvance.
Week7-clinicopen/clientfees$90.00$90.00$180.00
Week8-clinicopen/clientfees$90.00$90.00$180.00
Week9-clinicopen/clientfees$90.00n/a$90.00Summerisonly8weeks
Week10-clinicopen/clientfees$90.00n/a$90.00
TOTALCLIENTFEEINCOME$900.00$720.00$1,620.00Incomefromappointmentfees
%ofclientsshowandpay85%85%85%estimatedclientshowrate
Incomebasedupon%$765.00$612.00$1,377.00Appointmentfeesless15%noshow
PTAprogrambudgetforadjuncts$2,850.00$2,285.00$5,135.00
2Unitsoflabfeeperstudent(24)$600.00$600.00$1,200.00$25labfeeperstudent
OtherSources$3,615.00$3,615.00FoundationorGrantFunds
TOTALINCOME$3,615.00$4,215.00$3,650.00$11,480.00
Expenses
$315.00$660.00$500.00$1,475.00
HealthFair-marketingandsupplies$300.00$300.00
supplies$150.00$150.00$300.00
gel$100.00$80.00$180.00
Therabands$400.00$300.00$700.00
laundry$100.00$80.00$180.00
software(purchasedonce)$3,000.00$3,000.00EMRsoftwareestimate
adjunctfacultysalaryandbenefits$2,850.00$2,285.00$5,135.00Mayrequire1adjunctfaculty
TOTALEXPENSES$3,615.00$4,260.00$3,395.00$11,270.00
NET$-$(45.00)$255.00$210.00
Incomebasedonacademicquarterwith
atotalof10weeksofservice
IncomefromPTADepartmentand
othersources
$108.75perunittuitioncostperWCC’s
website
Studentlabfees,85%clientfees,
programbudget
ClinicAdministrator($12/hr–5
hoursweek,salaryandbenefits)
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DRAFTIncomeandExpense
DRAFTIncomeandExpenseFall2016
DRAFTFall2016
Week1-clinicopen/clientfees
DRAFTWeek1-clinicopen/clientfees
Week2-clinicopen/clientfees
DRAFTWeek2-clinicopen/clientfees
Week3-clinicopen/clientfees
DRAFTWeek3-clinicopen/clientfees
Week4-clinicopen/clientfees
DRAFTWeek4-clinicopen/clientfees
Week5-clinicopen/clientfees
DRAFTWeek5-clinicopen/clientfees
Week6-clinicopen/clientfees
DRAFTWeek6-clinicopen/clientfees
Week7-clinicopen/clientfees
DRAFTWeek7-clinicopen/clientfees$90.00
DRAFT$90.00
Week8-clinicopen/clientfees
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Week8-clinicopen/clientfees$90.00
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$90.00
Week9-clinicopen/clientfees
DRAFT
Week9-clinicopen/clientfees$90.00
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$90.00
$90.00
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$90.00
$900.00
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$900.00
85%
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85%
$765.00
DRAFT
$765.00$612.00
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$612.00
$2,850.00
DRAFT
$2,850.00$2,285.00
DRAFT
$2,285.00
$600.00
DRAFT
$600.00$600.00
DRAFT
$600.00
$3,615.00
DRAFT
$3,615.00
$4,215.00
DRAFT
$4,215.00$3,650.00
DRAFT
$3,650.00$11,480.00
DRAFT
$11,480.00
$500.00
DRAFT
$500.00$1,475.00
DRAFT
$1,475.00
$300.00
DRAFT
$300.00
$150.00
DRAFT
$150.00$300.00
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$300.00
$80.00DRAFT
$80.00$180.00DRAFT
$180.00
$300.00
DRAFT
$300.00$700.00
DRAFT
$700.00
$80.00
DRAFT
$80.00$180.00
DRAFT
$180.00
$3,000.00
DRAFT
$3,000.00
$2,285.00
DRAFT
$2,285.00$5,135.00
DRAFT
$5,135.00
$11,270.00
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$11,270.00
Forms – 53
MENTOR CONFIDENTIALITY AGREEMENT
This document has not yet received final approval from AAG
I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant
(PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby
agree to handle such information in a confidential manner at all times during and after my mentorship and
commit to the following obligations:
A. I will use and disclose confidential health information only in connection with and for the
purpose of performing my identified duties
B. I will request, obtain or communicate confidential health information only as necessary to
perform my identified duties and shall refrain from requesting, obtaining or
communicating more confidential health information than is necessary to accomplish my
identified duties.
C. I will take reasonable care to properly secure confidential health information on my
computer and will take steps to ensure that others cannot view or access such
information. When I am away from my workstation or when my tasks are completed, I
will log off my computer or use a password-protected screensaver in order to prevent
access by unauthorized users.
D. I will not disclose my personal password(s) to anyone without the express written
permission of my department head or record or post it in an accessible location and will
refrain from performing any tasks using another password.
E. I will document all disclosures of confidential health information, including those
authorized by clients of the PTA Student Clinic and any accidental disclosures, in the
appropriate client’s file.
I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor
Confidentiality or HIPAA training when I enter the role of Mentor.
I also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or
violation of any terms of this Agreement up to and including termination of involvement in the PTA Student
Clinic.
Mentor Signature:____________________________________________________________
Mentor Printed Name:_________________________________________________________
Date:___________________________________
PTA Student Clinic @ Whatcom Community College
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I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant
DRAFT
I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant
(PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby
DRAFT
(PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby
agree to handle such information in a confidential manner at all times during and after my mentorship and
DRAFT
agree to handle such information in a confidential manner at all times during and after my mentorship and
A. I will use and disclose confidential health information only in connection with and for the
DRAFT
A. I will use and disclose confidential health information only in connection with and for the
B. I will request, obtain or communicate confidential health information only as necessary to
DRAFT
B. I will request, obtain or communicate confidential health information only as necessary to
perform my identified duties and shall refrain from requesting, obtaining or
DRAFT
perform my identified duties and shall refrain from requesting, obtaining or
communicating more confidential health information than is necessary to accomplish my
DRAFT
communicating more confidential health information than is necessary to accomplish my
C. I will take reasonable care to properly secure confidential health information on my
DRAFT
C. I will take reasonable care to properly secure confidential health information on my
computer and will take steps to ensure that others cannot view or access such
DRAFT
computer and will take steps to ensure that others cannot view or access such
information. When I am away from my workstation or when my tasks are completed, I
DRAFT
information. When I am away from my workstation or when my tasks are completed, I
will log off my computer or use a password-protected screensaver in order to prevent
DRAFT
will log off my computer or use a password-protected screensaver in order to prevent
D. I will not disclose my personal password(s) to anyone without the express written
DRAFT
D. I will not disclose my personal password(s) to anyone without the express written
permission of my department head or record or post it in an accessible location and will
DRAFT
permission of my department head or record or post it in an accessible location and will
refrain from performing any tasks using another password.
DRAFT
refrain from performing any tasks using another password.
E. I will document all disclosures of confidential health information, including those
DRAFT
E. I will document all disclosures of confidential health information, including those
authorized by clients of the PTA Student Clinic and any accidental disclosures, in the
DRAFT
authorized by clients of the PTA Student Clinic and any accidental disclosures, in the
s file.
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s file.
I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor
DRAFT
I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor
Confidentiality or HIPAA training when I enter the role of Mentor.
DRAFT
Confidentiality or HIPAA training when I enter the role of Mentor.
I also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or
DRAFTI also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or
violation of any terms of this Agreement up to and including termination of involvement in the PTA Student
DRAFTviolation of any terms of this Agreement up to and including termination of involvement in the PTA Student
Mentor Signature:____________________________________________________________
DRAFTMentor Signature:____________________________________________________________
Mentor Printed Name:_________________________________________________________
DRAFTMentor Printed Name:_________________________________________________________
Date:___________________________________
DRAFTDate:___________________________________
54 – Forms
Identified Faculty/Mentor Job Description and Quarterly Contract
This document has not yet received final approval from AAG
Qualifications:
1. Current PT or PTA licensure in the state of Washington.
2. Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last
calendar year.
3. Demonstrated organizational skills.
Preferred qualifications:
1. Mentor experience
2. Completion of APTA CCIP (Credentialed Clinical Instructor Program)
3. Board Certification by the American Physical Therapy Association
Requirements:
1. Physical capacity to perform all essential functions of a physical therapist/physical therapist
assistant.
2. Ability to be physically present during time commitments, including Mentor training.
3. Absences from scheduled clinic assignment are allowed only in cases of illness or unavoidable
conflict.
Time commitments:
1. On campus clinic hours are Mondays: 1:00 pm- 4:00 pm
2. In addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic-
related work which includes:
a. Preparation for clinical education teaching. (30 minutes before clinic hours/appointment.)
b. Review of student PTA’s documentation and provision of feedback. (30 minutes after
clinic closes/ appointment ends.)
c. Review and teaching around established plan of care and provision of treatment.
Functional Descriptions for Winter and Spring Clinic Assignments
The students have NOT completed their clinical course work and there is considerable clinical skills
and clinical decision making teaching during this semester by the Mentor.
Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA
Mentors will be guiding follow up treatments. The intent is to role model excellence in examination,
treatment and clinical decision making. The instructor must be comfortable with multiple students
observing them doing intake exams and treatment, and as much as possible be transparent (verbalizing
along the way) what they are doing/seeing/ and why they are making selections. After the initial
examination and treatments, there will be discussion and information exchange with the students as the
students will document various aspects of the treatment and generate questions to understand the clinical
decision making used by the licensed therapist.
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Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last
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Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last
Completion of APTA CCIP (Credentialed Clinical Instructor Program)
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Completion of APTA CCIP (Credentialed Clinical Instructor Program)
Board Certification by the American Physical Therapy Association
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Board Certification by the American Physical Therapy Association
Physical capacity to perform all essential functions of a physical therapist/physical therapist
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Physical capacity to perform all essential functions of a physical therapist/physical therapist
Ability to be physically present during time commitments, including Mentor training.
DRAFT
Ability to be physically present during time commitments, including Mentor training.
Absences from scheduled clinic assignment are allowed only
DRAFT
Absences from scheduled clinic assignment are allowed only in cases of illness or unavoidable
DRAFT
in cases of illness or unavoidable
On campus clinic hours are Mondays: 1:00 pm- 4:00 pm
DRAFTOn campus clinic hours are Mondays: 1:00 pm- 4:00 pm
In addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic-
DRAFTIn addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic-
related work which includes:
DRAFTrelated work which includes:
a.
DRAFTa. Preparation for clinical education teaching. (30 minutes before clinic hours/appointment.)
DRAFTPreparation for clinical education teaching. (30 minutes before clinic hours/appointment.)
b.
DRAFTb. Review of student PTA’s documentation and provision of feedback. (30 minutes after
DRAFTReview of student PTA’s documentation and provision of feedback. (30 minutes after
clinic closes/ appointment ends.)
DRAFTclinic closes/ appointment ends.)
c.
DRAFTc. Review and teaching around established plan of care and provision of treatment.
DRAFTReview and teaching around established plan of care and provision of treatment.
Functional Descriptions for Winter and Spring Clinic Assignments
DRAFTFunctional Descriptions for Winter and Spring Clinic Assignments
DRAFTThe students have NOT completed their clinical course work and there is
DRAFTThe students have NOT completed their clinical course work and there is
and clinical decision making
DRAFTand clinical decision making teaching
DRAFTteaching
Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA
DRAFT
Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA
Forms – 55
New Patient Registration
First Name: _______ Initial: ______ Last Name: ____________
Address: City: State: Zip Code:
Birth Date: Home Phone: ____Cell Phone: ____________________
Marital Status: (Single / Married / Other) Work Status: (Employed / Student / Retired / Other)
Employer Name / School: Title: Phone:
In case of emergency, contact:
First Name: Last Name:
Relationship: Phone:
I give permission to discuss my medical condition with another person: (Yes / No) If yes, please list:
I would like to receive appointment reminders via (Phone / Email / Text)
Email Address:
Thank you for the opportunity to serve you and for participating in this educational experience. Please do not
hesitate to ask questions to your student therapist or supervising physical therapist at any time.
Patient Signature: Date:
If patient is a minor:
Guardian Signature: Date:
Whatcom Community College Student Physical Therapy Clinic
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Zip Code:
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Zip Code:
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Cell Phone:DRAFT
Cell Phone: ____________________DRAFT
____________________DRAFT
Employed
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Employed /
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/ Student
DRAFT
Student /
DRAFT
/ Retired
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Retired /
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/ Other
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Other)
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)
Phone:
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Phone:
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Last Name:
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Last Name:
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Phone:
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Phone:
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I give permission to discuss my medical condition with another person: (
DRAFT
I give permission to discuss my medical condition with another person: (
DRAFTI would like to receive appointment reminders via (
DRAFTI would like to receive appointment reminders via (Phone
DRAFTPhone
Email Address:
DRAFTEmail Address:
DRAFTThank you for the opportunity to serve you and for participating in this educational experience. Please do not
DRAFTThank you for the opportunity to serve you and for participating in this educational experience. Please do not
56 – Forms
Patient Satisfaction Survey
This document has not yet received final approval from AAG
1. How did you learn about the Student Clinic? (Circle One)
On campus Friend Physical Therapist Physician Website Other___________
2. Was this your first experience with physical therapy? (Circle One) Yes No
3. Was this your first experience with this facility? (Circle One) Yes No
4. What location on your body was the physical therapy treatment for?
____________________________________________________________________________________
Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree,
2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an
opinion on the question.
My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A
The PTA student was courteous. 1 2 3 4 5 N/A
All other students and staff members were courteous. 1 2 3 4 5 N/A
I was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A
My visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A
The location of the facility was convenient for me. 1 2 3 4 5 N/A
I was satisfied with the services provided by the students. 1 2 3 4 5 N/A
Parking was available for me. 1 2 3 4 5 N/A
My physical therapist understood my problem or concern. 1 2 3 4 5 N/A
The instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A
I was satisfied with the overall quality of my care. 1 2 3 4 5 N/A
I would recommend this facility to family and friends. 1 2 3 4 5 N/A
I would return to this facility in the future. 1 2 3 4 5 N/A
The cost of treatment received was reasonable. 1 2 3 4 5 N/A
Overall, I was satisfied with my experience. 1 2 3 4 5 N/A
PTA Student Clinic @ Whatcom Community College
DRAFT
This document has not yet received final approval from AAG
DRAFT
This document has not yet received final approval from AAG
On campus Friend Physical Therapist Physician Website Other___________
DRAFT
On campus Friend Physical Therapist Physician Website Other___________
Was this your first experience with physical therapy? (Circle One) Yes No
DRAFT
Was this your first experience with physical therapy? (Circle One) Yes No
Was this your first experience with this facility? (Circle One) Yes No
DRAFT
Was this your first experience with this facility? (Circle One) Yes No
What location on your body was the physical therapy treatment for?
DRAFT
What location on your body was the physical therapy treatment for?
____________________________________________________________________________________
DRAFT
____________________________________________________________________________________
Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree,
DRAFT
Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree,
2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an
DRAFT
2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an
My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A
DRAFT
My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A
The PTA student was courteous. 1 2 3 4 5 N/A
DRAFTThe PTA student was courteous. 1 2 3 4 5 N/A
All other students and staff members were courteous. 1 2 3 4 5 N/A
DRAFTAll other students and staff members were courteous. 1 2 3 4 5 N/A
I was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A
DRAFTI was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A
My visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A
DRAFTMy visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A
The location of the facility was convenient for me. 1 2 3 4 5 N/A
DRAFTThe location of the facility was convenient for me. 1 2 3 4 5 N/A
I was satisfied with the services provided by the students. 1 2 3 4 5 N/A
DRAFTI was satisfied with the services provided by the students. 1 2 3 4 5 N/A
Parking was available for me. 1 2 3 4 5 N/A
DRAFTParking was available for me. 1 2 3 4 5 N/A
My physical therapist understood my problem or concern. 1 2 3 4 5 N/A
DRAFTMy physical therapist understood my problem or concern. 1 2 3 4 5 N/A
The instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A
DRAFTThe instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A
I was satisfied with the overall quality of my care. 1 2 3 4 5 N/A
DRAFTI was satisfied with the overall quality of my care. 1 2 3 4 5 N/A
I would recommend this facility to family and friends. 1 2 3 4 5 N/A
DRAFT
I would recommend this facility to family and friends. 1 2 3 4 5 N/A
I would return to this facility in the future. 1 2 3 4 5 N/A
DRAFT
I would return to this facility in the future. 1 2 3 4 5 N/A
Forms – 57
Patient History 
This document has not yet received final approval from AAG 
Name:   (​Male​ / ​Female​) Date: 
Age: ________ DOB: ___/_____/____Height: __________ Weight: ________ Occupation:  
CHIEF COMPLAINT AND PRESENT ILLNESS 
Date symptoms/ injury started:  Date of most recent doctor visit: 
Diagnosis from your doctor:  Date of next doctor recheck:  
What is your primary reason for attending therapy? ​(circle) 
1) Pain  
2) Limited motion  
3) Weakness  
4) Activity reduction  
5) Loss of independence  
6) Unable to work  
7) Unable to do household tasks  
8) Unable ​to play sports or do recreation 
Are you currently off work because of this problem? (​Yes​ / ​No​) If yes, last day worked:  
How did your symptoms start?  
How would you describe your problem?  
RATE your pain level:    ​No pain  1  2  3  4  5  6  7  8  9  10  Worst pain 
How would you DESCRIBE your pain? 
__ Dull ache __ Burning __ Heavy __ Sore 
__ Deep ache __ Throbbing __ Twinge __ Other ​(explain) 
__ Stabbing __ Squeezing __ Cramp  
__ Nagging __ Drawing __ Sharp  
Do you have any numbness/ tingling? (​Yes​ / ​No​)   
Where?  
Prior to this onset were you free of these symptoms? (​Yes​ / ​No​) 
Explain:  
What eases the pain?  
What aggravates the pain?  
Have you had any other treatment for this problem? (​Yes​ / ​No​) 
If  yes, what?  
Did it help? (​Yes​ / ​No​) Do you feel you are (​getting better​, ​getting worse​, or ​staying the same​)? 
Please list diagnostic imaging or tests and relevant findings:       
PTA Student Clinic @ Whatcom Community College  
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58 – Forms
Attendance Policy for Pay-As-You-Go Patients
This document has not yet received final approval from AAG
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
time and be prepared for your treatment.
By signing below, I ____________________________________(print name) acknowledge and
agree to the policies outlined below.
I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I
check-in for my appointment. I understand that services of the PTA Student Clinic are
available to benefit me as a member of the underserved population which includes those with no
insurance, or those who have exhausted their insurance benefits. The Clinic services are not
intended to be used for the treatment of new injuries, or by students enrolled in an institution's
sports program.
I am eligible for Student Clinic Benefits: Initial Here _____________
Late arrival policy
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
not be treated due to limited time and availability of student therapists. After 2 late arrivals, I
may be discharged.
Cancellation Policy
I will call with two business days notice to cancel a scheduled PT appointment. If I provide less
than two business days notice, 1 no-show waiver will be allowed. The next incident may lead to
my discharge and no further appointments to be scheduled.
No Show Policy
I understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not
attend my scheduled appointment, I will be given one opportunity to re-schedule. A second no-
show may result in my being discharged and I may no longer be eligible for future treatments at
the Student Clinic.
I acknowledge and agree to the policies outlined.
___________________________________ ______________________
Patient Signature Date
PTA Student Clinic @ Whatcom Community College
DRAFT
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
DRAFT
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
By signing below, I ____________________________________(print name) acknowledge and
DRAFT
By signing below, I ____________________________________(print name) acknowledge and
I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I
DRAFT
I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I
I understand that services of the PTA Student Clinic are
DRAFT
I understand that services of the PTA Student Clinic are
available to benefit me as a member of the underserved population which includes those with no
DRAFT
available to benefit me as a member of the underserved population which includes those with no
insurance, or those who have exhausted their insurance benefits. The Clinic services are not
DRAFT
insurance, or those who have exhausted their insurance benefits. The Clinic services are not
intended to be used for the treatment of new injuries, or by students enrolled in an institution's
DRAFT
intended to be used for the treatment of new injuries, or by students enrolled in an institution's
I am eligible for Student Clinic Benefits: Initial Here _____________
DRAFT
I am eligible for Student Clinic Benefits: Initial Here _____________
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
DRAFT
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
not be treated due to limited time and availability of student therapists. After 2 late arrivals, I
DRAFT
not be treated due to limited time and availability of student therapists. After 2 late arrivals, I
Cancellation Policy
DRAFTCancellation Policy
I will call with two business days notice to cancel a scheduled PT appointment. If I provide less
DRAFTI will call with two business days notice to cancel a scheduled PT appointment. If I provide less
than two business days notice, 1 no-show waiver will be allowed. The next incident may lead to
DRAFTthan two business days notice, 1 no-show waiver will be allowed. The next incident may lead to
my discharge and no further appointments to be scheduled.
DRAFTmy discharge and no further appointments to be scheduled.
No Show Policy
DRAFTNo Show Policy
I understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not
DRAFTI understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not
attend my scheduled appointment, I will be given one opportunity to re-schedule. A second no-
DRAFTattend my scheduled appointment, I will be given one opportunity to re-schedule. A second no-
show may result in my being discharged and I may no longer be eligible for future treatments at
DRAFTshow may result in my being discharged and I may no longer be eligible for future treatments at
the Student Clinic.
DRAFTthe Student Clinic.
I acknowledge and agree to the policies outlined.
DRAFT
I acknowledge and agree to the policies outlined.
Forms – 59
Attendance Policy for Pay-In-Advance Patients
This document has not yet received final approval from AAG
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
time and be prepared for your treatment.
By signing below, I ____________________________________(print name) acknowledge and
agree to the policies outlined.
I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for
three (3) appointment credits, or $20 for five (5) appointment credits.
I understand that services of the PTA Student Clinic are available to benefit me as a member of
the underserved population which includes those with no insurance, or those who have exhausted
their insurance benefits. The Clinic services are not intended to be used for the treatment of new
injuries, or by students enrolled in an institution's sports program. I am eligible for Student
Clinic Benefits: Initial Here _____________

Late arrival policy
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I
do not have any credits left for future appointments, I may be discharged.
Cancellation Policy
I agree to call with two business days notice to cancel a scheduled PT appointment. If I provide
less than two business days notice, I understand that 1 appointment credit will be deducted from
my account. If no credits remain after the appointment credit is deducted, no further
appointments may be scheduled.
No Show Policy
If I fail to call to cancel my appointment and do not attend my scheduled appointment, 1
appointment credit will be deducted from my account. I will be given the opportunity to re-
schedule as long as appointment credits remain on my account.
I acknowledge and agree to the policies outlined.
__________________________________ ___________________________
Patient Signature Date
PTA Student Clinic @ Whatcom Community College
DRAFT
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
DRAFT
Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on
By signing below, I ____________________________________(print name) acknowledge and
DRAFT
By signing below, I ____________________________________(print name) acknowledge and
I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for
DRAFT
I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for
three (3) appointment credits, or $20 for five (5) appointment credits.
DRAFT
three (3) appointment credits, or $20 for five (5) appointment credits.
I understand that services of the PTA Student Clinic are available to benefit me as a member of
DRAFT
I understand that services of the PTA Student Clinic are available to benefit me as a member of
the underserved population which includes those with no insurance, or those who have exhausted
DRAFT
the underserved population which includes those with no insurance, or those who have exhausted
their insurance benefits. The Clinic services are not intended to be used for the treatment of new
DRAFT
their insurance benefits. The Clinic services are not intended to be used for the treatment of new
injuries, or by students enrolled in an institution's sports program. I am eligible for Student
DRAFT
injuries, or by students enrolled in an institution's sports program. I am eligible for Student
Clinic Benefits: Initial Here _____________
DRAFT
Clinic Benefits: Initial Here _____________
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
DRAFT
I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may
not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I
DRAFT
not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I
do not have any credits left for future appointments, I may be discharged.
DRAFT
do not have any credits left for future appointments, I may be discharged.
Cancellation Policy
DRAFTCancellation Policy
I agree to call with two business days notice to cancel a scheduled PT appointment. If I provide
DRAFTI agree to call with two business days notice to cancel a scheduled PT appointment. If I provide
less than two business days notice, I understand that 1 appointment credit will be deducted from
DRAFTless than two business days notice, I understand that 1 appointment credit will be deducted from
my account. If no credits remain after the appointment credit is deducted, no further
DRAFTmy account. If no credits remain after the appointment credit is deducted, no further
appointments may be scheduled.
DRAFTappointments may be scheduled.
No Show Policy
DRAFTNo Show Policy
If I fail to call to cancel my appointment and do not attend my scheduled appointment, 1
DRAFTIf I fail to call to cancel my appointment and do not attend my scheduled appointment, 1
appointment credit will be deducted from my account. I will be given the opportunity to re-
DRAFTappointment credit will be deducted from my account. I will be given the opportunity to re-
schedule as long as appointment credits remain on my account.
DRAFTschedule as long as appointment credits remain on my account.
I acknowledge and agree to the policies outlined.
DRAFTI acknowledge and agree to the policies outlined.
60 – Forms
PTA Student Clinic @ Whatcom Community College
Daily Self-Assessment Form
This document has not yet received final approval from AAG
Student Name: ___________________________________________________________ Date:
____________________________
1. What did you do to promote a safe and comfortable environment?
2. What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful
areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what?
3. What do you feel you did especially well during the treatment session?
4. Now that the session is over, would you have done anything differently to make the treatment
more comfortable, efficient or effective? If so, what?
DRAFT
Student Name: ___________________________________________________________ Date:
DRAFT
Student Name: ___________________________________________________________ Date:
What did you do to promote a safe and comfortable environment?
DRAFT
What did you do to promote a safe and comfortable environment?
What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful
DRAFT
What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful
areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what?
DRAFT
areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what?
What do you feel you did especially well during the treatment session?
DRAFTWhat do you feel you did especially well during the treatment session?
Now that the session is over, would you have done anything differently to make the treatment
DRAFT
Now that the session is over, would you have done anything differently to make the treatment
Forms – 61
PTA Student Clinic Focus Group
Date of focus group:
(Materials: pre-or post-survey, sign-up sheet for involvement-work groups, evaluation,
supervision)
Goals:
• To identify challenges in creating and implementing a PTA student clinic from the
industry perspective
• Identify opportunities for industry to participate in the development of the clinic
• Obtain suggestions from industry regarding ways to provide evaluations and supervision
at the clinic
1. What is the first word that comes to your mind when you think of a PTA student clinic?
2. In what ways do you think a PTA student clinic will benefit the healthcare industry and
our community?
3. Who do you envision receiving services at the PTA student clinic?
4. What are 2-3 challenges you anticipate in the implementation of the PTA student
clinic? (Use index cards: take 1 minute to write your answers/thoughts on the index
card)
5. In what ways will a PTA student clinic impact the local industry?
6. What do you like best about the proposed student clinic concept?
7. In what ways could industry be involved in the development of the clinic?
8. What do we need to consider regarding evaluations and supervision at the clinic? (be
prepared to answer to law here, have a copy of the law for handouts)
9. How is your malpractice insurance covered, personally or by your organization? If
personally, would it cover service provided in a student clinic at the college?
10. How can the college attract local PT’s willing to provide their time and mentorship?
(how will this benefit the PT?)
11. What types of risk management issues might we encounter?
12. If you could create the ideal PTA student clinic, what would it look like?
13. Of all the things we discussed this evening, what to you is most important?
14. What are we missing?
DRAFT
work groups, evaluation,
DRAFT
work groups, evaluation,
To identify challenges in creating and implementing a PTA student clinic from theDRAFT
To identify challenges in creating and implementing a PTA student clinic from the
Identify opportunities for industry to participate in the development of the clinic
DRAFT
Identify opportunities for industry to participate in the development of the clinic
Obtain suggestions from industry regarding ways to provide evaluations and supervision
DRAFT
Obtain suggestions from industry regarding ways to provide evaluations and supervision
What is the first word that comes to your mind when you think of a PTA student clinic?
DRAFT
What is the first word that comes to your mind when you think of a PTA student clinic?
what ways do you think a PTA student clinic will benefit the healthcare industry and
DRAFT
what ways do you think a PTA student clinic will benefit the healthcare industry and
Who do you envision receiving services at the PTA student clinic?
DRAFT
Who do you envision receiving services at the PTA student clinic?
What are 2-3 challenges you anticipate in the implementation of the PTA student
DRAFT
What are 2-3 challenges you anticipate in the implementation of the PTA student
(Use index cards: take 1 minute to write your answers/thoughts on the index
DRAFT
(Use index cards: take 1 minute to write your answers/thoughts on the index
In what ways will a PTA student clinic impact the local industry?
DRAFT
In what ways will a PTA student clinic impact the local industry?
What do you like best about the proposed student clinic concept?
DRAFT
What do you like best about the proposed student clinic concept?
In what ways could industry be involved in the development of the clinic?
DRAFTIn what ways could industry be involved in the development of the clinic?
What do we need to consider regarding evaluations and supervision at the clinic?
DRAFTWhat do we need to consider regarding evaluations and supervision at the clinic?
prepared to answer to law here, have a copy of the law for handouts)
DRAFTprepared to answer to law here, have a copy of the law for handouts)
9.
DRAFT9. How is your malpractice insurance covered, personally or by your organization? If
DRAFTHow is your malpractice insurance covered, personally or by your organization? If
personally, would it cover service provided in a student clinic at the college?
DRAFTpersonally, would it cover service provided in a student clinic at the college?
10.
DRAFT10. How can the college attract local PT’s willing to provide their time and mentorship?
DRAFTHow can the college attract local PT’s willing to provide their time and mentorship?
(how will this benefit the PT?)
DRAFT(how will this benefit the PT?)
What types of risk management issues might we encounter?
DRAFTWhat types of risk management issues might we encounter?
If you could create the ideal PTA student clinic, what would it look like?
DRAFT
If you could create the ideal PTA student clinic, what would it look like?
62 – Forms
DRAFT
PTA Student Clinic @ Whatcom Community College
Statistics Tracking
Week # of Evals # of Rx's PT Hours PTA Hours
1
2
3
4
5
6
7
8
9
10
Total
Average
Clinic
Administrator
hours
Forms – 63
64 – Forms
DRAFT
nity College
Student
Hours
Patient
Satisfaction
Surveys
received
PHYSICAL THERAPY ASSISTANT STUDENT CLINIC
BENEFITS
There are widespread benefits to having a student-run Physical Therapy Clinic for either Physical
Therapist or Physical Therapist Assistant programs that serve the communities, institutions and
individuals involved.
STUDENTS
ACADEMIC PROGRAMS
COMMUNITY MEMBERS
MENTORS
Participating in a student clinic is a unique experience that few
programs offer and will better prepare students for employment
By offering innovative programs that include student clinics, any
academic institution has the chance to stand out
Too many people currently find themselves without a means to get help
for injuries or conditions due to no insurance, exhausted benefits or
limited coverage
Offering a few hours a week to share real-world experience has a large
impact
Provide a safe and supportive
environment to learn how to
professionally interact with patients
Opportunity to closely supervise
the professional development of
students
Opportunity to receive physical
therapy services for low or no-cost
Opportunity to help shape the next
generation of therapists
Opportunity to learn from local
therapists without the demanding
schedule of a full clinic
Connect educational programs to their
local community
Contribute to educating physical
therapy students
Smaller time commitment as compared
to full-time Clinical Instructor
Practice clinical skills with patients
instead of fellow students
Reduce dependency on clinical sites
Learn about their physical
impairments and how to manage
them
Provide treatment to
under-served communities
+$$
A+

Final PTA Guide

  • 1.
    Creating a Physical TherapistAssistant Student Clinic How to get a PTA Student Clinic Started on Your Campus Guide by Whatcom Community College. Funded by the Carl D. Perkins SBCTC Innovation Grant 2015-16
  • 3.
    Creating a PhysicalTherapist Assistant Student Clinic CONTRIBUTORS MARGARET ANDERSON, BS, M.Ed., Physical Therapist Assistant Program Coordinator JILL LUDLOW, PTA, Academic Coordinator of Clinical Education, Physical Therapist Assistant Program CINDY BURMAN-WOODS, M.Ed., Workforce Special Projects Director MEGAN THOMAS, PTA, CWcHP, Research JARRETT MARTIN, Graphic Designer MARLA BRONSTEIN, Editor Funded by Carl D. Perkins SBCTC Innovation Grant 2015-2016
  • 4.
    Table of Contents 4ꟷ Table of Contents Planning and Development Convene faculty and community members 8 Incorporate Institutional Input 10 Budget 10 Recruitment Strategies 11 Industry Partnership 12 Research Student Clinic Models 12 Business Plan 13 Executive Summary 14 Mission/Vision Statement and Goals 14 Business Summary 15 Products and/or Services 16 Market Assessment 16 Strategic Implementation 17 Business Policies and Procedures 17 Marketing Plan 18 Monitoring Outcomes 18 Student Clinic Handbook Model 19 Roles and Responsibilities 19 Scope of Treatment 19 Daily Routine 19 Quarterly Project/Research 19 Outcome Measurements 19
  • 5.
    Table of Contentsꟷ 5 Table of Contents Glossary of Terms 20 Index Draft Business Plan for WCC 22 Draft Student Clinic Handbook for WCC 40 Comparison of Student Clinics 44 Focus Group Questions 46 Forms Clinical Administrator Job Description and Contract 47 On-site Clinical Education Questions - Mentor On-site Clinical Education Questions - Student 49 Consent Form 50 HIPAA Release Form 52 Mentor Confidentiality Agreement 54 On-site Clinic Mentor Job Description 55 Patient Registration 56 Patient Satisfaction Survey 57 Patient Medical History 58 Patient Attendance Policy Pay-As-You Go 59 Patient Attendance Policy Pay in Advance 60 Student Daily Self Assessment 61 Statistics Tracking 63
  • 6.
    How to startyour PTA Student Clinic Choose to move your program forward, to serve students and the community Research other student clinics Identify possible funding source(s) Establish student learning outcomes Launch Clinic Meeting or Exceeding Clinic Goals Determine a need for a more robust PTA Academic Program Meet with Institution Administrators to create partnerships Assess Risk Management & Liability Concerns Recruit and identify volunteer mentors Present to College Administration Hold a focus group Decide how to run the clinic. Management, logistics, etc Create a budget & business plan Market to target audience (Host Pilot Clinic) Clinic schedule is full Launch Successful! Clinic schedule isn’t full: ? Industry Outreach for marketing advice
  • 7.
    Introduction Introduction ꟷ 7 Thegeneral consensus in the Physical Therapist Assistant (PTA) profession is that it has become increasingly more difficult to place students at clinical internship sites, and at times, the students have limited opportunities to develop their pro- fessional qualities prior to entering a clinical site. Students in PTA programs come from a variety of backgrounds and do not always have experience in professional setting. Providing them a safe and supportive environment to learn these qualities will better prepare them for later clinical internship and work experiences. This guide has been designed to assist any institution whether public or private, community college or university, in planning, developing and implementing a stu- dent clinic for Physical Therapist Assistant students. There are a variety of ways to implement a student clinic to suit an institution’s priorities and accommodate a range of financial support. Keep in mind that the guide offers several options to consider and our goal is to lay out the steps to take while designing a student clinic for your Physical Therapist Assistant program. Through research gathered from established student clinic programs, outcomes have consistently shown positive feedback from students, faculty and clinical in- structors. Students feel supported in their learning process and have a more real- istic opportunity to practice their clinical skills and professional qualities. Faculty members appreciate more time to observe and guide the students while working under their supervision, and clinical instructors in local clinics and hospitals iden- tify a higher level of competence from the students and greater employee perfor- mance. Providing mentorship to students is one of the most effective and worthwhile ways that an experienced physical therapist and physical therapist assistant can help the next generation of students become successful and learn beyond standard curriculum. Being a Clinical Instructor while also carrying a full patient load can be demanding for some therapists. Providing an opportunity to mentor students a few hours a week in a student clinic may be more appealing and reasonable. One of the most difficult issues that health care professionals face is to deny services to a patient in need due to lack of ability to pay. Despite laws that require a person to carry health insurance, many policies do not cover physical therapy treatment. In many cases where coverage does exist, there are limitations and benefits are exhausted before the patient is fully recovered. For these groups to have access to treatment, education and self-management techniques, student clinics are essential to providing care for many people who are low-income and under-insured. The long term benefits are far reaching not only for the students’ education, but to improve the quality of life of the patients served.
  • 8.
    Getting Started: Planningand Development Process 8 ꟷ Getting Started This section outlines the recommended steps to take while developing the design of the student clinic as well as preparing information and background for the Business Plan and Student Handbook. Specifics vary depending on what kind of institution is creating the program. Draft documents for the Whatcom Community College (WCC) PTA Student Clinic are included in the Index. FOCUS GROUP Convene a group of faculty members, Program Director, Academic Coordinator of Clinical Education (ACCE) and institution administrator, at minimum. Invite Physical Therapy (PT) clinicians from the community, asking for their participation in a focus group, work group, and/or advisory board. 1. The Focus Group should consist of 5-7 industry members for initial discussion and brainstorming student clinic implementation. See Index - Focus Group Questions 2. Encourage participants to consider being a clinic volunteer (Mentor), discuss recruiting potential mentors at their places of employment 3. Identify challenges, opportunities and determine options for implementation of the student clinic 4. Determine clinic goals and how the Physical Therapist Assistant (PTA) program would benefit from a student clinic. For the purpose of example, as a result of WCC’s focus group, the following benefits were determined: ¾¾ Provides students with a period of mentorship while practicing hands- on skills and professional behavior with patients ¾¾ Provides additional practical experience early in the students’ training. ¾¾ Highlights unique educational opportunities within the program, which may attract more qualified applicants 5. Establish target patient population and physical conditions that will be served by the clinic. For the purpose of example, WCC’s inclusions and exclusions determined as a result of the focus group are as follows: ¾¾ Welcome underserved community members that may not have access to mainstream PT services. “Underserved” includes those who are uninsured, low income patients, or insured patients with exhausted benefits ¾¾ Campus students and faculty members are invited to use services ¾¾ “Excluded “population includes those who present with new injuries, or students enrolled in their institution’s athletics program
  • 9.
    Getting Started ꟷ9 6. Identify possible challenges that may interfere with the development of a clinic. For example, WCC’s challenges determined as a result of the focus group are as follows: ¾¾ Potential legal ramifications of student clinic operations, such as liability and insurance coverage ¾¾ Ensuring compliance with Washington state’s physical therapy practice regulations that relate to supervision of PTAs and students ¾¾ Recruiting volunteer mentors (PTs & PTAs) from local businesses, as well as institutional faculty ¾¾ Establishing financial solvency to sustain clinic functions in order to prevent clinic from draining resources from Program and/or institution 7. Gather industry feedback from local physical therapists: ¾¾ Determine ways to recruit potential mentors who have established history working with students during internships, and who would work at the clinic to perform patient evaluations ¾¾ Identify benefits to community Mentors, such as: ŠŠ Local therapists will help educate and shape the next generation of therapists ŠŠ Foster qualities potential employers desire from new graduate therapists ŠŠ Resolves issues of conflicts of interest or potential competition between Student Clinic and local businesses ŠŠ Establishes a cooperative relationship between Student Clinic and local businesses to meet the needs of patients
  • 10.
    Getting Started: Planningand Development Process 10 ꟷ Getting Started ADMINISTRATION INPUT Incorporate Institutional Administration input ¾¾ Include WorkForce Education and Special Projects departments ¾¾ Identify person who will monitor the department’s budget ¾¾ Determine need for Identified Faculty/Clinic Administrator ¾¾ Identify institutional communication and approval processes necessary to implement the clinic ¾¾ Consider contacting the institution’s Business Department for assistance on developing a successful business plan BUDGET Create Estimated Budget 1. Start-up expenses/needs: ¾¾ Electronic Medical Records (EMR) software ¾¾ If a PTA Student Clinic is being designed at the initial development of an institution’s PTA program, and a facility for the clinic is required to be built, part of those costs may be included in the budget. Equipment costs such as treatment tables, exercise machines, ultrasound, electrical stimulation, traction units, etc. may also be included. It is expected that most existing PTA programs already have a lab site in place. It may be difficult to anticipate until actual patient demographics can be analyzed 2. Overhead: ¾¾ Utilities may be covered by institution if the student clinic is located in an established facility on campus, such as the PTA lab space ¾¾ If an off site facility for the clinic is available, building maintenance and utilities costs will need to be included into the budget. ¾¾ The majority of established student clinics are held within the designated lab space, which typically include the above listed equipment. +$$
  • 11.
    Getting Started ꟷ11 3. Revolving expenses: 99 Linens (laundering and replacement) 99 Miscellaneous PT supplies 99 Printing costs: ŠŠ Patient forms may be absorbed by institution as part of the department’s budget 99 Equipment maintenance 4. Salaries/Personnel: ¾¾ Clinical Administrator will be a paid position. ŠŠ A consistent staff member managing clinic functions is essential for a well-functioning clinic ¾¾ Identified Faculty-Mentor salaries should be absorbed by institution. RECRUITMENT STRATEGIES Connect with local therapists who are interested in supporting a student clinic through mentorship 1. Targeted Clinicians: Promote participation from established local clinical sites with current connections to the program Key Points: ¾¾ Mentors will garner satisfaction of being associated with Student Clinic, contributing to professional education and helping underserved communities ¾¾ Partnerships are essential to coexist in similar market to avoid conflict and competition with local businesses ¾¾ Recruit clinicians already associated with the PTA program ¾¾ An investment in student success ¾¾ Clinicians may have more flexible schedule than full-time faculty 2. Program alumni: ¾¾ Former students are more familiar with program and curriculum ¾¾ May provide retrospective analysis of program and personal experiences as a former student
  • 12.
    Getting Started: Planningand Development Process 12 ꟷ Getting Started MARKETING Create and Maintain Industry Partnerships for the purpose of marketing and continuing business, while recognizing service boundaries ¾¾ Referral sources: ŠŠ Local PT clinics refer to clinic when patient exhausts insurance benefits ŠŠ Medical clinics serving low-income communities ¾¾ Formal recognition of partnership participation (such as donations of time and/or materials). Sample recognition options: ŠŠ Plaque to be displayed in the clinic ŠŠ Award Certificate presented to participating Mentors each quarter RESEARCH STUDENT CLINIC MODELS For this section, PTA Student Clinics at other institutions were contacted and given the opportunity to share the methods they use to set up and run their clinic. Topics discussed are set forth below. A summary of the results of these discussions of considerations and suggestions follow in the Index. Be advised they are not all- inclusive. See Index - Comparison of Student Clinic Models Topics: ¾¾ Clinic scheduling (days/week and hours/day) ¾¾ Student Clinic hours/credits may vary. (Check with your accrediting body to determine rules for clinical and lab hour requirements) ¾¾ Determine practical skills students learn in clinic that support patient care ¾¾ Identify PT/PTA supervision requirements which may vary from state to state ¾¾ Identify examples of successful business models to present to college administration ¾¾ Develop measurable outcomes for Students, Patients, and Mentors ¾¾ Identify additional expected and unexpected challenges faced
  • 13.
    Business Plan Modelꟷ 13 Business Plan Model This is a standard format that, when completed, will help your program identify specific details of how you are planning for your clinic to be set up and operate. A draft business plan for the creation of Whatcom Community College’s PTA Student Clinic can be found in the Index as an example of a completed formal business plan. Remember that your business plan should be only as big as you need to run your business. While every business owner should use planning to help them run their business, not every business owner needs a complete, formal business plan suitable for submitting to an institution, potential investor, or bank, or venture capital contest. You may not need to include outline points just because they are on this list, unless you’re developing a standard business plan that you’ll be showing to someone who expects to see a standard business plan TABLE OF CONTENTS Executive Summary 14 Mission/Vision Statement and Goals 14 Mission/Vision Statement 14 Goals and Objectives 14 Keys to Success 14 Business Summary 15 Business Background 15 Resources, Facilities and Equipment 15 Marketing Methods 15 Management and Organization 15 Products and/or Services 16 Market Assessment 16 External Analysis 16 Customers 16 Strategic Implementation 17 Marketing Plan 17 Sales Plan 17 Location and Facilities 17 Technology 17 Equipment and Tools 17 Financial Plan 17 Projected Balance Sheet 17 Outcomes 18
  • 14.
    14 ꟷ BusinessPlan Model Executive Summary Write this last, the executive summary is a page or two that highlights the points made elsewhere in your business plan. Summarize the problem you are solving for customers, your solution, the target market, the founding team, and financial forecast highlights. Keep things as brief as possible and entice your audience to learn more about your company. The Executive summary should summarize the following from the business plan: • Mission/Vision Statement • Company Summary • Products/Services • Market Assessment • Strategic Implementation • Expected Outcomes Mission/Vision Statement and Goals 1. Mission/Vision Statement Mission/vision statements are clear summaries of where the business is headed. It describes what the business produces, for whom the products are produced, and unique business characteristics. It will reflect the values of the management team and the type of business culture you are trying to create. Mission: Should be short, definitely not longer than two or three sentences. The mission statement supports the vision and serves to communicate its purpose and direction. Vision: The Vision Statement may be a paragraph or a whole page. It should paint a picture of the future that will come to be as we carry out our mission. 2. Goals and Objectives What do you want your business to achieve? Be specific in terms of financial performance, resource commitments (time and money) and risk. When will various milestones be achieved? Describe the problem that you solve for your customers and the solution that you are providing. 3. Keys to Success What do you need, or must happen, for you to succeed? Business Plan Model
  • 15.
    Business Plan Modelꟷ 15 Business Summary The material in this section is an introduction to the business. Not all sections may be applicable. 1. Organization Background What does your business do? Who were the founders of the business? What were the important milestones in the development of the business? 2. Resources, Facilities and Equipment With what do you produce your products or services? What are the land, equipment, human and financial resources? Who provides them? How are resource providers rewarded? 3. Marketing Methods What is your annual sales volume in dollars and units? Explain how you work with others to improve returns. This may include a strategic alliance with suppliers or customers that you can leverage. How much does it cost to produce and deliver your products and services? How is contracting used? 4. Management, Organization and Ownership Structure Who is currently on the management team? How have management responsibilities been divided among the management team? What are the lines of authority? Who acts as the president/CEO/Spokesperson/Chief Financial Officer? Who determines employees’ salaries and conducts performance reviews? What is the educational background of the management team members? What is the management team’s reputation in the community? What special skills and abilities does the management team have? What additional skills does the management team need? Who are the key people and personnel that make your business run? Who do you go to for advice and support? Do management and employees have avenues for personal development? Sketch a diagram of lines of authority for your operation. Do you need special permits to operate, or a record for inspections? If you do, please describe them. 5. Social Responsibility What environmental practices do you follow? What procedures do you use for handling chemicals? What will be the roles of management and employees in community organizations? What will be your involvement at the local/state/national level in commodity organizations? What training and new employee orientation practices will you offer to insure proper handling of hazardous materials and safe operation of equipment?
  • 16.
    Business Plan Model 16ꟷ Business Plan Model 6. Internal Analysis What are the strengths and weaknesses of your business? What things can you build on? Think only about the things that you can control. Suggested areas to consider: ŠŠ financial position ŠŠ productivity ŠŠ location ŠŠ resources Products and/or Services Describe the products and services you plan to sell/provide. How is your product or service unique? Are you producing a commodity or a differentiated product? How does your product or service compare to other products in Quality? Price? Location? What experience do you have with this product/service? Market Assessment 1. Examining the General Market What important customer need(s) is the market not currently fulfilling? What is the growth potential for each segment of the market? What opportunities and threats does your firm face? What trends, relevant to your business, do you see? 2. Customer Analysis Who will be your customers? What do you sell or provide to each of the customers? How does your product/service solve a key customer problem? How difficult is it to retain a customer? How much does it cost to support a customer?
  • 17.
    Business Plan Modelꟷ 17 Strategic Implementation 1. Production What is your competitive advantage? What technology will you use? Risk Management/Liability Concerns 2. Resource Needs In order to effectively organize your business you need to insure the resources are available. Assess those needs here. Staffing ¾¾ What skills are needed? ¾¾ How will human resources be acquired? Financial ¾¾ What level of financial resources will be needed ¾¾ Financial Projections Does the business fall under the institution’s Tax exempt status? ¾¾ Income: Consider how will you fund the business? ¾¾ Expenses What procedures will be used for monitoring overall business performance? Physical ¾¾ What type, quantity and quality of physical resources will be required? Contingency Plan ¾¾ What will you do if you can’t follow through with your primary plan? ¾¾ How are you preparing for an emergency in your business? ¾¾ How will the business function if something happens to one of the key members of the management team? 3. Business Policies and Procedures (Specific Student Clinic Example) ¾¾ Standard clinic operations ¾¾ Personnel roles and responsibilities ¾¾ Fee structure ¾¾ Scheduling ŠŠ Service Capacity ŠŠ Scheduling in Advance ŠŠ Walk-ins ŠŠ Cancellation Policy ŠŠ Late arrival policy ¾¾ Intake and Documentation ¾¾ Discharge and Documentation ¾¾ Staffing ¾¾ Training/Orientation
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    Business Plan Model 18ꟷ Business Plan Model 4. Marketing Strategy What advertising and promotion will be used to increase sales/awareness? 5. Performance Standards What performance standards will be used to monitor this enterprise or business unit? What procedures will be used to monitor performance? Who is responsible for monitoring performance? What industry benchmarks will be used to assess performance? 6. Monitoring What tools will be used to monitor outcomes? Who and how will changes necessary for business success be decided and implemented?
  • 19.
    Student Clinic Handbook StudentClinic Handbook ꟷ 19 The intention of creating a student clinic is to develop effective opportunities for students to grow professionally, as well as academically, and optimally prepare them for working in the community. Learning goals are closely aligned with expectations during external clinical internships. By providing a clinical experience within an academic program, there is greater influence from faculty and mentors to support student growth earlier in their curriculum. Guiding the students to develop the Core Values as outlined by the APTA is a primary goal. See Index - WCC Draft Student Clinic Handbook The Student Clinic Handbook will: Define roles and responsibilities ¾¾ Mentor to Student ¾¾ Student to Student support while providing treatment ¾¾ Clinic Administrator ¾¾ Identified Faculty/ ACCE/Program Coordinator Set forth scope of treatment techniques and activities Determine Daily Routine Review Student Clinic Assessment and Outcomes ¾¾ Perform monthly to allow for continuous updating of program objectives and implementation (See Index - specific surveys) ŠŠ Patient satisfaction survey ŠŠ Student Feedback survey ŠŠ Mentor feedback survey ¾¾ Statistics Tracking - Essential for continuing support from institution and local volunteer recruitment.
  • 20.
    Glossary of Terms 20ꟷ Glossary of Terms ACCE: Academic Coordinator of Clinical Education – Establishes expected competencies and monitors student performance in clinical settings, gathers contracts with outside facilities who accept students for clinical internships, maintains communication with clinical sites and students APTA: American Physical Therapy Association – Professional association which establishes standards for care and conduct among PT’s and PTA’s CLINICAL INSTRUCTOR: A person who is responsible for the direct one-on- one instruction and supervision of the Physical Therapist Assistant Student (“Student”.) This person can either be a PT or a PTA. The instruction customarily takes place at the Clinical Instructor’s work site/clinic. DSHS: Department of Social and Health Services - State government agency that supports community members to find and receive resources to improve their health and safety EMR: Electronic Medical Records – computer software which documents patient information, treatment interventions and assessment tools; HIPAA secured HIPAA: Health Insurance Portability and Accountability Act – Protects patient privacy by securing access to sensitive health information limited to treating providers and family members who are explicitly designated to receive health information HPEC: WCC’s Health Professions Education Center INSTITUTION: A public, private or a community/technical college. MA: Medical Assistant – Healthcare provider who performs intake procedures as well as patient care such as taking vital signs and other basic tests MENTOR – A person who is responsible for the direct instruction and supervision of the Physical Therapist Assistant Student (“Student”) in the clinical education setting taking place at the institution’s place of instruction, following the institution’s educational programming. This person can either be a PT or a PTA. PATIENT: For the purpose of this document, Patients of the PTA Student Clinic are as follows: A member of the underserved population as defined by those with no insurance or who have exhausted their insurance benefits. Patients who present with new injuries, or who are enrolled in an institution’s sports program. No one will be refused service for lack of ability to pay. PT: Physical Therapist – Performs initial evaluations, treatments, supervises PTAs and students in observing and implementing patient treatments. Ultimately responsible for patient
  • 21.
    Getting Started ꟷ21 PTA: Physical Therapist Assistant – Performs follow-up treatments under the supervision of a PT, supervises and guides students in observing and implementing patient treatments STUDENT: Institution’s Physical Therapist Assistant Student WCC: Whatcom Community College Glossary of Terms ꟷ 21
  • 22.
    Business Plan The PTAStudent Clinic @Whatcom Community College 475 Stuart Rd., Bellingham, WA 98226 360.383.3258 MARGARET ANDERSON, BS, MEd, Physical Therapist Assistant Program Coordinator JILL LUDLOW, PTA, Academic Coordinator of Clinical Education, Physical Therapist Assistant Program MEGAN THOMAS, PTA, CWcHP, Research CINDY BURMAN-WOODS, Workforce Special Projects Director JARRETT MARTIN, Graphic Designer MARLA BRONSTEIN, Editor 22 ꟷ Index
  • 23.
    Table of Contents ExecutiveSummary....................................................................... 1 Mission/Vision Statement and Goals ............................................. 3 Mission/Vision Statement Goals and Objectives Keys to Success Company Summary ....................................................................... 4 Company Background Resources, Facilities and Equipment Management and Organization Ownership Structure Social Responsibility Internal Analysis Products and/or Services............................................................... 6 Market Assessment ....................................................................... 7 Examining the General Market Customer Analysis Strategic Implementation ............................................................... 9 Student Clinic Policies and Procedures ......................................... 9 Resource Needs.......................................................................... 11 Risk Management/Liability Concerns........................................... 13 Marketing Strategy....................................................................... 14 Monitoring.................................................................................... 15 Expected Outcomes ..........................................................................15 Monitoring .........................................................................................15 Index ꟷ 23
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    Page 1 of16 Physical Therapist Assistant Student Clinic Business Plan Executive Summary Mission/Vision Statement Mission: To provide quality education and experience to Physical Therapist Assistant (“PTA”) students while providing quality patient services in an affordable setting. Vision: The intention of creating a Student Clinic is to provide an opportunity for PTA students to grow professionally, as well as academically, while providing low-cost treatment and services to benefit underserved and/or underinsured community members. Organization Summary The PTA Student Clinic (“Clinic”) will provide an on-campus, educational opportunity for the students in the Physical Therapist Assistant program at Whatcom Community College (“WCC”). The clinic will allow students to develop their clinical skills and professional qualities, while also providing services to low-income and under-served communities in Whatcom County. Clinic will serve as an extension of clinical internships and offers an alternative setting for therapists interested in providing mentorships to students. Products/Services Clinic will provide an opportunity for patients to receive physical therapy services performed by supervising Physical Therapists, Physical Therapist Assistants, and Physical Therapist Assistant Students. The products generated include health promotion for the community patients and education enhancement for the students. Market Assessment There are currently no student clinics in Whatcom County for either PT or PTA programs. The nearest student clinic is University of Puget Sound for PT students only. Local industry members support the implementation of the Student Clinic and have determined there is no competition between the Student Clinic and established physical therapy businesses based on the proposed business model. Services of the clinic will be available to the underserved population as defined by those with no insurance or those who have exhausted their insurance benefits. The Clinic services will not be available to treat new injuries, or for students enrolled in an institution’s sports program so as to avoid conflict with currently available services. 24 ꟷ Index
  • 25.
    Page 2 of16 Strategic Implementation By the second and third quarters of WCC’s five quarter PTA program students will have received enough information to fully participate in the Student Clinic as part of their lab requirement, allowing them the opportunity to act as Reporter, Interpreter, Manager and Student Therapy Assistant, as fully defined in the Student Handbook. Students will be closely supervised by a licensed Physical Therapist and Physical Therapist Assistant. Providing services to an otherwise underserved population will enable the students to obtain additional skills and bring these skills to their clinical experience. Clinicians from the community will have the opportunity to participate and partner in an important part of the PTA student education. Expected Outcomes Expected outcomes include an increase in student learning and performance, both clinically and professionally, and an increase in student confidence when performing patient care. We expect an increase in health benefits to community patients who participate in Clinic services. Daily feedback reports from students and mentors will be completed, and weekly statistics will be kept and reviewed monthly in order to inform the program for continuous improvement. Index ꟷ 25
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    Page 3 of16 Mission/Vision Statement and Goals Mission/Vision Statement Mission: To provide quality education and experience to Physical Therapist Assistant (PTA) students while providing quality patient services in an affordable setting. Vision: Whatcom Community College has determined there is a need for a Physical Therapy Assistant Student Clinic. The intention of creating a clinic is to develop effective opportunities for PTA students to grow professionally, as well as academically, and optimally prepare them for working in the community. The Student Clinic will provide an opportunity for PTA students to be mentored while providing low-cost treatment and services to underserved and/or underinsured community members. Faculty and volunteers from the physical therapy community will provide positive mentorship to support students in expanding their knowledge and confidence with patient interactions. By providing a clinical experience within an academic program, there is greater opportunity for influence from faculty and mentors to support student growth earlier in their curriculum. Goals and Objectives The Student Clinic intends to achieve financial sustainability by maintaining low overhead costs and utilizing income from donations to support revolving expenses. The Student Clinic will partner with current practicing PTs and PTAs as leveraged resources from community businesses to provide evaluations, mentorship and support to promote professionalism and enhance knowledge. Local community members who qualify for services will utilize the Student Clinic for accessible physical therapy services when they may be unable to obtain services otherwise. Milestones such as an increase in applicants to the PTA Program, as students seek this unique patient care experience over other programs, a full patient load and an increase in measurable outcome scores for student achievement will indicate growth and success. Keys to Success For optimal success of the Student Clinic, community members will consistently fill the available treatment times during both Spring and Summer quarters and operate at a break-even (self-sustaining). Students will work with supervising therapists and mentors to observe and implement physical therapy treatments, and will portray professional behavior while integrating didactic curriculum into the practical clinic setting. For long term success, the clinic requires continually rotating volunteers to support initial evaluation and re-assessments every 5th visit, in order to maintain congruency with Washington State RCW 18.74.170, Section 2(a). 26 ꟷ Index
  • 27.
    Page 4 of16 Company Summary Company Background The PTA Student Clinic functions within the non-profit academic institution, Whatcom Community College, and is beholden to those stakeholders and administrators. Whatcom Community College is accredited by the Northwest Commission on Colleges and Universities. The Student Clinic will be managed by the WCC Physical Therapy Assistant department, currently led by PTA Program Coordinator Margaret Anderson. The Student Clinic will provide outpatient physical therapy services, performed by PTA students under the supervision of licensed PTAs and PTs. The treatment services will be provided to benefit the patient base consisting of community members as defined in the Glossary. The Student Clinic will not accept patients for services who present with new injuries or who may be enrolled in their institution's sports programs. The collaboration in the development of this business plan included Margaret Anderson, PTA Program Coordinator; Jill Ludlow, PTA Program Academic Coordinator of Clinical Education; Cindy Burman-Woods, Health Programs Special Project Director; and Megan Thomas, Consultant. Gathering research from previously established student clinics across the United States was essential to the development of this business plan, followed by connecting with administrators and industry professionals to provide their input. Resources, Facilities and Equipment Services are produced in tandem with volunteer and faculty physical therapists performing evaluations, and with PTA students participating in implementing treatments. Services are provided through a combination of manual therapy techniques, patient education and physical assessments. Space and equipment resources are already established in the existing lab for PTA students in WCC’s Health Professions Education Center (HPEC) building. Human resources in terms of staffing include HPEC’s Program Assistant, current PTA faculty, PTA Clinic Administrator, volunteer PT/PTA supervisors/mentors, and PTA students. Fees provided by Student Lab fees, community patients and donations from local businesses who seek to support the Student Clinic will contribute to revolving expenses. WCC provides the space, equipment, faculty and students. Volunteer Mentors will be recruited through community outreach. WCC faculty are compensated by standard negotiated contract salary agreements. Volunteer Mentors will receive a certificate of participation at the end of each quarter. Local businesses providing support and/or donations to the program will receive a certificate and/or plaque to be displayed in their business office and at the Student Clinic to indicate support. Index ꟷ 27
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    Page 5 of16 Management and Organization The management team includes a Clinic Administrator to assume administrative responsibility of the Student Clinic. The PTA Program Coordinator and Academic Coordinator of Clinical Education (“ACCE”) will be available for supervisory needs as well as decision making regarding changes to the format, policies or procedures of the Student Clinic. The Clinic Administrator will maintain management of daily Student Clinic activities which include intake of patients, communicating with students, scheduling appointments, monitoring supplies, taking payments for appointments and communication with PTA Program Coordinator. Any changes to Student Clinic functions may be discussed and determined by Program Coordinator and ACCE. Lines of Authority are as such: Student → Mentor → ACCE /or Program Coordinator →Dean for Workforce Education → Vice Presidents for Instruction and Administration→ President. All staff and faculty salaries are determined by WCC Human Resources in conjunction with negotiated contracts and/or WCC administration. Ownership Structure As noted above, the PTA Student Clinic functions within the non-profit academic institution, Whatcom Community College, and is beholden to those stakeholders and administrators. There are no specific owners of the Student Clinic, as it is connected and a part of an academic program. As an educational focused entity, CAPTE (Commission on Accreditation in Physical Therapy Education) inspects and evaluates the PTA program every 5 to 10 years and will assess the clinic from the perspective of its success as a clinical component of the academic program. WCC will assess the clinic’s viability as a program of the college. Social Responsibility Environmental practices and safe equipment handling will be followed according to the policies and procedures outlined by Whatcom Community College. During Mentor training, policies regarding hazardous materials and equipment operation will be addressed to ensure the safety of all participants. Internal Analysis The primary strength of this Student Clinic is the unique educational opportunity being provided to the students, who will gain exposure to direct patient care and integrate didactic curriculum into practical treatment interventions, while being guided and supported by local therapists. The primary weaknesses of the Student Clinic include limited financial support, which is contingent upon donations and participation in the Student Clinic by community members, and potential limitations of available volunteers to provide mentorship and supervision. Additional weaknesses may include the undetermined impact of a lack of clinic schedule continuity (only offered initially two quarters per year) and unpredictable 28 ꟷ Index
  • 29.
    Page 6 of16 workforce needs for PTAs in the region, should local demand decline in coming years and impact enrollments. Products and/or Services The Student Clinic will provide outpatient physical therapy services, including, but not limited to: manual therapy techniques, therapeutic exercises, posture and body mechanics training, use of therapeutic modalities (i.e. ultrasound, traction) and symptom management techniques. The PTA Student Clinic is unique in that PTA students will be provided opportunities to implement a portion of the treatments, under the supervision of a licensed PT or PTA. Underserved and underinsured community members will gain access to physical therapy services, where they otherwise have limited or no access to such services. The Student Clinic produces a differentiated product, as many other companies provide physical therapy services, however this Student Clinic provides services to community members who are unable to access services at other businesses due to a variety of factors including exhausted benefits. The significant price reduction in physical therapy services as compared with a for-profit clinic allows for the same services to be provided by the student clinic at a reduced rate, due to low overhead and utilizing skills of student PTAs to implement aspects of treatment. There are approximately a dozen other community college based student PTA clinics currently functioning across the United States. The nearest student clinic to WCC is part of University of Puget Sound’s Doctor of Physical Therapy Program in Tacoma, WA, 128 miles away, which is exclusively for student Physical Therapists. Index ꟷ 29
  • 30.
    Page 7 of16 Market Assessment Examining the General Market The primary customer base targeted for the Student Clinic is one that is currently unable to access physical therapy services due to a lack of insurance, exhaustion of current insurance benefits or insurance that is not accepted at many established business locations. Based on discussion with local physical therapy business members, the customer base this Student Clinic is seeking is not desired due to reduced, or lack of, reimbursement. The PTA Student Clinic may be a positive drawing factor in a future student choosing the program at WCC over another institution. The Student Clinic will promote health and education in the local community to members who do not otherwise have access to standard physical therapy services. Local businesses will have the opportunity to refer patients who they are unable to treat, or who are undesired to be treated, and simultaneously support the education of PTA students. There are no comparable businesses in northwest Washington, and the customer base of the PTA Student Clinic is unique. There is no expectation that local businesses would claim that patients who choose to take advantage of the low-cost student PTA clinic would otherwise be able to utilize their services. The nearest community college PTA program is 86 miles away at Lake Washington Institute of Technology, which does not have a student clinic, therefore there is no direct threat of another student clinic competing with this business. Anticipated trends include having the same patient population attending treatment sessions weekly, or every other week, for the duration of Winter and Spring quarters. Some community patients may continue to be treated in the following academic year with a new cohort. There may be some inconsistency in attendance due to the target population's anticipated challenges with transportation, time management, or child care concerns and the lack of continuity of the clinic offering services throughout the year. The primary legal issue faced by the PTA Student Clinic is ensuring that initial evaluations are performed by a licensed physical therapist, and follow up treatments are supervised by a licensed physical therapist or physical therapist assistant, with the appropriate ratio of students to licensed staff, as per Washington State Law RCW 18.74.180, Section 3(c) (i) “The physical therapist may supervise a total of two assistive personnel at any one time.” and (ii): “In addition to the two assistive personnel authorized in (c)(i) of this subsection, the physical therapist may supervise a total of two persons who are pursuing a course of study leading to a degree as a physical therapist or a physical therapist assistant.” 30 ꟷ Index
  • 31.
    Page 8 of16 Customer Analysis Target customers include community members from Whatcom County who are not currently insured, have exhausted eligible insurance benefits or who have been denied access to treatment by local businesses. Physical therapy services address movement dysfunctions, pain due to injuries which can lead to loss of work or ability to perform activities of daily living, and educate the community on how to live with, and manage chronic pain or disabilities. Target customers are limited in access to such services, therefore the Student Clinic is solving a major barrier in their ability to benefit from these services, which may improve their quality of life, ability to work, or care for their children or other family members. When a customer receiving physical therapy services acknowledges improvement in their condition, they are very likely to continue participating in their treatment. When community patients receive enough treatment to resolve their impairment, they will cease to require our services and will not be appropriate to be retained as patients. Customer retention is likely to be high if they are benefiting from the Student Clinic services. The costs associated with customer support primarily include the salary of the Student Clinic Administrator and associated faculty, with a small amount of resources used for supplies and equipment. There are currently no student clinics in Whatcom County for either PT or PTA programs. The nearest student clinic is University of Puget Sound for PT students only. Local industry members support the implantation of the Student Clinic and have determined there is no competition between the Student Clinic and established physical therapy businesses. Services of the Student Clinic will be available to the underserved population as defined by those with no insurance or who may have exhausted their insurance benefits. The Student Clinic services will not be available to treat new injuries, or for students enrolled in an institution's sports program. Index ꟷ 31
  • 32.
    Page 9 of16 Strategic Implementation Production The Student Clinic has a competitive advantage by providing affordable physical therapy services to people who do not otherwise have access to such services. Technology such as Electronic Medical Records (EMR) will be used to document each treatment and assist with scheduling, as well as review of documentation by supervising therapists. Student Clinic Policies and Procedures Standard Student Clinic Operations Student Clinic Schedule  First year of operation, Student Clinic will run Spring and Summer Quarters, 2017, and students participating will be 1st year students. They will have completed enough coursework to begin limited treatment interventions. After that, Student Clinic will operate one day a week for Winter and Spring Quarters. Scheduling Appointments  Appointments will be made via a direct phone number for scheduling that includes an answering system that will be monitored by the Clinic Administrator.  Patients will be seen for one hour appointments from 1 p.m. until 4 p.m.  There will be expected variation due to students and supervising PTs and PTAs availability, as well as patients not showing up for their appointments, not returning after evaluation or not fulfilling complete cycle of visits.  Appointment Scheduling Options - See Index - Patient Attendance Policy  1 patient per hour per 4 students per team  Scheduling in advance - allows for better planning of staffing  Reminder calls will be made on the business day prior to appointment.  Walk-in appointments as available on first come, first served.  Cancellation Policy See Index - Patient Attendance Policy  Late arrival policy See Index - Patient Attendance Policy Fees for Service – Pilot Year  Pay in Advance- $15 for three appointments, $20 for five. Not Refundable.  Pay as You Go- $5.00 per appointment Volunteer Mentors (Physical Therapists and Physical Therapist Assistants)  Training/orientation  PT/PTA volunteers must complete training to prepare and understand expectations and responsibilities of being a mentor.  Volunteer PTs and PTAs must have individual malpractice insurance coverage. 32 ꟷ Index
  • 33.
    Page 10 of16 Students providing non-treatment roles and observing  Modified Reporter, Interpreter, Manager, Educator (RIME) framework for development of medical professionals See Index - Student Handbook for clarification Clinic Administrator Job Description and contract- See Index Consent  All staff and volunteers must sign consent to participate in student clinic which includes behavior and mentorship expectations, parameters for excusal of participation. Student Handbook – See Index  Student orientation/training  Roles and Responsibilities  Scope of Treatment  Student Daily Routine  Outcome Measurements  Statistics Tracking  Code of Conduct  Disciplinary Actions for violations of Code of Conduct  Behavioral expectations (professional attire, behavior, arrive at determined time, respect for socioeconomic factions, ethical standards, comply with letter and spirit of the law, report inappropriate/non-compliant actions to supervisor)  How to find a replacement in case of absence (applies to students and mentors)  Lines of communication: Who to report to for questions  Direct supervisor (PT or PTA)  Identified faculty/Program Director  Program Director or ACCE  How and where to report child, domestic or elder abuse  Responsibilities during treatment Documentation training - EMR vs. paper  Supervising PT/PTA to review notes prior to next treatment  Forms (All samples attached at index)  Patient intake/registration  Contact info, demographics, emergency contact  Consent to Treatment-Adult/ Consent to Treatment- Minors/Waivers/HIPAA  Medical History/ Wellness goals  Treatment Log (via EMR)  Surveys  Patient Satisfaction Surveys  Student Surveys  Faculty/Mentor Surveys  Patient Evaluations Completed by faculty members or volunteer mentors Index ꟷ 33
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    Page 11 of16  Collaboration with Doctor of Physical Therapy (DPT) programs in regional areas.  Washington State is a direct access state that allows the patient to self-refer for physical therapy services and does not require a prescription from a medical provider.  A patient’s 5th visit re-evaluation is required regardless of insurance coverage, per Washington State law RCW 18.74.170, Section 2(a) Intake and Documentation  PTA students initially process intake forms  PT evaluates patient; from there student follows treatment plan under supervision of PT or PTA  Student clinic can utilize EMR vs. paper charts depending on Student Clinic’s ability to access EMR Discharges Patients will be discharged when goals are met or if patient is not benefitting from services  Patients must be reevaluated by PT or discharged at 5th visit.  Anticipate scarcity of formal discharges due to nature of Student Clinic only being opened during select quarters  High potential for chronic conditions being treated, so patients will most likely return each quarter and not require discharges  There is no legal obligation to create discharge documentation due to no insurance or referring Medical Doctor (MD) to inform Resource Needs Staffing Paid position: Clinic Administrator  Provides support to program by scheduling appointments and handling patient payments.  Communicates any changes in Student Clinic needs including supplies and equipment  Communicates about Mentor involvement and possible concerns Unpaid Position(s)  Mentors: provide supervision and treatment assistance; volunteers Quarterly contracts acknowledging their commitment to participate as a mentor, which provides the opportunity to rotate with other therapists and prevent exhaustion of volunteers  Student PTAs: assist with treatments as outlined by supervising therapists. Students expected to participate during 2 quarters of their program. Contingency If staff members or students have a personal emergency, or are unable to uphold their duties in the Student Clinic for a period of time, they must take action to find a replacement for their position. An alternate will be identified (in 34 ꟷ Index
  • 35.
    Page 12 of16 advance) to take over Clinic Administrator duties if the designated staff member is unable to fulfill their duties. If either the Program Director or ACCE become unable to maintain their position, their replacement will be trained in the Student Clinic functions and needs. Financial Financial Requirements  Tax exempt - Student Clinic is on campus and considered an additional clinical education experience, it is considered to be part of the institution’s business.  Create means to accept donations  Establish an independent budget code and account through Business Office that can handle deposits from evaluation and treatment fees, as well as donations  Recurring expenses to be paid from this account  May be the only source of funds to be used for any Student Clinic needs Expenses  Salary for Clinic Administrator  Potential cost to do evaluations of patients if not pro-bono (est. $180- $200/patient)  Supplies/Laundry Income See attached Income/Expense Forecast  Donations/grants from local clinics/hospitals/foundations or agencies can add to resources  Fees for service for evaluations and treatments by those with capacity to pay. This fee structure will be re-evaluated after the first year. First Year: $5 per appointment (2 unexcused no-shows will result in patient dismissal); $15 for three appointments paid in advance (no-show penalty waived, appointment fee withdrawn from balance); $20 for five appointments paid in advance (no-show penalty waived, appointment fee withdrawn from balance)  Contingency  Donations to be solicited from local businesses, foundations or individuals to cover unaccounted for costs and expenses. If the Student Clinic is unable to be sustained according to this plan, then further efforts towards fundraising and gaining administrative support will be sought out to provide greater financial stability.  Excess funds that are not needed for supplies, may potentially be used for equipment purchases or continuing education courses or workshops for faculty participating in the clinic. Physical needs Equipment Needs  HPEC is set up and fully equipped for needs of Student Clinic except for EMR software, a cloud-based software.  Lab equipment typically present in PT/PTA lab Index ꟷ 35
  • 36.
    Page 13 of16  If needed, Student Clinic will purchase additional equipment with institution funds depending on available funds/donations Parking  Parking spaces are sufficient for patients during Student Clinic hours. The parking lot is compliant with American Disabilities Act (ADA). Emergency Procedures  In case of emergency, existing procedures for HPEC outlined by WCC are to be utilized. Risk Management/Liability Concerns Responsibility for the patient’s treatment  As determined by the Physical Therapist Practice Act, the most recent physical therapist to evaluate or treat a patient is the responsible party in case of negligence or injury. Malpractice Insurance  Supervising Physical Therapist/Physical Therapist Assistants will be required to pay for and maintain their own individual malpractice insurance. Most policies cover the policyholder regardless of what venue they are treating patients in which will be verified for WCC Clinic. Facility Coverage  Provide Insurance Policy Rider with Business Plan  College institutions maintain a standard level of liability insurance in case of an accidental injury on campus grounds. This covers students, faculty and visitors. Insurance documentation available through WCC Administrative Offices. Student Coverage  Students are covered by their institution for injury to a patient that occurs during, or as a result of, clinical experience during treatment  Students are required to have individual health insurance in case of self- injury. HIPAA regulations  The PTA Student Clinic will uphold all HIPAA policies in order to protect the privacy of the community patients who under treatment.  Students are educated in HIPAA regulations  Patients will sign HIPAA acknowledgement form 36 ꟷ Index
  • 37.
    Page 14 of16 Marketing Strategy For the launch of the Student Clinic, a Health and Wellness Fair will be planned for the Winter Quarter 2017 to serve as an opportunity for students to meet and educate local community members regarding the availability of affordable physical therapy services, as well as schedule patients for the first week(s) of the Student Clinic in Spring Quarter 2017. Fliers and marketing materials will be distributed in strategic locations to our target population. Local businesses will be informed of the Student Clinic as a resource to refer appropriate patient population. Future sessions of the Student Clinic are anticipated to run Winter and Spring Quarters. Facilities that offer shuttles to transport potential patients will also be contacted. Possible other means of marketing include use of social media, public service announcements, flyers and press releases. Index ꟷ 37
  • 38.
    Page 15 of16 Monitoring Expected Outcomes Evaluations and surveys are established to assess performance of the overall Student Clinic, student performance, Mentor performance and patient satisfaction. Feedback will inform continuous improvement of the clinic’s processes, services, student experience and operations. See forms in the Index. Monitoring  Utilization of evaluations and surveys will monitor performance and any changes required will be implemented by the ACCE and/or Program Coordinator.  Student clinical assessments, which are consistent with established clinical guidelines, will be used to ensure students are progressing professionally and academically.  Reviews for Mentors are completed by students and will be reviewed by Program Coordinator and ACCE. 38 ꟷ Index
  • 39.
    Page 16 of16 Income and Expense Fall 2016 Winter 2017 Spring 2017 Summer 2017 Annual NOTES Income Income based on academic quarter with a total of 10 weeks of service Week 1- clinic open / client fees 90.00$ 90.00$ 180.00$ Week 2- clinic open / client fees 90.00$ 90.00$ 180.00$ Fee $ per appointment $5.00 Week 3- clinic open / client fees 90.00$ 90.00$ 180.00$ Appointments per day 18 Week 4- clinic open / client fees 90.00$ 90.00$ 180.00$ Clients may be paying a reduced Week 5- clinic open / client fees 90.00$ 90.00$ 180.00$ rate, based on $15 for 3 visits Week 6- clinic open / client fees 90.00$ 90.00$ 180.00$ or $20 for 5 visits, paid in advance. Week 7- clinic open / client fees 90.00$ 90.00$ 180.00$ Week 8- clinic open / client fees 90.00$ 90.00$ 180.00$ Week 9- clinic open / client fees 90.00$ n/a 90.00$ Summer is only 8 weeks Week 10- clinic open / client fees 90.00$ n/a 90.00$ TOTAL CLIENT FEE INCOME 900.00$ 720.00$ 1,620.00$ Income from appointment fees % of clients show and pay 85% 85% 85% estimated client show rate Income based upon % 765.00$ 612.00$ 1,377.00$ Appointment fees less 15% no show Income from PTA Department and other sources $108.75 per unit tuition cost per WCC’s  website PTA program adjunct instructor 2,850.00$ 2,285.00$ 5,135.00$ Foundation or Grant Funds 2 Units of lab fee per student (24) 600.00$ 600.00$ 1,200.00$ $25 lab fee per student Other Sources 3,615.00$ 3,615.00$ Foundation or Grant Funds TOTAL INCOME 3,615.00$ 4,215.00$ 3,650.00$ 11,480.00$ Student lab fees, 85% client fees, program budget Expenses Clinic Administrator ($12/hr – 5  hours week, salary and benefits) 315.00$ 660.00$ 500.00$ 1,475.00$ Health Fair-marketing and supplies 300.00$ 300.00$ supplies 150.00$ 150.00$ 300.00$ gel 100.00$ 80.00$ 180.00$ Thera bands 400.00$ 300.00$ 700.00$ laundry 100.00$ 80.00$ 180.00$ software (purchased once) 3,000.00$ 3,000.00$ EMR software estimate adjunct faculty salary and benefits 2,850.00$ 2,285.00$ 5,135.00$ May require 1 adjunct faculty TOTAL EXPENSES 3,615.00$ 4,260.00$ 3,395.00$ 11,270.00$ NET -$ (45.00)$ 255.00$ 210.00$ PILOT YEAR MAY HAVE REDUCED INCOME AS THE STUDENT CLINIC GEARS UP FOR FULL OPERATION AND COMMUNITY AWARENESS BUILDS Index ꟷ 39
  • 40.
      Physical Therapist Assistant Student Clinic   Student/Mentor Handbook  Clinic Policies and Procedures  This document has not yet received final approval from AAG   ● 1. Roles and Responsibilities  o Clinic Administrator  ▪Schedules appointments by phone and in person  ▪ Time of appointment  ▪ Gives directions to clinic, and room number to report to  ▪ Request they arrive 15 minutes early to fill out paperwork  ▪ Collects payment for appointment $5.00, per treatment, or $20 for  five treatments paid in advance, cash or checks accepted.  ▪ Communicates scheduling changes to students/Mentors  o Identified Faculty and ACCE/Program Coordinator  ▪ Communicate any changes in clinic needs including supplies  and equipment   ▪ Communicate regarding student progress or concerns  ▪ Communicate about Mentor involvement and possible  concerns  ▪ Faculty to review student’s Daily Self­Assessment to provide  feedback and planning for next treatment  ▪ Once per month hold a large group mentoring session  o Student   ▪ Students are required to be on time to each clinic session and to  dress professionally for Student Clinic. (see pg 47 of the PTA  Program Student Handbook)  ▪  Attempts will be made to fill all treatment appointment times. If  either of the treatment appointment times assigned to a student is  unfilled or cancelled, he/she will be assigned duties by the  instructor.  ▪ Appointment Reminder Calls  ● On the Thursday before clinic, the student will receive the  names and phone numbers of the clients for that week to  confirm. Student will inform Clinic Administrator of  cancellations.  ● Each Student Physical Therapist Assistant will give his/her  clients a reminder call of the upcoming appointment. This  message must include:  o Time of appointment  o Directions to clinic, and room number to report to  o Request they arrive 15 minutes early to fill out  paperwork  PAGE 1 OF 4  DRAFT a DRAFT an DRAFT nd DRAFT d i DRAFT in DRAFT n p DRAFT pe DRAFT er DRAFT rs DRAFT so DRAFT on DRAFT n o DRAFT oo DRAFT om DRAFT m n DRAFT nu DRAFT um DRAFT mb DRAFT be DRAFT er DRAFT r t DRAFT to DRAFT o r DRAFT re DRAFT ep DRAFT po DRAFT or DRAFT rt DRAFT t t DRAFT to DRAFT o t DRAFT te DRAFT es DRAFT s e DRAFT ea DRAFT ar DRAFT rl DRAFT ly DRAFT y t DRAFT to DRAFT o f DRAFT fi DRAFT ifif DRAFT fif l DRAFT ll DRAFT l o DRAFT ou DRAFT ut DRAFT t p DRAFT pa DRAFT ap DRAFT papa DRAFT apa e DRAFT er DRAFT rw DRAFT wo DRAFT or DRAFT rk DRAFT k o DRAFT oi DRAFT in DRAFT nt DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t $ DRAFT $5 DRAFT 5. DRAFT .0 DRAFT 00 DRAFT 0, DRAFT , p DRAFT pe DRAFT er DRAFT r t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t, DRAFT , o DRAFT or DRAFT r $ DRAFT $2 DRAFT 20 DRAFT 0 f DRAFT fo DRAFT ofof DRAFT fof r DRAFT r a DRAFT ad DRAFT dv DRAFT va DRAFT an DRAFT nc DRAFT ce DRAFT e, DRAFT , c DRAFT ca DRAFT as DRAFT sh DRAFT h o DRAFT or DRAFT r c DRAFT ch DRAFT he DRAFT ec DRAFT ck DRAFT ks DRAFT s a DRAFT ac DRAFT cc DRAFT ce DRAFT ep DRAFT pt DRAFT te DRAFT ed DRAFT d. DRAFT . h DRAFT he DRAFT ed DRAFT du DRAFT ul DRAFT li DRAFT in DRAFT ng DRAFT g c DRAFT ch DRAFT ha DRAFT an DRAFT ng DRAFT ge DRAFT es DRAFT s t DRAFT to DRAFT o s DRAFT st DRAFT tu DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT ts DRAFT s/ DRAFT /M DRAFT Me DRAFT en DRAFT nt DRAFT to DRAFT or DRAFT rs DRAFT s A DRAFT AC DRAFT CC DRAFT CE DRAFT E/ DRAFT /P DRAFT Pr DRAFT ro DRAFT og DRAFT gr DRAFT ra DRAFT am DRAFT m C DRAFT Co DRAFT oo DRAFT or DRAFT rd DRAFT di DRAFT in DRAFT na DRAFT at DRAFT to DRAFT or DRAFT r e DRAFT e a DRAFT an DRAFT ny DRAFT y c DRAFT ch DRAFT ha DRAFT an DRAFT ng DRAFT ge DRAFT es DRAFT s i DRAFT in DRAFT n c DRAFT cl DRAFT li DRAFT in DRAFT ni DRAFT ic DRAFT c n DRAFT ne DRAFT ee DRAFT ed DRAFT ds DRAFT s i DRAFT in DRAFT nc DRAFT cl DRAFT lu DRAFT ud DRAFT di DRAFT in DRAFT ng DRAFT g p DRAFT pm DRAFT me DRAFT en DRAFT nt DRAFT t u DRAFT un DRAFT ni DRAFT ic DRAFT ca DRAFT at DRAFT te DRAFT e r DRAFT re DRAFT eg DRAFT ga DRAFT ar DRAFT rd DRAFT di DRAFT in DRAFT ng DRAFT g s DRAFT st DRAFT tu DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT t p DRAFT pr DRAFT ro DRAFT og DRAFT gr DRAFT re DRAFT es DRAFT ss DRAFT s o DRAFT or DRAFT r c DRAFT c m DRAFT mu DRAFT un DRAFT ni DRAFT ic DRAFT ca DRAFT at DRAFT te DRAFT e a DRAFT ab DRAFT bo DRAFT ou DRAFT ut DRAFT t M DRAFT Me DRAFT en DRAFT nt DRAFT to DRAFT or DRAFT r i DRAFT in DRAFT nv DRAFT vo DRAFT ol DRAFT lv DRAFT ve DRAFT em DRAFT me DRAFT en DRAFT nt DRAFT t a DRAFT an DRAFT n o DRAFT on DRAFT nc DRAFT ce DRAFT er DRAFT rn DRAFT ns DRAFT s F DRAFT Fa DRAFT ac DRAFT cu DRAFT ul DRAFT lt DRAFT ty DRAFT y t DRAFT to DRAFT o r DRAFT re DRAFT ev DRAFT vi DRAFT ie DRAFT ew DRAFT w s DRAFT st DRAFT tu DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT t’ DRAFT ’s DRAFT s D DRAFT Da DRAFT ai DRAFT il DRAFT ly DRAFT y S DRAFT Se DRAFT el DRAFT lf DRAFT f­ DRAFT ­f­f DRAFT f­f A DRAFT A f DRAFT fe DRAFT efef DRAFT fef e DRAFT ed DRAFT db DRAFT ba DRAFT ac DRAFT ck DRAFT k a DRAFT an DRAFT nd DRAFT d p DRAFT pl DRAFT la DRAFT an DRAFT nn DRAFT ni DRAFT in DRAFT ng DRAFT g f DRAFT fo DRAFT ofof DRAFT fof r DRAFT r n DRAFT ne DRAFT ex DRAFT xt DRAFT t t DRAFT tr DRAFT re DRAFT e ▪ DRAFT▪ O DRAFTOn DRAFTnc DRAFTce DRAFTe p DRAFTpe DRAFTer DRAFTr m DRAFTmo DRAFTon DRAFTnt DRAFTth DRAFTh h DRAFTho DRAFTol DRAFTld DRAFTd a DRAFTa l DRAFTla DRAFTar DRAFTrg DRAFTge DRAFTe g DRAFTgr DRAFTr o DRAFTo S DRAFTSt DRAFTtu DRAFTutut DRAFTtut d DRAFTde DRAFTen DRAFTnt DRAFTt ▪ DRAFT▪ S DRAFTSt DRAFTtu DRAFTutut DRAFTtut d DRAFTde DRAFTen DRAFTnt DRAFTts DRAFTs a DRAFTar DRAFTre DRAFTe r DRAFTre DRAFTeq DRAFTqu DRAFTui DRAFTir DRAFTre DRAFTed DRAFTd t DRAFTto DRAFTo b DRAFTbe DRAFTe d DRAFTdr DRAFTre DRAFTes DRAFTss DRAFTs p DRAFTpr DRAFTro DRAFTof DRAFTfe DRAFTefef DRAFTfef s DRAFTss DRAFTsi DRAFTio DRAFTon DRAFTna DRAFTal DRAFTll DRAFTly DRAFTy f DRAFTfo DRAFTofof DRAFTfof r DRAFTr P DRAFTPr DRAFTro DRAFTog DRAFTgr DRAFTra DRAFTam DRAFTm S DRAFTSt DRAFTtu DRAFTutut DRAFTtut d DRAFTde DRAFTen DRAFTnt DRAFTt H DRAFTHa DRAFTan DRAFTn ▪ DRAFT▪ A DRAFTAt DRAFTtt DRAFTte DRAFTem DRAFTmp DRAFTpt DRAFTts DRAFTs w DRAFTwi DRAFTil DRAFTll DRAFTl b DRAFTbe DRAFTe e DRAFTei DRAFTit DRAFTth DRAFThe DRAFTer DRAFTr o DRAFTof DRAFTf t DRAFTth DRAFThe DRAFTe t DRAFTtr DRAFTre DRAFTe u DRAFTun DRAFTnf DRAFTfi DRAFTifif DRAFTfif l DRAFTll DRAFTle DRAFTed DRAFTd o DRAFTor DRAFTr c DRAFTc i DRAFTin DRAFTns DRAFTst DRAFTtr DRAFTru DRAFTurur DRAFTrur c DRAFTct DRAFTto DRAFTor DRAFTr ▪ DRAFT▪ A DRAFTAp DRAFTpApA DRAFTApA p DRAFTpppp DRAFTppp o DRAFToi DRAFTi 40 ꟷ Index
  • 41.
      o Reminder that payment for  treatment is paid in  advance, cash or checks accepted.  ● Check and initial confirm box after call  ▪Modified RIME system: ​R​eporter, ​I​nterpreter, ​M​anager,  E​ducator, will identify the role of each student in treatment  group.   ● Reporter​: Gather and communicate clinical information  on patient; Distinguish important information from  unimportant information; Communicate relevant  subjective information; Identify opportunities for data  collection  ● Interpreter​: Identify potential problems or challenges in  treatment; offer possible solutions to identified  problems; develop support for individual treatment  interventions  ● Manager​: Monitor treatment time during each  intervention; Communicate with Identified  Faculty/Clinic Adminstrator regarding supplies or  equipment needs; Document objective data measures;  Determine questions to ask Mentor regarding treatment  interventions or diagnosis  ● Treatment​: Perform treatment intervention as outlined  by supervising physical therapist; Monitor patient’s  response to treatment; Communicate objective data  measures to Manager for documentation  ● Educator​: Mentor serves this role to provide clinical  problem solving, critical thinking and treatment  strategies  o Mentor  ▪ Support critical thinking and clinical problem solving pre­ and  post­treatment  ▪ Demonstrate and integrate therapeutic techniques  ▪ Teach students how to be a good caregiver  ▪ Promote effective communication techniques  ▪ Model and encourage professional behavior and positive  interactions with patients  o Limits on Physical Therapy Practice  ▪ The student clinic is legally required to refuse service to anyone  with a communicable disease or under the influence of an  intoxicant.  2  DRAFT M DRAFT Ma DRAFT an DRAFT na DRAFT ag DRAFT ge DRAFT er DRAFT r, DRAFT , nDRAFT ntDRAFT t iDRAFT inDRAFT n tDRAFT trDRAFT reDRAFT eaDRAFT atDRAFT tmDRAFT meDRAFT enDRAFT ntDRAFT t a DRAFT at DRAFT te DRAFT e c DRAFT cl DRAFT li DRAFT in DRAFT ni DRAFT ic DRAFT ca DRAFT al DRAFT l i DRAFT in DRAFT nf DRAFT fo DRAFT ofof DRAFT fof r DRAFT rm DRAFT ma DRAFT at DRAFT ti DRAFT io DRAFT on DRAFT n r DRAFT rt DRAFT ta DRAFT an DRAFT nt DRAFT t i DRAFT in DRAFT nf DRAFT fo DRAFT ofof DRAFT fof r DRAFT rm DRAFT ma DRAFT at DRAFT ti DRAFT io DRAFT on DRAFT n f DRAFT fr DRAFT rfrf DRAFT frf o DRAFT om DRAFT m ; DRAFT ; C DRAFT Co DRAFT om DRAFT mm DRAFT mu DRAFT un DRAFT ni DRAFT ic DRAFT ca DRAFT at DRAFT te DRAFT e r DRAFT re DRAFT el DRAFT le DRAFT ev DRAFT va DRAFT an DRAFT nt DRAFT t n DRAFT n; DRAFT ; I DRAFT Id DRAFT de DRAFT en DRAFT nt DRAFT ti DRAFT if DRAFT fy DRAFT yfyf DRAFT fyf o DRAFT op DRAFT pp DRAFT po DRAFT or DRAFT rt DRAFT tu DRAFT un DRAFT ni DRAFT it DRAFT ti DRAFT ie DRAFT es DRAFT s f DRAFT fo DRAFT ofof DRAFT fof r DRAFT r d DRAFT da DRAFT at DRAFT ta DRAFT a n DRAFT nt DRAFT ti DRAFT if DRAFT fy DRAFT yfyf DRAFT fyf p DRAFT po DRAFT ot DRAFT te DRAFT en DRAFT nt DRAFT ti DRAFT ia DRAFT al DRAFT l p DRAFT pr DRAFT ro DRAFT ob DRAFT bl DRAFT le DRAFT em DRAFT ms DRAFT s o DRAFT or DRAFT r c DRAFT ch DRAFT ha DRAFT al DRAFT ll DRAFT le DRAFT en DRAFT ng DRAFT ge DRAFT es DRAFT s i DRAFT i f DRAFT ff DRAFT ffff DRAFT fff e DRAFT efef DRAFT fef r DRAFT r p DRAFT po DRAFT os DRAFT ss DRAFT si DRAFT ib DRAFT bl DRAFT le DRAFT e s DRAFT so DRAFT ol DRAFT lu DRAFT ut DRAFT ti DRAFT io DRAFT on DRAFT ns DRAFT s t DRAFT to DRAFT o i DRAFT id DRAFT de DRAFT en DRAFT nt DRAFT ti DRAFT if DRAFT fi DRAFT ifif DRAFT fif e DRAFT ed DRAFT d ; DRAFT ; d DRAFT de DRAFT ev DRAFT ve DRAFT el DRAFT lo DRAFT op DRAFT p s DRAFT su DRAFT up DRAFT pp DRAFT po DRAFT or DRAFT rt DRAFT t f DRAFT fo DRAFT ofof DRAFT fof r DRAFT r i DRAFT in DRAFT nd DRAFT di DRAFT iv DRAFT vi DRAFT id DRAFT du DRAFT ua DRAFT al DRAFT l t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT m e DRAFT en DRAFT nt DRAFT ti DRAFT io DRAFT on DRAFT ns DRAFT s n DRAFT na DRAFT ag DRAFT gaga DRAFT aga e DRAFT er DRAFT r: DRAFT : M DRAFT Mo DRAFT on DRAFT ni DRAFT it DRAFT to DRAFT or DRAFT r t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t t DRAFT ti DRAFT im DRAFT me DRAFT e d DRAFT du DRAFT ur DRAFT ri DRAFT in DRAFT ng DRAFT g e DRAFT e i DRAFT in DRAFT nt DRAFT te DRAFT er DRAFT rv DRAFT ve DRAFT en DRAFT nt DRAFT ti DRAFT io DRAFT on DRAFT n; DRAFT ; C DRAFT Co DRAFT om DRAFT mm DRAFT mu DRAFT un DRAFT ni DRAFT ic DRAFT ca DRAFT at DRAFT te DRAFT e w DRAFT wi DRAFT it DRAFT th DRAFT h I DRAFT Id DRAFT de DRAFT en DRAFT nt DRAFT ti DRAFT i F DRAFT Fa DRAFT ac DRAFT cu DRAFT ul DRAFT lt DRAFT ty DRAFT y/ DRAFT /C DRAFT Cl DRAFT li DRAFT in DRAFT ni DRAFT ic DRAFT c A DRAFT Ad DRAFT dm DRAFT mi DRAFT in DRAFT ns DRAFT st DRAFT tr DRAFT ra DRAFT at DRAFT to DRAFT or DRAFT r r DRAFT re DRAFT eg DRAFT ga DRAFT ar DRAFT rd DRAFT di DRAFT i e DRAFT eq DRAFT qu DRAFT ui DRAFT ip DRAFT pm DRAFT me DRAFT en DRAFT nt DRAFT t n DRAFT ne DRAFT ee DRAFT ed DRAFT ds DRAFT s; DRAFT ; D DRAFT Do DRAFT oc DRAFT cu DRAFT um DRAFT me DRAFT en DRAFT nt DRAFT t o DRAFT ob DRAFT bj DRAFT j D DRAFT De DRAFT et DRAFT te DRAFT er DRAFT rm DRAFT mi DRAFT in DRAFT ne DRAFT e q DRAFT qu DRAFT ue DRAFT es DRAFT st DRAFT ti DRAFT io DRAFT on DRAFT ns DRAFT s t DRAFT to DRAFT o a DRAFT as DRAFT sk DRAFT k M DRAFT M i DRAFTin DRAFTnt DRAFTte DRAFTer DRAFTrv DRAFTve DRAFTen DRAFTnt DRAFTti DRAFTio DRAFTon DRAFTns DRAFTs o DRAFTor DRAFTr d DRAFTdi DRAFTia DRAFTag DRAFTgn DRAFTno DRAFTos DRAFTsi DRAFTis DRAFTs ● DRAFT● T DRAFTTr DRAFTrTrT DRAFTTrT e DRAFTea DRAFTat DRAFTtm DRAFTme DRAFTen DRAFTnt DRAFTt: DRAFT: P DRAFTPe DRAFTer DRAFTrf DRAFTfo DRAFTofof DRAFTfof r DRAFTrm DRAFTm t DRAFTtr DRAFTr b DRAFTby DRAFTy s DRAFTsu DRAFTup DRAFTpe DRAFTer DRAFTrv DRAFTvi DRAFTis DRAFTsi DRAFTin DRAFTng DRAFTg p DRAFTph DRAFThy DRAFTy r DRAFTre DRAFTes DRAFTsp DRAFTpo DRAFTon DRAFTns DRAFTse DRAFTe t DRAFTto DRAFTo t DRAFTtr DRAFTre DRAFTea DRAFTa m DRAFTme DRAFTea DRAFTas DRAFTsu DRAFTur DRAFTre DRAFTes DRAFTs t DRAFTto DRAFTo M DRAFTM ● DRAFT● E DRAFTEd DRAFTdu DRAFTuc DRAFTca DRAFTat DRAFTto DRAFTor DRAFTr: DRAFT: p DRAFTpr DRAFTro DRAFTob DRAFTbl DRAFTle DRAFTe s DRAFTst DRAFTtr DRAFTra DRAFTa o DRAFTo M DRAFTMe DRAFTen DRAFTnt DRAFTto DRAFTor DRAFTr ▪ DRAFT▪ S DRAFTSu DRAFTup DRAFTpp DRAFTp p DRAFTp ▪ DRAFT▪ Index ꟷ 41
  • 42.
    ▪ A WCC student athlete enrolled in the institution’s sports program  is not eligible for treatment.  ▪ A Patient who present with a new injury is not eligible for  treatment unless referred by their PT.  oNoise levels  ▪ During intake interview keep voices low to protect your Patient’s  privacy while going over the health intake form.  ● 2. Scope of Treatment may include:  o Body mechanics training  o Therapeutic exercise   o Modalities  o Balance training  o Patient Education  o Any treatment deemed necessary by PT  o Patient referrals  ▪ Identify patients who may benefit from other services such as  CareNav, support groups or other community services  ▪ Discuss appropriateness of referrals with supervising  therapist/mentor  ● 3. Student Daily Routine  o PT evaluation   ▪ Greet the patient and escort to treatment area  ▪ Introduce all members of treating team (RIME)  ▪ Gather equipment needed for the PT  ▪ Document relevant information from the evaluation into EMR  ▪ PT to review documention at end of evaluation.  o Daily Treatment  ▪ Review of patient chart for 30 minutes prior to clinic opening  ▪ Prepare treatment area  ▪ Record Subjective information on chart. Review goals of treatment  Note any possible changes to patients current level of function.  Consult with Mentor if you have any questions.   o Treatment (45 minutes)   ▪ Wash your hands.  ▪ If you leave a treatment area announce your presence to your  patient before you enter the area and only enter after the client  consents.  ▪ You may use treatment techniques learned in 1​st​  through 3​rd  quarter.  ▪ You must complete the treatment in the time allotted.   ▪ Wash your hands after the treatment   3  DRAFT o DRAFT or DRAFT r eDRAFT ecDRAFT ctDRAFT t yDRAFT yoDRAFT ouDRAFT urDRAFT r PDRAFT PaDRAFT atDRAFT tiDRAFT ieDRAFT enDRAFT ntDRAFT t’DRAFT ’sDRAFT s r DRAFT rm DRAFT m. DRAFT . e DRAFT es DRAFT ss DRAFT sa DRAFT ar DRAFT ry DRAFT y b DRAFT by DRAFT y P DRAFT PT DRAFT T n DRAFT nt DRAFT ts DRAFT s w DRAFT wh DRAFT ho DRAFT o m DRAFT ma DRAFT ay DRAFT y b DRAFT be DRAFT en DRAFT ne DRAFT ef DRAFT fi DRAFT ifif DRAFT fif t DRAFT t f DRAFT fr DRAFT rfrf DRAFT frf o DRAFT om DRAFT m o DRAFT ot DRAFT th DRAFT he DRAFT er DRAFT r s DRAFT se DRAFT er DRAFT rv DRAFT vi DRAFT ic DRAFT ce DRAFT e u DRAFT up DRAFT pp DRAFT po DRAFT or DRAFT rt DRAFT t g DRAFT gr DRAFT ro DRAFT ou DRAFT up DRAFT ps DRAFT s o DRAFT or DRAFT r o DRAFT ot DRAFT th DRAFT he DRAFT er DRAFT r c DRAFT co DRAFT om DRAFT mm DRAFT mu DRAFT un DRAFT ni DRAFT it DRAFT ty DRAFT y s DRAFT se DRAFT er DRAFT rv DRAFT v a DRAFT ap DRAFT pp DRAFT pr DRAFT ro DRAFT op DRAFT pr DRAFT ri DRAFT ia DRAFT at DRAFT te DRAFT en DRAFT ne DRAFT es DRAFT ss DRAFT s o DRAFT of DRAFT f r DRAFT re DRAFT ef DRAFT fe DRAFT efef DRAFT fef r DRAFT rr DRAFT ra DRAFT al DRAFT ls DRAFT s w DRAFT wi DRAFT it DRAFT th DRAFT h s DRAFT su DRAFT up DRAFT pe DRAFT e a DRAFT ap DRAFT pi DRAFT is DRAFT st DRAFT t/ DRAFT /m DRAFT me DRAFT en DRAFT nt DRAFT to DRAFT or DRAFT r y DRAFT y R DRAFT Ro DRAFT ou DRAFT ut DRAFT ti DRAFT in DRAFT ne DRAFT e v DRAFT va DRAFT al DRAFT lu DRAFT ua DRAFT at DRAFT ti DRAFT io DRAFT on DRAFT n ▪ DRAFT▪ G DRAFTGr DRAFTre DRAFTee DRAFTet DRAFTt t DRAFTth DRAFThe DRAFTe p DRAFTpa DRAFTat DRAFTti DRAFTie DRAFTen DRAFTnt DRAFTt a DRAFTan DRAFTnd DRAFTd e DRAFTes DRAFTsc DRAFTco DRAFTor DRAFTrt DRAFTt t DRAFTto DRAFTo t DRAFTtr DRAFTre DRAFTe ▪ DRAFT▪ I DRAFTIn DRAFTnt DRAFTtr DRAFTro DRAFTod DRAFTdu DRAFTuc DRAFTce DRAFTe a DRAFTal DRAFTll DRAFTl m DRAFTme DRAFTem DRAFTmb DRAFTbe DRAFTer DRAFTrs DRAFTs o DRAFTof DRAFTf t DRAFTtr DRAFTre DRAFTea DRAFTat DRAFTti DRAFTi ▪ DRAFT▪ G DRAFTGa DRAFTat DRAFTth DRAFThe DRAFTer DRAFTr e DRAFTeq DRAFTqu DRAFTui DRAFTip DRAFTpm DRAFTme DRAFTen DRAFTnt DRAFTt n DRAFTne DRAFTee DRAFTed DRAFTde DRAFTed DRAFTd f DRAFTf ▪ DRAFT▪ D DRAFTDo DRAFToc DRAFTcu DRAFTum DRAFTme DRAFTen DRAFTnt DRAFTt r DRAFTre DRAFTel DRAFTle DRAFTev DRAFTva DRAFTan DRAFTnt DRAFTt i DRAFTin DRAFTnf DRAFTfo DRAFTofof DRAFTfof r DRAFTr ▪ DRAFT▪ P DRAFTPT DRAFTT t DRAFTto DRAFTo r DRAFTre DRAFTev DRAFTvi DRAFTie DRAFTew DRAFTw d DRAFTdo DRAFToc DRAFTcu DRAFTum DRAFTme DRAFTe o DRAFTo D DRAFTDa DRAFTai DRAFTil DRAFTly DRAFTy T DRAFTTr DRAFTre DRAFTea DRAFTat DRAFTtm DRAFTme DRAFTen DRAFTnt DRAFTt ▪ DRAFT▪ R DRAFTRe DRAFTev DRAFTvi DRAFTie DRAFTew DRAFTw o DRAFTof DRAFTf p DRAFTpa DRAFTat DRAFTti DRAFTi ▪ DRAFT▪ P DRAFTPr DRAFTre DRAFTep DRAFTpa DRAFTar DRAFTre DRAFTe t DRAFTtr DRAFTre DRAFTe ▪ DRAFT▪ R DRAFTRe DRAFTec DRAFTco DRAFTor DRAFTrd DRAFTd S DRAFTS N DRAFTNo DRAFTot DRAFTte DRAFTe C DRAFTCo DRAFTo o DRAFTo T DRAFTTr DRAFTre DRAFTea DRAFTat DRAFTtm DRAFTm 42 ꟷ Index
  • 43.
    o Completing the visit  ▪ Walk patient back to the waiting area and give them evaluation  form to fill out and schedule next visit  ▪Complete documentation for patient’s treatment.  ▪ Documentation notes are property of Whatcom Community  College and MAY NOT BE TAKEN OUT OF THE CLINIC  AREA.  o Clean treatment area and prepare area for next patient  o Debriefing period for 30 minutes after clinic closing  o Fill out Daily Self Assessment Form  ● 4.  Outcome Measurements ­ The goal is to maintain a full appointment  schedule, allowing students to participate fully each week of the Student Clinic.  o Perform monthly to allow for continuous updating of student clinic  outcomes.  ▪ Patient satisfaction surveys  ● Comfort level during treatment  ● Student professionalism rating  ● Effectiveness of treatment ­ Compare to initial  treatment using visual scale Global Rating of Change  (GROC) assessment (or other applicable assessment  rating scale)  ▪ Student Feedback Surveys  1. Student clinic specific  2. Mentor specific  3. Daily Self Assessment Form  ▪ Mentor feedback surveys  ● Interest in future participation with student clinic  ● Assessment of learning goals: were they appropriate  and practical for students and did the students progress  in specified areas  ● Student clinic organization: how well did the clinic run  as compared to a private clinic  ● 5. Statistics Tracking See Index ­ Forms ­ Statistics Tracking  o Number of student hours in clinic  o Number of patients per week  o Evaluations vs. Treatments  o Mentor Hours PT vs. PTA  o Average patient satisfaction rating  o Essential for continuing support from institution and local volunteer  recruitment  4  DRAFT CDRAFT CoDRAFT omDRAFT mmDRAFT muDRAFT unDRAFT niDRAFT itDRAFT tyDRAFT y F DRAFT F T DRAFT TH DRAFT HE DRAFT E C DRAFT CL DRAFT LI DRAFT IN DRAFT NI DRAFT IC DRAFT C p DRAFT pa DRAFT at DRAFT ti DRAFT ie DRAFT en DRAFT nt DRAFT t n DRAFT ni DRAFT ic DRAFT c c DRAFT cl DRAFT lo DRAFT os DRAFT si DRAFT in DRAFT ng DRAFT g m DRAFT ma DRAFT ai DRAFT in DRAFT nt DRAFT ta DRAFT ai DRAFT in DRAFT n a DRAFT a f DRAFT fu DRAFT ufuf DRAFT fuf l DRAFT ll DRAFT l a DRAFT ap DRAFT pp DRAFT po DRAFT oi DRAFT in DRAFT nt DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t e DRAFT e f DRAFT fu DRAFT ufuf DRAFT fuf l DRAFT ll DRAFT ly DRAFT ylyl DRAFT lyl e DRAFT ea DRAFT ac DRAFT ch DRAFT h w DRAFT we DRAFT ee DRAFT ek DRAFT k o DRAFT of DRAFT fofo DRAFT ofo t DRAFT th DRAFT he DRAFT e S DRAFT St DRAFT tu DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT t C DRAFT Cl DRAFT lClC DRAFT ClC i DRAFT in DRAFT ni DRAFT ic DRAFT c. DRAFT . c DRAFT co DRAFT on DRAFT nt DRAFT ti DRAFT in DRAFT nu DRAFT uo DRAFT ou DRAFT us DRAFT s u DRAFT up DRAFT pd DRAFT da DRAFT at DRAFT ti DRAFT in DRAFT ng DRAFT g o DRAFT of DRAFT f s DRAFT st DRAFT tu DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT t c DRAFT cl DRAFT li DRAFT in DRAFT ni DRAFT ic DRAFT c t DRAFT ti DRAFT io DRAFT on DRAFT n s DRAFT su DRAFT ur DRAFT rv DRAFT ve DRAFT ey DRAFT ys DRAFT s o DRAFT or DRAFT rt DRAFT t l DRAFT le DRAFT ev DRAFT ve DRAFT el DRAFT l d DRAFT du DRAFT ur DRAFT ri DRAFT in DRAFT ng DRAFT g t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t u DRAFT ud DRAFT de DRAFT en DRAFT nt DRAFT t p DRAFT pr DRAFT ro DRAFT of DRAFT fe DRAFT efef DRAFT fef s DRAFT ss DRAFT si DRAFT io DRAFT on DRAFT na DRAFT al DRAFT li DRAFT is DRAFT sm DRAFT m r DRAFT ra DRAFT at DRAFT ti DRAFT in DRAFT ng DRAFT g E DRAFT Ef DRAFT ff DRAFT ffff DRAFT fff e DRAFT efef DRAFT fef c DRAFT ct DRAFT ti DRAFT iv DRAFT ve DRAFT en DRAFT ne DRAFT es DRAFT ss DRAFT s o DRAFT of DRAFT f t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t ­ DRAFT ­ C DRAFT Co DRAFT om DRAFT mp DRAFT pa DRAFT ar DRAFT re DRAFT e t DRAFT t t DRAFT tr DRAFT re DRAFT ea DRAFT at DRAFT tm DRAFT me DRAFT en DRAFT nt DRAFT t u DRAFT us DRAFT si DRAFT in DRAFT ng DRAFT g v DRAFT vi DRAFT is DRAFT su DRAFT ua DRAFT al DRAFT l s DRAFT sc DRAFT ca DRAFT al DRAFT le DRAFT e G DRAFT Gl DRAFT lo DRAFT ob DRAFT ba DRAFT al DRAFT l ( DRAFT (G DRAFT GR DRAFT RO DRAFT OC DRAFT C) DRAFT ) a DRAFT as DRAFT ss DRAFT se DRAFT es DRAFT ss DRAFT sm DRAFT me DRAFT en DRAFT nt DRAFT t ( DRAFT (o DRAFT or DRAFT r o DRAFT ot DRAFT th DRAFT he DRAFT er DRAFT r a DRAFT ap DRAFT p r DRAFT ra DRAFT at DRAFT ti DRAFT in DRAFT ng DRAFT g s DRAFT sc DRAFT ca DRAFT al DRAFT le DRAFT e) DRAFT ) ▪ DRAFT▪ S DRAFTSt DRAFTtu DRAFTud DRAFTde DRAFTen DRAFTnt DRAFTt F DRAFTFe DRAFTee DRAFTed DRAFTdb DRAFTba DRAFTac DRAFTck DRAFTk S DRAFTSu DRAFTur DRAFTrv DRAFTve DRAFTey DRAFTys DRAFTs 1 DRAFT1. DRAFT. S DRAFTSt DRAFTtu DRAFTud DRAFTde DRAFTen DRAFTnt DRAFTt c DRAFTcl DRAFTli DRAFTin DRAFTni DRAFTic DRAFTc s DRAFTsp DRAFTpe DRAFTec DRAFTci DRAFTif DRAFTfi DRAFTifif DRAFTfif c DRAFTc 2 DRAFT2. DRAFT. M DRAFTMe DRAFTen DRAFTnt DRAFTto DRAFTor DRAFTr s DRAFTsp DRAFTpe DRAFTec DRAFTci DRAFTif DRAFTfi DRAFTifif DRAFTfif c DRAFTc 3 DRAFT3. DRAFT. D DRAFTDa DRAFTai DRAFTil DRAFTly DRAFTy S DRAFTSe DRAFTel DRAFTlf DRAFTf A DRAFTAs DRAFTss DRAFTse DRAFTes DRAFTs ▪ DRAFT▪ M DRAFTMe DRAFTen DRAFTnt DRAFTto DRAFTor DRAFTr f DRAFTfe DRAFTefef DRAFTfef e DRAFTed DRAFTdb DRAFTba DRAFTac DRAFTck DRAFTk s DRAFTsu DRAFTu ● DRAFT● I DRAFTIn DRAFTnt DRAFTte DRAFTer DRAFTre DRAFTes DRAFTst DRAFTt i DRAFTi ● DRAFT● A DRAFTAs DRAFTss DRAFTse DRAFTes DRAFTs a DRAFTan DRAFTnd DRAFTd S DRAFT St DRAFT ta DRAFT at DRAFT ti DRAFT is DRAFT sisi DRAFT isi t DRAFT ti DRAFT ic DRAFT cs DRAFT scsc DRAFT csc N DRAFT N Index ꟷ 43
  • 44.
    PHYSICAL THERAPIST ASSISTANTPROGRAM COMPARISON SUMMARY Institutions have been consistently running a Student Clinic such as this as early as 1977. Clinics overall may not run year round due to curriculum and stafÞng constraints. a. Student Clinic Hours Student Clinics may be considered part of a laboratory class. Check with your accrediting body to determine rules for clinical and lab hour requirements. The majority of programs reported running their clinics two days a week for a limited number of hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are included in the second and third quarters of the student’s program. Only one clinic has available treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis. b. Practical Skills/Patient Care Where the patient pain/injury base varies from Chronic pain to high trauma, many serve the low income and underinsured population that may also be low compliance. Even though many appointment times may be available each day, the students may not see more than one or two patients. Students are expected to help with collecting patient health histories. Only one clinic allowed students to run the initial patient evaluation, the others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they treated pediatric patients. Only one conÞrmed that Neurological patients were seen. c. PTA Student Clinic Existence There are currently many established PT student clinics, however it is less common for community college PTA programs. Students and staff from each program conÞrmed that the educational and empowerment opportunities are priceless. Teaching students how to have rapport with patients and working side by side with PTs Òhelps to foster strong, innovative clinical decision making skills.Ó One programÕs students reported that they felt Òsafe to failÓ in a campus clinic setting. d. PT/PTA supervision requirements For all but one program initial evaluations were done by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3. Even thought the PTs and PTAs are required to carry insurance, the need for concerted Risk Managment was brought up by a few programs. The cost of additional liability insurance was covered by the institutions. e. Examples of Business Models Successful, revenue generating examples of business models vary from charging $50 for Þrst time patients, to free access for low income and underinsured patient population. Only one program stated they participated in research. The majority of the institutions already had lab facility and equipment in place. Partnerships and referrals from the PT community were keys for success. f. How to Measure Outcomes Student, patient and mentor surveys are used to help programs develop and measure outcomes for Students, Patients and Mentors. g. Expected and Unexpected Challenges If the clinic is dependent upon community PTs and PTAs to step up and volunteer, the task of recruitment is ongoing. For the initial year of the WCC program, there are plans in place to host a Health Fair in partnership with the other on- campus health programs prior to the Student Clinic open to spread the word. All Student Clinics must be sensitive to competition in the industry, and keep communications lines open to make sure that the clinic is being consistent and mindful of self-referring patients who are or are not eligible for treatment. Expenses of the clinic should be closely monitored to determine if fees need to be raised or lowered. DRAFT Institutions have been consistently running a Student Clinic such as this as early as 1977. DRAFT Institutions have been consistently running a Student Clinic such as this as early as 1977. Clinics overall may not run year round due to curriculum and stafÞng constraints DRAFT Clinics overall may not run year round due to curriculum and stafÞng constraints. DRAFT . Student Clinics may be considered part of a laboratory class. DRAFT Student Clinics may be considered part of a laboratory class. Check with your accrediting body to determine rules for clinical and lab hour requirements. TheDRAFT Check with your accrediting body to determine rules for clinical and lab hour requirements. The majority of programs reported running their clinics two days a week for a limited number of DRAFT majority of programs reported running their clinics two days a week for a limited number of hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are DRAFT hours per day, based upon student and instructor availability. At WCC, the clinic lab hours are included in the second and third quarters of the student’s program. DRAFT included in the second and third quarters of the student’s program. Only one clinic has available DRAFT Only one clinic has available treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis. DRAFT treatment sessions Þve days a week, but only on an Òas student/instructor availableÓ basis. Where the patient pain/injury base varies from Chronic DRAFT Where the patient pain/injury base varies from Chronic pain to high trauma, many serve the low income and underinsured population that may also be DRAFT pain to high trauma, many serve the low income and underinsured population that may also be low compliance. Even though many appointment times may be available each day, the students DRAFT low compliance. Even though many appointment times may be available each day, the students may not see more than one or two patients. Students are expected to help with collecting DRAFT may not see more than one or two patients. Students are expected to help with collecting patient health histories. Only one clinic allowed students to run the initial patient evaluation, the DRAFT patient health histories. Only one clinic allowed students to run the initial patient evaluation, the others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they DRAFT others were all done by licensed PTs. About half of the clinics contacted conÞrmed that they treated pediatric patients. Only one conÞrmed that Neurological patients were seen. DRAFT treated pediatric patients. Only one conÞrmed that Neurological patients were seen. c. PTA Student Clinic Existence DRAFT c. PTA Student Clinic Existence There are currently many established PT student clinics, DRAFT There are currently many established PT student clinics, however it is less common for community college PTA programs. Students and staff from each DRAFT however it is less common for community college PTA programs. Students and staff from each program conÞrmed that the educational and empowerment opportunities are priceless. Teaching DRAFT program conÞrmed that the educational and empowerment opportunities are priceless. Teaching students how to have rapport with patients and working side by side with PTs Òhelps to foster DRAFT students how to have rapport with patients and working side by side with PTs Òhelps to foster strong, innovative clinical decision making skills DRAFT strong, innovative clinical decision making skills.Ó One programÕs students reported that they felt DRAFT .Ó One programÕs students reported that they felt Òsafe to failÓ in a campus clinic setting. DRAFT Òsafe to failÓ in a campus clinic setting. d. PT/PTA supervision requirements DRAFTd. PT/PTA supervision requirements For all but one program initial evaluations were DRAFTFor all but one program initial evaluations were done by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3. DRAFTdone by PTs. In many States, the ratio is 1:2 ratio ICE1-2; 1:4 for ICE3. and PTAs are required to carry insurance, the need for concerted Risk Managment was brought DRAFTand PTAs are required to carry insurance, the need for concerted Risk Managment was brought up by a few programs. The cost of additional liability insurance was covered by the institutions. DRAFTup by a few programs. The cost of additional liability insurance was covered by the institutions. Examples of Business Models DRAFTExamples of Business Models Successful, revenue generating examples of business DRAFTSuccessful, revenue generating examples of business models DRAFTmodels vary from charging $50 for Þrst time patients, to free access for low income and DRAFTvary from charging $50 for Þrst time patients, to free access for low income and underinsured patient population. Only one program stated they participated in research. The DRAFTunderinsured patient population. Only one program stated they participated in research. The majority of the institutions already had lab facility and equipment in place. Partnerships and DRAFTmajority of the institutions already had lab facility and equipment in place. Partnerships and referrals from the PT community were keys for success. DRAFTreferrals from the PT community were keys for success. How to Measure Outcomes DRAFTHow to Measure Outcomes programs develop and measure outcomes for Students, Patients and Mentors. DRAFTprograms develop and measure outcomes for Students, Patients and Mentors. 44 ꟷ Index
  • 45.
    Facilities contacted: Drexel University(DPT) Sarah Wegner Assistant Clinical Professor, Coordinator of Experiential Learning [email protected] http://drexel.edu/cnhp/practices/11th-street/ Tulsa Community College Suzanne Reese Program Director: oversees clinic, no teaching [email protected] http://ptc.tulsacc.edu/index.html Univ. of Puget Sound Ann M Wilson Clinical Associate Professor and Director of Clinical Education [email protected] http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical- therapy/our-program/clinical-education/on-site-clinic/ Gateway Community College Jessica Goodman, Malka Stromer [email protected][email protected] http://www.gatewaycc.edu/hug-clinic Salt Lake Community College Diana Ploeger Program Coordinator [email protected]  http://www.slcc.edu/ptassistant/ El Paso Community College Debra L Tomacelli-Brock Program Coordinator https://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx Lake Superior College Brenda Martin [email protected] http://www.lsc.edu/current-students/physical-therapy-clinic/ DRAFT Clinical Associate Professor and Director of Clinical Education DRAFT Clinical Associate Professor and Director of Clinical Education http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical- DRAFT http://www.pugetsound.edu/academics/departments-and-programs/graduate/school-of-physical- DRAFT therapy/our-program/clinical-education/on-site-clinic/ DRAFT therapy/our-program/clinical-education/on-site-clinic/ DRAFT Gateway Community College DRAFT Gateway Community College Jessica Goodman, Malka Stromer DRAFT Jessica Goodman, Malka Stromer [email protected], [email protected], [email protected] [email protected] http://www.gatewaycc.edu/hug-clinic DRAFThttp://www.gatewaycc.edu/hug-clinic DRAFTSalt Lake Community College DRAFTSalt Lake Community College Diana Ploeger DRAFTDiana Ploeger Program Coordinator DRAFTProgram Coordinator [email protected] [email protected] http://www.slcc.edu/ptassistant/ DRAFThttp://www.slcc.edu/ptassistant/ DRAFTEl Paso Community College DRAFTEl Paso Community College Debra L Tomacelli-Brock DRAFTDebra L Tomacelli-Brock Program Coordinator DRAFTProgram Coordinator https://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx DRAFThttps://www.epcc.edu/InstructionalPrograms/Pages/PTA.aspx DRAFT Lake Superior College DRAFT Lake Superior College IndexIndex ꟷꟷ 4545
  • 46.
    PTA Student ClinicFocus Group Date of focus group: (Materials: pre-or post-survey, sign-up sheet for involvement-work groups, evaluation, supervision) Goals: • To identify challenges in creating and implementing a PTA student clinic from the industry perspective • Identify opportunities for industry to participate in the development of the clinic • Obtain suggestions from industry regarding ways to provide evaluations and supervision at the clinic 1. What is the first word that comes to your mind when you think of a PTA student clinic? 2. In what ways do you think a PTA student clinic will benefit the healthcare industry and our community? 3. Who do you envision receiving services at the PTA student clinic? 4. What are 2-3 challenges you anticipate in the implementation of the PTA student clinic? (Use index cards: take 1 minute to write your answers/thoughts on the index card) 5. In what ways will a PTA student clinic impact the local industry? 6. What do you like best about the proposed student clinic concept? 7. In what ways could industry be involved in the development of the clinic? 8. What do we need to consider regarding evaluations and supervision at the clinic? (be prepared to answer to law here, have a copy of the law for handouts) 9. How is your malpractice insurance covered, personally or by your organization? If personally, would it cover service provided in a student clinic at the college? 10. How can the college attract local PT’s willing to provide their time and mentorship? (how will this benefit the PT?) 11. What types of risk management issues might we encounter? 12. If you could create the ideal PTA student clinic, what would it look like? 13. Of all the things we discussed this evening, what to you is most important? 14. What are we missing? DRAFT work groups, evaluation, DRAFT work groups, evaluation, To identify challenges in creating and implementing a PTA student clinic from theDRAFT To identify challenges in creating and implementing a PTA student clinic from the Identify opportunities for industry to participate in the development of the clinic DRAFT Identify opportunities for industry to participate in the development of the clinic Obtain suggestions from industry regarding ways to provide evaluations and supervision DRAFT Obtain suggestions from industry regarding ways to provide evaluations and supervision What is the first word that comes to your mind when you think of a PTA student clinic? DRAFT What is the first word that comes to your mind when you think of a PTA student clinic? DRAFT what ways do you think a PTA student clinic will benefit the healthcare industry and DRAFT what ways do you think a PTA student clinic will benefit the healthcare industry and Who do you envision receiving services at the PTA student clinic? DRAFT Who do you envision receiving services at the PTA student clinic? What are 2-3 challenges you anticipate in the implementation of the PTA student DRAFT What are 2-3 challenges you anticipate in the implementation of the PTA student (Use index cards: take 1 minute to write your answers/thoughts on the index DRAFT (Use index cards: take 1 minute to write your answers/thoughts on the index In what ways will a PTA student clinic impact the local industry? DRAFT In what ways will a PTA student clinic impact the local industry? What do you like best about the proposed student clinic concept? DRAFT What do you like best about the proposed student clinic concept? In what ways could industry be involved in the development of the clinic? DRAFTIn what ways could industry be involved in the development of the clinic? What do we need to consider regarding evaluations and supervision at the clinic? DRAFTWhat do we need to consider regarding evaluations and supervision at the clinic? prepared to answer to law here, have a copy of the law for handouts) DRAFTprepared to answer to law here, have a copy of the law for handouts) 9. DRAFT9. How is your malpractice insurance covered, personally or by your organization? If DRAFTHow is your malpractice insurance covered, personally or by your organization? If personally, would it cover service provided in a student clinic at the college? DRAFTpersonally, would it cover service provided in a student clinic at the college? 10. DRAFT10. How can the college attract local PT’s willing to provide their time and mentorship? DRAFTHow can the college attract local PT’s willing to provide their time and mentorship? (how will this benefit the PT?) DRAFT(how will this benefit the PT?) What types of risk management issues might we encounter? DRAFTWhat types of risk management issues might we encounter? 46 ꟷ Index
  • 47.
    PTA Student Clinic@ Whatcom Community College Clinic Administrator Job Description and Contract This document has not yet received final approval from AAG Qualifications: ● No history of disciplinary actions ● Preferably 2-3 years of Clinical Administration experience Duties include, and are not limited to: ● Uphold the Mission and Vision of the PTA Student Clinic ● Schedule patient treatments from incoming phone calls ● Maintain a positive and supportive influence in the learning process of PTA students ● Act as a liaison between patients, students, faculty and volunteer mentors ● Monitor and document income from patient evaluations and follow up treatments ● Provide customer service, and administration of other duties as assigned for the Student Clinic By signing below, I agree to adhere to the performance expectations listed above. ________________________________________ _______________________ Name Date PTA Student Clinic @ Whatcom Community College DRAFT This document has not yet received final approval from AAG DRAFT This document has not yet received final approval from AAG Preferably 2-3 years of Clinical Administration experience DRAFT Preferably 2-3 years of Clinical Administration experience Uphold the Mission and Vision of the PTA Student Clinic DRAFT Uphold the Mission and Vision of the PTA Student Clinic Schedule patient treatments from incoming phone calls DRAFT Schedule patient treatments from incoming phone calls Maintain a positive and supportive influence in the learning process of PTA students DRAFT Maintain a positive and supportive influence in the learning process of PTA students Act as a liaison between patients, students, faculty and volunteer mentors DRAFT Act as a liaison between patients, students, faculty and volunteer mentors Monitor and document income from patient evaluations and follow up treatments DRAFT Monitor and document income from patient evaluations and follow up treatments Provide customer service, and administration of other duties as assigned for the DRAFT Provide customer service, and administration of other duties as assigned for the By signing below, I agree to adhere to the performance expectations listed above. DRAFT By signing below, I agree to adhere to the performance expectations listed above. ________________________________________ _______________________ DRAFT________________________________________ _______________________ Name Date DRAFTName Date Forms – 47
  • 48.
    Education Questions This documenthas not yet received final approval from AAG Mentor Do you feel your student has the background to understand what is expected of him/her in this setting and to perform at a level necessary to meet the expected skills? What kind of teaching methods seem to work best with this student (demonstration, practice, research, case studies, observation, other) What strengths have you observed during this student’s performance? What areas of performance have you observed that need improvement? What format have you established for communicating your feedback, expectations, and goals to your student? How would you describe your student’s performance so far. What changes would you like to see in your student’s behavior before this quarter is over? PTA Student Clinic @ Whatcom Community College DRAFT This document has not yet received final approval from AAG DRAFT This document has not yet received final approval from AAG to understand what is expected of him/her in this DRAFT to understand what is expected of him/her in this setting and to perform at a level necessary to meet the expected skills? DRAFT setting and to perform at a level necessary to meet the expected skills? seem to work best with this student (demonstration, practice, DRAFT seem to work best with this student (demonstration, practice, have you observed during this student’s performance? DRAFT have you observed during this student’s performance? What areas of performance have you observed that DRAFT What areas of performance have you observed that need improvement DRAFT need improvement? DRAFT ? What format have you established for DRAFT What format have you established for communicating DRAFT communicating your feedback, expectations, and goals to DRAFT your feedback, expectations, and goals to How would you describe your student’s DRAFT How would you describe your student’s performance DRAFT performance so far. DRAFT so far. would you like to see in your student’s behavior before this quarter is over? DRAFTwould you like to see in your student’s behavior before this quarter is over? 48 – Forms
  • 49.
    PTA Student Clinic@ Whatcom Community College Education Questions This document has not yet received final approval from AAG Student Describe how you have been challenged in this setting. Describe what you see as your strengths in this setting. What areas of your performance do you think need improvement? Describe the most effective constructive feedback you’ve received from your Mentor. Describe how you have incorporated this constructive feedback into your performance. How would you summarize your learning experience so far? What changes would you like to see in this learning environment? PTA Student Clinic @ Whatcom Community College DRAFT This document has not yet received final approval from AAG DRAFT This document has not yet received final approval from AAG improvement DRAFT improvement? DRAFT ? effective constructive feedback DRAFT effective constructive feedback you’ve received from your Mentor. DRAFT you’ve received from your Mentor.effective constructive feedback you’ve received from your Mentor.effective constructive feedback DRAFT effective constructive feedback you’ve received from your Mentor.effective constructive feedback have incorporated this constructive feedback DRAFT have incorporated this constructive feedback into your performance. DRAFT into your performance.have incorporated this constructive feedback into your performance.have incorporated this constructive feedback DRAFT have incorporated this constructive feedback into your performance.have incorporated this constructive feedback your learning experience so far? DRAFT your learning experience so far? would you like to see in this learning environment? DRAFT would you like to see in this learning environment? Forms – 49
  • 50.
    PTA Student Clinic@ Whatcom Community College Consent & Liability Waiver This document has not yet received final approval from AAG By initialing the following statements I am acknowledging that I have fully read and understand each statement: DISCLAIMERS You are consenting to undergo physical therapy treatment for your condition, including initial evaluation and limited plan of care. Treatment will be provided by a student in training to become a licensed physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of care in: scope of treatment due to students performing treatments, treatment times within traditional school hours and number of treatment days. __________ You understand that responding to a specific treatment can vary widely from person to person. It is not always possible to accurately predict your response to a certain therapy modality or procedure. We cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions. Services may include techniques that involve bodily contact, touching and/or direct contact, however your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged to discuss them with the supervising physical therapist. __________ You have the right to ask your physical therapist or physical therapist assistant (a licensed professional or Whatcom Community College PTA program faculty) what type of treatment he or she is planning based on your history, diagnosis, symptoms and testing results. Treatments may include but are not limited to therapeutic exercises, massage, functional activities and physical modalities. You may also discuss the potential risks and benefits of a specific treatment at any time during the treatment. You have the right to decline any portion of your treatment at any time before or during your treatment session. __________ CONSENT TO TREATMENT I consent to evaluation and treatment by the authorized personnel of Whatcom Community College as may be dictated by prudent medical practice because of my illness, injury, or condition. I understand that I will receive a portion of my treatment from a student with an educational objective, under the direct supervision of Whatcom Community College personnel. I understand that information about my case may be used without personal identifiers for educational purposes. I understand that I may be refused treatment if I appear obviously intoxicated, under the influence of drugs or the physical therapist deems my treatment medically unnecessary or outside the scope of this clinic’s practice. I reserve the right to refuse and withdraw from participation in physical therapy services at any time. This consent is intended as a waiver of liability of such treatment except for acts of negligence. __________ TREATMENT OF MINORS PTA Student Clinic @ Whatcom Community College DRAFT By initialing the following statements I am acknowledging that I have fully read and understand each statement: DRAFT By initialing the following statements I am acknowledging that I have fully read and understand each statement: You are consenting to undergo physical therapy treatment for your condition, including initial evaluation DRAFT You are consenting to undergo physical therapy treatment for your condition, including initial evaluation and limited plan of care. Treatment will be provided by a student in training to become a licensed DRAFT and limited plan of care. Treatment will be provided by a student in training to become a licensed physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of DRAFT physical therapist assistant. Limited plan of care may differ from a traditional physical therapy plan of care in: scope of treatment due to students performing treatments, treatment times within traditional DRAFT care in: scope of treatment due to students performing treatments, treatment times within traditional school hours and number of treatment days. __________ DRAFT school hours and number of treatment days. __________ You understand that responding to a specific treatment can vary widely from person to person. It is not DRAFT You understand that responding to a specific treatment can vary widely from person to person. It is not always possible to accurately predict your response to a certain therapy modality or procedure. We DRAFT always possible to accurately predict your response to a certain therapy modality or procedure. We cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is DRAFT cannot guarantee that our treatment will help the condition for which you are seeking treatment. There is also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions. DRAFT also a risk that your treatment may cause pain or injury, or may aggravate previously existing conditions. Services may include techniques that involve bodily contact, touching and/or direct contact, however DRAFT Services may include techniques that involve bodily contact, touching and/or direct contact, however your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged DRAFT your comfort and modesty will be addressed at all times. If you have any concerns, you are encouraged to discuss them with the supervising physical therapist. __________ DRAFT to discuss them with the supervising physical therapist. __________ You have the right to ask your physical therapist or physical therapist assistant (a licensed professional DRAFT You have the right to ask your physical therapist or physical therapist assistant (a licensed professional or Whatcom Community College PTA program faculty) what type of treatment he or she is planning DRAFTor Whatcom Community College PTA program faculty) what type of treatment he or she is planning based on your history, diagnosis, symptoms and testing results. Treatments may include but are not DRAFTbased on your history, diagnosis, symptoms and testing results. Treatments may include but are not limited to therapeutic exercises, massage, functional activities and physical modalities. You may also DRAFTlimited to therapeutic exercises, massage, functional activities and physical modalities. You may also discuss the potential risks and benefits of a specific treatment at any time during the treatment. You have DRAFTdiscuss the potential risks and benefits of a specific treatment at any time during the treatment. You have the right to decline any portion of your treatment at any time before or during your treatment session. DRAFTthe right to decline any portion of your treatment at any time before or during your treatment session. __________ DRAFT__________ CONSENT TO TREATMENT DRAFTCONSENT TO TREATMENT I consent to evaluation and treatment by the authorized personnel of Whatcom Community College as DRAFTI consent to evaluation and treatment by the authorized personnel of Whatcom Community College as may be dictated by prudent medical practice because of my illness, injury, or condition. I understand that DRAFTmay be dictated by prudent medical practice because of my illness, injury, or condition. I understand that I will receive a portion of my treatment from a student with an educational objective, under the direct DRAFTI will receive a portion of my treatment from a student with an educational objective, under the direct supervision of Whatcom Community College personnel. I understand that information about my case DRAFTsupervision of Whatcom Community College personnel. I understand that information about my case may be used without personal identifiers for educational purposes. I understand that I may be refused DRAFT may be used without personal identifiers for educational purposes. I understand that I may be refused 50 – Forms
  • 51.
    I, __________________________________, asa parent or legal guardian of _________________________________, give consent to services as directed by the Physical Therapist upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student Clinic. __________ NON-DISCRIMINATION: Admission to our clinic is non-discriminatory for services rendered, regardless of race, color, national origin, disability, economic status or age. All clients who come to our clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. WAIVER AND RELEASE I hereby release, discharge and acquit Whatcom Community College, its agents, representatives, affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow emergency and or medical services, including but not limited to ambulance service, Emergency Medical Technician, physician or urgent care services. __________ NOTICE OF PRIVACY PRACTICES I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant Student Clinic and authorize release of any medical records necessary to facilitate my treatment process. I have read a Notice of Patient Information Practices from Whatcom Community College regarding confidentiality and use of my personal health information and understand I may contact the supervising physical therapist at any time that I have questions. _____ By signing below, I acknowledge and agree to all terms stated above. Name of Patient (Please print) Signature of Patient Signature of Legal Guardian for patient under 18 years old Date PTA Student Clinic @ Whatcom Community College DRAFT upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at DRAFT upon being informed of such services listed and recorded in the plan of care. I agree to be on premises at all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student DRAFT all times and will cooperate fully with the students, staff, faculty and practitioners of the WCC Student Admission to our clinic is non-discriminatory for services rendered, DRAFT Admission to our clinic is non-discriminatory for services rendered, regardless of race, color, national origin, disability, economic status or age. All clients who come to our DRAFT regardless of race, color, national origin, disability, economic status or age. All clients who come to our clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of DRAFT clinic for services are protected against discrimination, assured by Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. DRAFT 1964, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. I hereby release, discharge and acquit Whatcom Community College, its agents, representatives, DRAFT I hereby release, discharge and acquit Whatcom Community College, its agents, representatives, affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of DRAFT affiliates, employees or assigns, of and from any and all liability, claim, demand, damage, cause of action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow DRAFT action, or loss of any kind arising out of or resulting from my refusal to accept, receive or allow emergency and or medical services, including but not limited to ambulance service, Emergency Medical DRAFT emergency and or medical services, including but not limited to ambulance service, Emergency Medical Technician, physician or urgent care services. __________ DRAFT Technician, physician or urgent care services. __________ NOTICE OF PRIVACY PRACTICES DRAFT NOTICE OF PRIVACY PRACTICES I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant DRAFT I hereby assign all benefits directly to the Whatcom Community College Physical Therapy Assistant Student Clinic and authorize release of any medical records necessary to facilitate my treatment DRAFT Student Clinic and authorize release of any medical records necessary to facilitate my treatment process. I have read a Notice of Patient Information Practices from Whatcom Community College DRAFTprocess. I have read a Notice of Patient Information Practices from Whatcom Community College regarding confidentiality and use of my personal health information and understand I may contact the DRAFTregarding confidentiality and use of my personal health information and understand I may contact the supervising physical therapist at any time that I have questions. _____ DRAFTsupervising physical therapist at any time that I have questions. _____ By signing below, I acknowledge and agree to all terms stated above. DRAFTBy signing below, I acknowledge and agree to all terms stated above. Name of Patient (Please print) DRAFTName of Patient (Please print) Signature of Patient DRAFTSignature of Patient Signature of Legal Guardian for patient under 18 years old DRAFT Signature of Legal Guardian for patient under 18 years old DRAFT DRAFT DRAFT Forms – 51
  • 52.
    DRAFT HIPAA Privacy AuthorizationForm **Authorization for Use or Disclosure of Protected Health Information (Required by the Health Insurance Portability and Accountability Act, 45 C.F.R. Parts 160 and 164)** **1.
Authorization**
 I
authorize
________________________________________
(healthcare
provider)
to
use
 and
disclose
the
protected
health
information
described
below
to
 ______________________________________________
(individual
seeking
the
information).
 **2.
Effective
Period**
 This
authorization
for
release
of
information
covers
the
period
of
healthcare
 from:
 a. □ ______________ to ______________. **OR** b. □ all past, present, and future periods. **3.
Extent
of
Authorization**
 a.
□
I
authorize
the
release
of
my
complete
health
record
(including
records
 relating
to
mental
healthcare,
communicable
diseases,
HIV
or
AIDS,
and
treatment
of
 alcohol
or
drug
abuse).

 **OR** b.
□
I
authorize
the
release
of
my
complete
health
record
with
the
exception
 of
the
following
information:

 
□
Mental
health
records


 
□
Communicable
diseases
(including
HIV
and
AIDS)


 
□
Alcohol/drug
abuse
treatment

 
□
Other
(please
specify):
_______________________________________________

 52 – Forms
  • 53.
    Sheet1 Page1 IncomeandExpenseFall2016Winter2017Spring2017Summer2017AnnualNOTES Income Week1-clinicopen/clientfees$90.00$90.00$180.00 Week2-clinicopen/clientfees$90.00$90.00$180.00Fee$perappointment$5.00 Week3-clinicopen/clientfees$90.00$90.00$180.00Appointmentsperday18 Week4-clinicopen/clientfees$90.00$90.00$180.00Clientsmaybepayingareduced Week5-clinicopen/clientfees$90.00$90.00$180.00rate,basedon$15for3visits Week6-clinicopen/clientfees$90.00$90.00$180.00or$20for5visits,paidinadvance. Week7-clinicopen/clientfees$90.00$90.00$180.00 Week8-clinicopen/clientfees$90.00$90.00$180.00 Week9-clinicopen/clientfees$90.00n/a$90.00Summerisonly8weeks Week10-clinicopen/clientfees$90.00n/a$90.00 TOTALCLIENTFEEINCOME$900.00$720.00$1,620.00Incomefromappointmentfees %ofclientsshowandpay85%85%85%estimatedclientshowrate Incomebasedupon%$765.00$612.00$1,377.00Appointmentfeesless15%noshow PTAprogrambudgetforadjuncts$2,850.00$2,285.00$5,135.00 2Unitsoflabfeeperstudent(24)$600.00$600.00$1,200.00$25labfeeperstudent OtherSources$3,615.00$3,615.00FoundationorGrantFunds TOTALINCOME$3,615.00$4,215.00$3,650.00$11,480.00 Expenses $315.00$660.00$500.00$1,475.00 HealthFair-marketingandsupplies$300.00$300.00 supplies$150.00$150.00$300.00 gel$100.00$80.00$180.00 Therabands$400.00$300.00$700.00 laundry$100.00$80.00$180.00 software(purchasedonce)$3,000.00$3,000.00EMRsoftwareestimate adjunctfacultysalaryandbenefits$2,850.00$2,285.00$5,135.00Mayrequire1adjunctfaculty TOTALEXPENSES$3,615.00$4,260.00$3,395.00$11,270.00 NET$-$(45.00)$255.00$210.00 Incomebasedonacademicquarterwith atotalof10weeksofservice IncomefromPTADepartmentand othersources $108.75perunittuitioncostperWCC’s website Studentlabfees,85%clientfees, programbudget ClinicAdministrator($12/hr–5 hoursweek,salaryandbenefits) DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFT DRAFTIncomeandExpense DRAFTIncomeandExpenseFall2016 DRAFTFall2016 Week1-clinicopen/clientfees DRAFTWeek1-clinicopen/clientfees Week2-clinicopen/clientfees DRAFTWeek2-clinicopen/clientfees Week3-clinicopen/clientfees DRAFTWeek3-clinicopen/clientfees Week4-clinicopen/clientfees DRAFTWeek4-clinicopen/clientfees Week5-clinicopen/clientfees DRAFTWeek5-clinicopen/clientfees Week6-clinicopen/clientfees DRAFTWeek6-clinicopen/clientfees Week7-clinicopen/clientfees DRAFTWeek7-clinicopen/clientfees$90.00 DRAFT$90.00 Week8-clinicopen/clientfees DRAFT Week8-clinicopen/clientfees$90.00 DRAFT $90.00 Week9-clinicopen/clientfees DRAFT Week9-clinicopen/clientfees$90.00 DRAFT $90.00 $90.00 DRAFT $90.00 $900.00 DRAFT $900.00 85% DRAFT 85% $765.00 DRAFT $765.00$612.00 DRAFT $612.00 $2,850.00 DRAFT $2,850.00$2,285.00 DRAFT $2,285.00 $600.00 DRAFT $600.00$600.00 DRAFT $600.00 $3,615.00 DRAFT $3,615.00 $4,215.00 DRAFT $4,215.00$3,650.00 DRAFT $3,650.00$11,480.00 DRAFT $11,480.00 $500.00 DRAFT $500.00$1,475.00 DRAFT $1,475.00 $300.00 DRAFT $300.00 $150.00 DRAFT $150.00$300.00 DRAFT $300.00 $80.00DRAFT $80.00$180.00DRAFT $180.00 $300.00 DRAFT $300.00$700.00 DRAFT $700.00 $80.00 DRAFT $80.00$180.00 DRAFT $180.00 $3,000.00 DRAFT $3,000.00 $2,285.00 DRAFT $2,285.00$5,135.00 DRAFT $5,135.00 $11,270.00 DRAFT $11,270.00 Forms – 53
  • 54.
    MENTOR CONFIDENTIALITY AGREEMENT Thisdocument has not yet received final approval from AAG I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant (PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby agree to handle such information in a confidential manner at all times during and after my mentorship and commit to the following obligations: A. I will use and disclose confidential health information only in connection with and for the purpose of performing my identified duties B. I will request, obtain or communicate confidential health information only as necessary to perform my identified duties and shall refrain from requesting, obtaining or communicating more confidential health information than is necessary to accomplish my identified duties. C. I will take reasonable care to properly secure confidential health information on my computer and will take steps to ensure that others cannot view or access such information. When I am away from my workstation or when my tasks are completed, I will log off my computer or use a password-protected screensaver in order to prevent access by unauthorized users. D. I will not disclose my personal password(s) to anyone without the express written permission of my department head or record or post it in an accessible location and will refrain from performing any tasks using another password. E. I will document all disclosures of confidential health information, including those authorized by clients of the PTA Student Clinic and any accidental disclosures, in the appropriate client’s file. I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor Confidentiality or HIPAA training when I enter the role of Mentor. I also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or violation of any terms of this Agreement up to and including termination of involvement in the PTA Student Clinic. Mentor Signature:____________________________________________________________ Mentor Printed Name:_________________________________________________________ Date:___________________________________ PTA Student Clinic @ Whatcom Community College DRAFT I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant DRAFT I acknowledge that during the course of performing my identified duties in the Physical Therapist Assistant (PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby DRAFT (PTA) Student Clinic I may have access to, use, or disclose confidential health information. I hereby agree to handle such information in a confidential manner at all times during and after my mentorship and DRAFT agree to handle such information in a confidential manner at all times during and after my mentorship and A. I will use and disclose confidential health information only in connection with and for the DRAFT A. I will use and disclose confidential health information only in connection with and for the B. I will request, obtain or communicate confidential health information only as necessary to DRAFT B. I will request, obtain or communicate confidential health information only as necessary to perform my identified duties and shall refrain from requesting, obtaining or DRAFT perform my identified duties and shall refrain from requesting, obtaining or communicating more confidential health information than is necessary to accomplish my DRAFT communicating more confidential health information than is necessary to accomplish my C. I will take reasonable care to properly secure confidential health information on my DRAFT C. I will take reasonable care to properly secure confidential health information on my computer and will take steps to ensure that others cannot view or access such DRAFT computer and will take steps to ensure that others cannot view or access such information. When I am away from my workstation or when my tasks are completed, I DRAFT information. When I am away from my workstation or when my tasks are completed, I will log off my computer or use a password-protected screensaver in order to prevent DRAFT will log off my computer or use a password-protected screensaver in order to prevent D. I will not disclose my personal password(s) to anyone without the express written DRAFT D. I will not disclose my personal password(s) to anyone without the express written permission of my department head or record or post it in an accessible location and will DRAFT permission of my department head or record or post it in an accessible location and will refrain from performing any tasks using another password. DRAFT refrain from performing any tasks using another password. E. I will document all disclosures of confidential health information, including those DRAFT E. I will document all disclosures of confidential health information, including those authorized by clients of the PTA Student Clinic and any accidental disclosures, in the DRAFT authorized by clients of the PTA Student Clinic and any accidental disclosures, in the s file. DRAFT s file. I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor DRAFT I understand that as a mentor of the PTA Student Clinic, I have an obligation to complete Mentor Confidentiality or HIPAA training when I enter the role of Mentor. DRAFT Confidentiality or HIPAA training when I enter the role of Mentor. I also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or DRAFTI also understand and agree that my failure to fulfill any of the obligation set forth in the Agreement and/or violation of any terms of this Agreement up to and including termination of involvement in the PTA Student DRAFTviolation of any terms of this Agreement up to and including termination of involvement in the PTA Student Mentor Signature:____________________________________________________________ DRAFTMentor Signature:____________________________________________________________ Mentor Printed Name:_________________________________________________________ DRAFTMentor Printed Name:_________________________________________________________ Date:___________________________________ DRAFTDate:___________________________________ 54 – Forms
  • 55.
    Identified Faculty/Mentor JobDescription and Quarterly Contract This document has not yet received final approval from AAG Qualifications: 1. Current PT or PTA licensure in the state of Washington. 2. Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last calendar year. 3. Demonstrated organizational skills. Preferred qualifications: 1. Mentor experience 2. Completion of APTA CCIP (Credentialed Clinical Instructor Program) 3. Board Certification by the American Physical Therapy Association Requirements: 1. Physical capacity to perform all essential functions of a physical therapist/physical therapist assistant. 2. Ability to be physically present during time commitments, including Mentor training. 3. Absences from scheduled clinic assignment are allowed only in cases of illness or unavoidable conflict. Time commitments: 1. On campus clinic hours are Mondays: 1:00 pm- 4:00 pm 2. In addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic- related work which includes: a. Preparation for clinical education teaching. (30 minutes before clinic hours/appointment.) b. Review of student PTA’s documentation and provision of feedback. (30 minutes after clinic closes/ appointment ends.) c. Review and teaching around established plan of care and provision of treatment. Functional Descriptions for Winter and Spring Clinic Assignments The students have NOT completed their clinical course work and there is considerable clinical skills and clinical decision making teaching during this semester by the Mentor. Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA Mentors will be guiding follow up treatments. The intent is to role model excellence in examination, treatment and clinical decision making. The instructor must be comfortable with multiple students observing them doing intake exams and treatment, and as much as possible be transparent (verbalizing along the way) what they are doing/seeing/ and why they are making selections. After the initial examination and treatments, there will be discussion and information exchange with the students as the students will document various aspects of the treatment and generate questions to understand the clinical decision making used by the licensed therapist. DRAFT Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last DRAFT Currently in clinical practice with a minimum of 400 hours of direct patient care work in the last Completion of APTA CCIP (Credentialed Clinical Instructor Program) DRAFT Completion of APTA CCIP (Credentialed Clinical Instructor Program) Board Certification by the American Physical Therapy Association DRAFT Board Certification by the American Physical Therapy Association Physical capacity to perform all essential functions of a physical therapist/physical therapist DRAFT Physical capacity to perform all essential functions of a physical therapist/physical therapist Ability to be physically present during time commitments, including Mentor training. DRAFT Ability to be physically present during time commitments, including Mentor training. Absences from scheduled clinic assignment are allowed only DRAFT Absences from scheduled clinic assignment are allowed only in cases of illness or unavoidable DRAFT in cases of illness or unavoidable On campus clinic hours are Mondays: 1:00 pm- 4:00 pm DRAFTOn campus clinic hours are Mondays: 1:00 pm- 4:00 pm In addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic- DRAFTIn addition to the on-campus hours, there is an expectation of ~ 3-4 hours a week spent on clinic- related work which includes: DRAFTrelated work which includes: a. DRAFTa. Preparation for clinical education teaching. (30 minutes before clinic hours/appointment.) DRAFTPreparation for clinical education teaching. (30 minutes before clinic hours/appointment.) b. DRAFTb. Review of student PTA’s documentation and provision of feedback. (30 minutes after DRAFTReview of student PTA’s documentation and provision of feedback. (30 minutes after clinic closes/ appointment ends.) DRAFTclinic closes/ appointment ends.) c. DRAFTc. Review and teaching around established plan of care and provision of treatment. DRAFTReview and teaching around established plan of care and provision of treatment. Functional Descriptions for Winter and Spring Clinic Assignments DRAFTFunctional Descriptions for Winter and Spring Clinic Assignments DRAFTThe students have NOT completed their clinical course work and there is DRAFTThe students have NOT completed their clinical course work and there is and clinical decision making DRAFTand clinical decision making teaching DRAFTteaching Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA DRAFT Specifically, the PT Mentor will be doing the initial evaluations of the patients and the PT and PTA Forms – 55
  • 56.
    New Patient Registration FirstName: _______ Initial: ______ Last Name: ____________ Address: City: State: Zip Code: Birth Date: Home Phone: ____Cell Phone: ____________________ Marital Status: (Single / Married / Other) Work Status: (Employed / Student / Retired / Other) Employer Name / School: Title: Phone: In case of emergency, contact: First Name: Last Name: Relationship: Phone: I give permission to discuss my medical condition with another person: (Yes / No) If yes, please list: I would like to receive appointment reminders via (Phone / Email / Text) Email Address: Thank you for the opportunity to serve you and for participating in this educational experience. Please do not hesitate to ask questions to your student therapist or supervising physical therapist at any time. Patient Signature: Date: If patient is a minor: Guardian Signature: Date: Whatcom Community College Student Physical Therapy Clinic DRAFT DRAFT Zip Code: DRAFT Zip Code: DRAFT DRAFT Cell Phone:DRAFT Cell Phone: ____________________DRAFT ____________________DRAFT Employed DRAFT Employed / DRAFT / Student DRAFT Student / DRAFT / Retired DRAFT Retired / DRAFT / Other DRAFT Other) DRAFT ) Phone: DRAFT Phone: DRAFT DRAFT Last Name: DRAFT Last Name: DRAFT DRAFT Phone: DRAFT Phone: DRAFT DRAFT I give permission to discuss my medical condition with another person: ( DRAFT I give permission to discuss my medical condition with another person: ( DRAFTI would like to receive appointment reminders via ( DRAFTI would like to receive appointment reminders via (Phone DRAFTPhone Email Address: DRAFTEmail Address: DRAFTThank you for the opportunity to serve you and for participating in this educational experience. Please do not DRAFTThank you for the opportunity to serve you and for participating in this educational experience. Please do not 56 – Forms
  • 57.
    Patient Satisfaction Survey Thisdocument has not yet received final approval from AAG 1. How did you learn about the Student Clinic? (Circle One) On campus Friend Physical Therapist Physician Website Other___________ 2. Was this your first experience with physical therapy? (Circle One) Yes No 3. Was this your first experience with this facility? (Circle One) Yes No 4. What location on your body was the physical therapy treatment for? ____________________________________________________________________________________ Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree, 2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an opinion on the question. My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A The PTA student was courteous. 1 2 3 4 5 N/A All other students and staff members were courteous. 1 2 3 4 5 N/A I was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A My visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A The location of the facility was convenient for me. 1 2 3 4 5 N/A I was satisfied with the services provided by the students. 1 2 3 4 5 N/A Parking was available for me. 1 2 3 4 5 N/A My physical therapist understood my problem or concern. 1 2 3 4 5 N/A The instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A I was satisfied with the overall quality of my care. 1 2 3 4 5 N/A I would recommend this facility to family and friends. 1 2 3 4 5 N/A I would return to this facility in the future. 1 2 3 4 5 N/A The cost of treatment received was reasonable. 1 2 3 4 5 N/A Overall, I was satisfied with my experience. 1 2 3 4 5 N/A PTA Student Clinic @ Whatcom Community College DRAFT This document has not yet received final approval from AAG DRAFT This document has not yet received final approval from AAG On campus Friend Physical Therapist Physician Website Other___________ DRAFT On campus Friend Physical Therapist Physician Website Other___________ Was this your first experience with physical therapy? (Circle One) Yes No DRAFT Was this your first experience with physical therapy? (Circle One) Yes No Was this your first experience with this facility? (Circle One) Yes No DRAFT Was this your first experience with this facility? (Circle One) Yes No What location on your body was the physical therapy treatment for? DRAFT What location on your body was the physical therapy treatment for? ____________________________________________________________________________________ DRAFT ____________________________________________________________________________________ Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree, DRAFT Please rate your degree of satisfaction with each of the following statements. (1=strongly disagree, 2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an DRAFT 2=disagree, 3=neither agree nor disagree, 4=agree, 5=strongly agree, N/A if you do not have an My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A DRAFT My privacy was respected during my physical therapy care. 1 2 3 4 5 N/A The PTA student was courteous. 1 2 3 4 5 N/A DRAFTThe PTA student was courteous. 1 2 3 4 5 N/A All other students and staff members were courteous. 1 2 3 4 5 N/A DRAFTAll other students and staff members were courteous. 1 2 3 4 5 N/A I was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A DRAFTI was satisfied with the treatment provided by the students. 1 2 3 4 5 N/A My visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A DRAFTMy visit for physical therapy was scheduled quickly. 1 2 3 4 5 N/A The location of the facility was convenient for me. 1 2 3 4 5 N/A DRAFTThe location of the facility was convenient for me. 1 2 3 4 5 N/A I was satisfied with the services provided by the students. 1 2 3 4 5 N/A DRAFTI was satisfied with the services provided by the students. 1 2 3 4 5 N/A Parking was available for me. 1 2 3 4 5 N/A DRAFTParking was available for me. 1 2 3 4 5 N/A My physical therapist understood my problem or concern. 1 2 3 4 5 N/A DRAFTMy physical therapist understood my problem or concern. 1 2 3 4 5 N/A The instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A DRAFTThe instructions my PT/student PTAs gave me were helpful 1 2 3 4 5 N/A I was satisfied with the overall quality of my care. 1 2 3 4 5 N/A DRAFTI was satisfied with the overall quality of my care. 1 2 3 4 5 N/A I would recommend this facility to family and friends. 1 2 3 4 5 N/A DRAFT I would recommend this facility to family and friends. 1 2 3 4 5 N/A I would return to this facility in the future. 1 2 3 4 5 N/A DRAFT I would return to this facility in the future. 1 2 3 4 5 N/A Forms – 57
  • 58.
    Patient History  This document has not yet received final approval from AAG  Name:   (​Male​ / ​Female​) Date:  Age: ________ DOB: ___/_____/____Height: __________ Weight: ________ Occupation:   CHIEF COMPLAINT AND PRESENT ILLNESS  Date symptoms/ injury started:  Date of most recent doctor visit:  Diagnosis from your doctor: Date of next doctor recheck:   What is your primary reason for attending therapy? ​(circle)  1) Pain   2) Limited motion   3) Weakness   4) Activity reduction   5) Loss of independence   6) Unable to work   7) Unable to do household tasks   8) Unable ​to play sports or do recreation  Are you currently off work because of this problem? (​Yes​ / ​No​) If yes, last day worked:   How did your symptoms start?   How would you describe your problem?   RATE your pain level:    ​No pain  1  2  3  4  5  6  7  8  9  10  Worst pain  How would you DESCRIBE your pain?  __ Dull ache __ Burning __ Heavy __ Sore  __ Deep ache __ Throbbing __ Twinge __ Other ​(explain)  __ Stabbing __ Squeezing __ Cramp   __ Nagging __ Drawing __ Sharp   Do you have any numbness/ tingling? (​Yes​ / ​No​)    Where?   Prior to this onset were you free of these symptoms? (​Yes​ / ​No​)  Explain:   What eases the pain?   What aggravates the pain?   Have you had any other treatment for this problem? (​Yes​ / ​No​)  If  yes, what?   Did it help? (​Yes​ / ​No​) Do you feel you are (​getting better​, ​getting worse​, or ​staying the same​)?  Please list diagnostic imaging or tests and relevant findings:        PTA Student Clinic @ Whatcom Community College   DRAFT nDRAFT ntDRAFT t dDRAFT doDRAFT ocDRAFT ctDRAFT toDRAFT orDRAFT r vDRAFT viDRAFT isDRAFT siDRAFT itDRAFT t:DRAFT : o DRAFT oc DRAFT ct DRAFT to DRAFT or DRAFT r r DRAFT re DRAFT ec DRAFT ch DRAFT he DRAFT ec DRAFT ck DRAFT k: DRAFT : p DRAFT pr DRAFT ro DRAFT ob DRAFT bl DRAFT le DRAFT em DRAFT m? DRAFT ? ( DRAFT (Y DRAFT Ye DRAFT es DRAFT s / DRAFT / N DRAFT No DRAFT o) DRAFT ) I DRAFT If DRAFT f y DRAFT ye DRAFT es DRAFT s, DRAFT , l DRAFT la DRAFT as DRAFT st DRAFT t d DRAFT da DRAFT ay DRAFT y w DRAFT wo DRAFT or DRAFT rk DRAFT ke DRAFT ed DRAFT d e DRAFT em DRAFT m? DRAFT ? n DRAFT n 1 DRAFT 1 2 DRAFT 2 3 DRAFT 3 4 DRAFT 4 5 DRAFT 5 6 DRAFT 6 7 DRAFT 7 8 DRAFT 8 9 DRAFT 9 1 DRAFT 10 DRAFT 0 W DRAFT Wo DRAFT or DRAFT rs DRAFT st DRAFT t p DRAFT pa DRAFT ai DRAFT in DRAFT n y DRAFT yo DRAFT ou DRAFT ur DRAFT r p DRAFT pa DRAFT ai DRAFT in DRAFT n? DRAFT ? n DRAFTni DRAFTin DRAFTng DRAFTg _ DRAFT__ DRAFT_ H DRAFTHe DRAFTea DRAFTav DRAFTvy DRAFTy _ DRAFT__ DRAFT_ S DRAFTSo DRAFTor DRAFTre DRAFTe h DRAFThr DRAFTro DRAFTob DRAFTbb DRAFTbi DRAFTin DRAFTng DRAFTg _ DRAFT__ DRAFT_ T DRAFTTw DRAFTwi DRAFTin DRAFTng DRAFTge DRAFTe _ DRAFT__ DRAFT_ O DRAFTOt DRAFTth DRAFThe DRAFTer DRAFTr ( DRAFT(e DRAFTe(e( DRAFT(e( x DRAFTxexe DRAFTexe p DRAFTpxpx DRAFTxpx l DRAFTla DRAFTai DRAFTi _ DRAFT_ S DRAFTSq DRAFTqu DRAFTue DRAFTee DRAFTez DRAFTzi DRAFTin DRAFTng DRAFTg _ DRAFT__ DRAFT_ C DRAFTCr DRAFTra DRAFTam DRAFTmp DRAFTp _ DRAFT__ DRAFT_ D DRAFTDr DRAFTra DRAFTaw DRAFTwi DRAFTin DRAFTng DRAFTg _ DRAFT__ DRAFT_ S DRAFTSh DRAFTha DRAFTar DRAFTrp DRAFTp h DRAFTha DRAFTav DRAFTve DRAFTe a DRAFTan DRAFTny DRAFTy n DRAFTnu DRAFTum DRAFTmb DRAFTbn DRAFTne DRAFTes DRAFTss DRAFTs/ DRAFT/ t DRAFTti DRAFTin DRAFTng DRAFTgl DRAFTli DRAFTin DRAFTng DRAFTg? DRAFT? ( DRAFT(Y DRAFTYe DRAFTes DRAFTs / DRAFT/ N DRAFTNo DRAFTo) DRAFT) r DRAFTre DRAFTe? DRAFT? t DRAFTth DRAFThi DRAFTis DRAFTs o DRAFTon DRAFTns DRAFTse DRAFTet DRAFTt w DRAFTwe DRAFTer DRAFTre DRAFTe y DRAFTyo DRAFTou DRAFTu f DRAFTfr DRAFTrfrf DRAFTfrf e DRAFTee DRAFTe o DRAFTof DRAFTf t DRAFTth DRAFThe DRAFTes DRAFTse DRAFTe p DRAFTpa DRAFTai DRAFTin DRAFTn? DRAFT? h DRAFThe DRAFTe p DRAFTpa DRAFTai DRAFTin DRAFTn? DRAFT? t DRAFT tr DRAFT r 58 – Forms
  • 59.
    Attendance Policy forPay-As-You-Go Patients This document has not yet received final approval from AAG Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on time and be prepared for your treatment. By signing below, I ____________________________________(print name) acknowledge and agree to the policies outlined below. I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I check-in for my appointment. I understand that services of the PTA Student Clinic are available to benefit me as a member of the underserved population which includes those with no insurance, or those who have exhausted their insurance benefits. The Clinic services are not intended to be used for the treatment of new injuries, or by students enrolled in an institution's sports program. I am eligible for Student Clinic Benefits: Initial Here _____________ Late arrival policy I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may not be treated due to limited time and availability of student therapists. After 2 late arrivals, I may be discharged. Cancellation Policy I will call with two business days notice to cancel a scheduled PT appointment. If I provide less than two business days notice, 1 no-show waiver will be allowed. The next incident may lead to my discharge and no further appointments to be scheduled. No Show Policy I understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not attend my scheduled appointment, I will be given one opportunity to re-schedule. A second no- show may result in my being discharged and I may no longer be eligible for future treatments at the Student Clinic. I acknowledge and agree to the policies outlined. ___________________________________ ______________________ Patient Signature Date PTA Student Clinic @ Whatcom Community College DRAFT Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on DRAFT Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on By signing below, I ____________________________________(print name) acknowledge and DRAFT By signing below, I ____________________________________(print name) acknowledge and I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I DRAFT I agree to pay for evaluation and/or treatment in the amount of $5.00, payable at the time I I understand that services of the PTA Student Clinic are DRAFT I understand that services of the PTA Student Clinic are available to benefit me as a member of the underserved population which includes those with no DRAFT available to benefit me as a member of the underserved population which includes those with no insurance, or those who have exhausted their insurance benefits. The Clinic services are not DRAFT insurance, or those who have exhausted their insurance benefits. The Clinic services are not intended to be used for the treatment of new injuries, or by students enrolled in an institution's DRAFT intended to be used for the treatment of new injuries, or by students enrolled in an institution's I am eligible for Student Clinic Benefits: Initial Here _____________ DRAFT I am eligible for Student Clinic Benefits: Initial Here _____________ I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may DRAFT I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may not be treated due to limited time and availability of student therapists. After 2 late arrivals, I DRAFT not be treated due to limited time and availability of student therapists. After 2 late arrivals, I Cancellation Policy DRAFTCancellation Policy I will call with two business days notice to cancel a scheduled PT appointment. If I provide less DRAFTI will call with two business days notice to cancel a scheduled PT appointment. If I provide less than two business days notice, 1 no-show waiver will be allowed. The next incident may lead to DRAFTthan two business days notice, 1 no-show waiver will be allowed. The next incident may lead to my discharge and no further appointments to be scheduled. DRAFTmy discharge and no further appointments to be scheduled. No Show Policy DRAFTNo Show Policy I understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not DRAFTI understand that as a Pay-As-You-Go Patient, if I fail to call to cancel ahead of time and do not attend my scheduled appointment, I will be given one opportunity to re-schedule. A second no- DRAFTattend my scheduled appointment, I will be given one opportunity to re-schedule. A second no- show may result in my being discharged and I may no longer be eligible for future treatments at DRAFTshow may result in my being discharged and I may no longer be eligible for future treatments at the Student Clinic. DRAFTthe Student Clinic. I acknowledge and agree to the policies outlined. DRAFT I acknowledge and agree to the policies outlined. Forms – 59
  • 60.
    Attendance Policy forPay-In-Advance Patients This document has not yet received final approval from AAG Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on time and be prepared for your treatment. By signing below, I ____________________________________(print name) acknowledge and agree to the policies outlined. I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for three (3) appointment credits, or $20 for five (5) appointment credits. I understand that services of the PTA Student Clinic are available to benefit me as a member of the underserved population which includes those with no insurance, or those who have exhausted their insurance benefits. The Clinic services are not intended to be used for the treatment of new injuries, or by students enrolled in an institution's sports program. I am eligible for Student Clinic Benefits: Initial Here _____________
 Late arrival policy I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I do not have any credits left for future appointments, I may be discharged. Cancellation Policy I agree to call with two business days notice to cancel a scheduled PT appointment. If I provide less than two business days notice, I understand that 1 appointment credit will be deducted from my account. If no credits remain after the appointment credit is deducted, no further appointments may be scheduled. No Show Policy If I fail to call to cancel my appointment and do not attend my scheduled appointment, 1 appointment credit will be deducted from my account. I will be given the opportunity to re- schedule as long as appointment credits remain on my account. I acknowledge and agree to the policies outlined. __________________________________ ___________________________ Patient Signature Date PTA Student Clinic @ Whatcom Community College DRAFT Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on DRAFT Clinic treatment hours are limited due to the institution’s academic schedule. Please arrive on By signing below, I ____________________________________(print name) acknowledge and DRAFT By signing below, I ____________________________________(print name) acknowledge and I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for DRAFT I agree to pay in advance for evaluations and/or treatments in the amount of (circle one) $15 for three (3) appointment credits, or $20 for five (5) appointment credits. DRAFT three (3) appointment credits, or $20 for five (5) appointment credits. I understand that services of the PTA Student Clinic are available to benefit me as a member of DRAFT I understand that services of the PTA Student Clinic are available to benefit me as a member of the underserved population which includes those with no insurance, or those who have exhausted DRAFT the underserved population which includes those with no insurance, or those who have exhausted their insurance benefits. The Clinic services are not intended to be used for the treatment of new DRAFT their insurance benefits. The Clinic services are not intended to be used for the treatment of new injuries, or by students enrolled in an institution's sports program. I am eligible for Student DRAFT injuries, or by students enrolled in an institution's sports program. I am eligible for Student Clinic Benefits: Initial Here _____________ DRAFT Clinic Benefits: Initial Here _____________ I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may DRAFT I understand that if I arrive more than 15 minutes after my scheduled appointment time, I may not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I DRAFT not be treated due to limited time and availability of student therapists. After 2 late arrivals, if I do not have any credits left for future appointments, I may be discharged. DRAFT do not have any credits left for future appointments, I may be discharged. Cancellation Policy DRAFTCancellation Policy I agree to call with two business days notice to cancel a scheduled PT appointment. If I provide DRAFTI agree to call with two business days notice to cancel a scheduled PT appointment. If I provide less than two business days notice, I understand that 1 appointment credit will be deducted from DRAFTless than two business days notice, I understand that 1 appointment credit will be deducted from my account. If no credits remain after the appointment credit is deducted, no further DRAFTmy account. If no credits remain after the appointment credit is deducted, no further appointments may be scheduled. DRAFTappointments may be scheduled. No Show Policy DRAFTNo Show Policy If I fail to call to cancel my appointment and do not attend my scheduled appointment, 1 DRAFTIf I fail to call to cancel my appointment and do not attend my scheduled appointment, 1 appointment credit will be deducted from my account. I will be given the opportunity to re- DRAFTappointment credit will be deducted from my account. I will be given the opportunity to re- schedule as long as appointment credits remain on my account. DRAFTschedule as long as appointment credits remain on my account. I acknowledge and agree to the policies outlined. DRAFTI acknowledge and agree to the policies outlined. 60 – Forms
  • 61.
    PTA Student Clinic@ Whatcom Community College Daily Self-Assessment Form This document has not yet received final approval from AAG Student Name: ___________________________________________________________ Date: ____________________________ 1. What did you do to promote a safe and comfortable environment? 2. What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what? 3. What do you feel you did especially well during the treatment session? 4. Now that the session is over, would you have done anything differently to make the treatment more comfortable, efficient or effective? If so, what? DRAFT Student Name: ___________________________________________________________ Date: DRAFT Student Name: ___________________________________________________________ Date: What did you do to promote a safe and comfortable environment? DRAFT What did you do to promote a safe and comfortable environment? What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful DRAFT What were your strategies to get feedback during the treatment (i.e. regarding comfort, painful areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what? DRAFT areas, etc.)? Did they work? Were you surprised by any of the feedback? If so, what? What do you feel you did especially well during the treatment session? DRAFTWhat do you feel you did especially well during the treatment session? Now that the session is over, would you have done anything differently to make the treatment DRAFT Now that the session is over, would you have done anything differently to make the treatment Forms – 61
  • 62.
    PTA Student ClinicFocus Group Date of focus group: (Materials: pre-or post-survey, sign-up sheet for involvement-work groups, evaluation, supervision) Goals: • To identify challenges in creating and implementing a PTA student clinic from the industry perspective • Identify opportunities for industry to participate in the development of the clinic • Obtain suggestions from industry regarding ways to provide evaluations and supervision at the clinic 1. What is the first word that comes to your mind when you think of a PTA student clinic? 2. In what ways do you think a PTA student clinic will benefit the healthcare industry and our community? 3. Who do you envision receiving services at the PTA student clinic? 4. What are 2-3 challenges you anticipate in the implementation of the PTA student clinic? (Use index cards: take 1 minute to write your answers/thoughts on the index card) 5. In what ways will a PTA student clinic impact the local industry? 6. What do you like best about the proposed student clinic concept? 7. In what ways could industry be involved in the development of the clinic? 8. What do we need to consider regarding evaluations and supervision at the clinic? (be prepared to answer to law here, have a copy of the law for handouts) 9. How is your malpractice insurance covered, personally or by your organization? If personally, would it cover service provided in a student clinic at the college? 10. How can the college attract local PT’s willing to provide their time and mentorship? (how will this benefit the PT?) 11. What types of risk management issues might we encounter? 12. If you could create the ideal PTA student clinic, what would it look like? 13. Of all the things we discussed this evening, what to you is most important? 14. What are we missing? DRAFT work groups, evaluation, DRAFT work groups, evaluation, To identify challenges in creating and implementing a PTA student clinic from theDRAFT To identify challenges in creating and implementing a PTA student clinic from the Identify opportunities for industry to participate in the development of the clinic DRAFT Identify opportunities for industry to participate in the development of the clinic Obtain suggestions from industry regarding ways to provide evaluations and supervision DRAFT Obtain suggestions from industry regarding ways to provide evaluations and supervision What is the first word that comes to your mind when you think of a PTA student clinic? DRAFT What is the first word that comes to your mind when you think of a PTA student clinic? what ways do you think a PTA student clinic will benefit the healthcare industry and DRAFT what ways do you think a PTA student clinic will benefit the healthcare industry and Who do you envision receiving services at the PTA student clinic? DRAFT Who do you envision receiving services at the PTA student clinic? What are 2-3 challenges you anticipate in the implementation of the PTA student DRAFT What are 2-3 challenges you anticipate in the implementation of the PTA student (Use index cards: take 1 minute to write your answers/thoughts on the index DRAFT (Use index cards: take 1 minute to write your answers/thoughts on the index In what ways will a PTA student clinic impact the local industry? DRAFT In what ways will a PTA student clinic impact the local industry? What do you like best about the proposed student clinic concept? DRAFT What do you like best about the proposed student clinic concept? In what ways could industry be involved in the development of the clinic? DRAFTIn what ways could industry be involved in the development of the clinic? What do we need to consider regarding evaluations and supervision at the clinic? DRAFTWhat do we need to consider regarding evaluations and supervision at the clinic? prepared to answer to law here, have a copy of the law for handouts) DRAFTprepared to answer to law here, have a copy of the law for handouts) 9. DRAFT9. How is your malpractice insurance covered, personally or by your organization? If DRAFTHow is your malpractice insurance covered, personally or by your organization? If personally, would it cover service provided in a student clinic at the college? DRAFTpersonally, would it cover service provided in a student clinic at the college? 10. DRAFT10. How can the college attract local PT’s willing to provide their time and mentorship? DRAFTHow can the college attract local PT’s willing to provide their time and mentorship? (how will this benefit the PT?) DRAFT(how will this benefit the PT?) What types of risk management issues might we encounter? DRAFTWhat types of risk management issues might we encounter? If you could create the ideal PTA student clinic, what would it look like? DRAFT If you could create the ideal PTA student clinic, what would it look like? 62 – Forms
  • 63.
    DRAFT PTA Student Clinic@ Whatcom Community College Statistics Tracking Week # of Evals # of Rx's PT Hours PTA Hours 1 2 3 4 5 6 7 8 9 10 Total Average Clinic Administrator hours Forms – 63
  • 64.
    64 – Forms DRAFT nityCollege Student Hours Patient Satisfaction Surveys received
  • 65.
    PHYSICAL THERAPY ASSISTANTSTUDENT CLINIC BENEFITS There are widespread benefits to having a student-run Physical Therapy Clinic for either Physical Therapist or Physical Therapist Assistant programs that serve the communities, institutions and individuals involved. STUDENTS ACADEMIC PROGRAMS COMMUNITY MEMBERS MENTORS Participating in a student clinic is a unique experience that few programs offer and will better prepare students for employment By offering innovative programs that include student clinics, any academic institution has the chance to stand out Too many people currently find themselves without a means to get help for injuries or conditions due to no insurance, exhausted benefits or limited coverage Offering a few hours a week to share real-world experience has a large impact Provide a safe and supportive environment to learn how to professionally interact with patients Opportunity to closely supervise the professional development of students Opportunity to receive physical therapy services for low or no-cost Opportunity to help shape the next generation of therapists Opportunity to learn from local therapists without the demanding schedule of a full clinic Connect educational programs to their local community Contribute to educating physical therapy students Smaller time commitment as compared to full-time Clinical Instructor Practice clinical skills with patients instead of fellow students Reduce dependency on clinical sites Learn about their physical impairments and how to manage them Provide treatment to under-served communities +$$ A+