How to Develop a Treatment Plan

Now that Drs. Shah and Mendoza have a working diagnosis, they've asked you to recommend a treatment plan for this patient. The physician's role at this stage is to recommend therapies that will ease or eliminate the patient's symptoms and that will help the injury to heal and prevent further damage. Another important goal is to help the patient return to normal functioning as soon as possible, minimizing the time lost from sports, school, and home activities, while also keeping the patient from further aggravating their injury.

Use the step-by-step instructions that follow to develop a treatment plan for William Rand. You will address all of the necessary components of treatment for this patient and make recommendations in terms of the different treatment options.

Getting Started

1. Get prepared to do your work in this task.
   
   
   • Go to the email sent to you by Dr. Mendoza, and download the attachments. You will need the following throughout the task:
     
     
   • Treatment Plan Template - This is the form that physicians at Lakeshore Hospital use to develop a treatment plan.
     
     
   • Carefully review the email from Dr. Mendoza to become familiar with the goals of this task.
     
     
2. Briefly review the attachment to the email-- the Treatment Plan Template -- to familiarize yourself with its contents.
   
   • Read the general instructions in the beginning of the document so you'll understand how to use it and be aware of the questions you'll need to answer.
     
     
   • Remind yourself of the list of the various treatment components that may be present in a sports injury treatment plan.
     
     
3. Explore the available resources to get a reminder on how to develop a treatment plan.
   
   
   • First, work with your teammates to create a quick list of the questions that you have about how physicians in sports medicine create a treatment plan for a patient. These questions, as before, might help you to focus your thought process during this task.
     
     
   • As you read, take notes on any material you find that answers the questions you raised with your team or that may help you to develop the treatment plan.
     
     
   • Read section 5 of the Diagnosis and Treatment Process document: Develop a treatment plan (and/or prevention plan). This section describes some of the considerations a physician must make when developing an appropriate treatment plan for a patient.
     
     
4. Organize your team to do the critique.
   
   
   • If you need a refresher on getting organized, refer back to the step-by-step in Task 1.

Completing the Treatment Plan Template: Sections A and B

Note: You will follow the same set of steps (given below) to fill out both Section A and Section B of the template. The difference between the two tables is the time frame for which the physician is planning—1-3 days following the injury in Section A and 4-14 days following the injury in Section B.

1. First, identify the most pressing issues that William Rand's treatment must address during the next few days (Section A) and in the next few weeks (Section B).
   
   
   1. Use the following questions to prompt your thinking about William's needs. As you answer the questions, take notes to record a list of these needs and any important details you and your teammates generate.
      
      
      • What has happened to William Rand? That is, what specific parts of William's anatomy need to be healed or repaired?
        
        
      • What symptoms and signs does William have that need to be eased or eliminated? (These can range from generalized symptoms to specific limitations in motions or functions of the joint.)
        
        
      • What progress, both general and specific, does William need to make before he can return to her normal activities? What might be done to speed up his recovery?
        
        
      • What do you think needs to be done, if anything, to prevent William from increasing the damage to his hip?
        
        
        • For example, if there is a fracture, what might cause the fracture to get worse? What could prevent that from occurring?
          
          
        • In addition, you should consider whether William's hip needs to be immobilized. If there is significant damage to a bone or ligament, it can lead to further damage. What could be done to prevent that?
          
          
      • What kinds of things do you think William must do in order to prevent future injuries? How might he prepare his body for injury-free participation in sports?
        
        
   2. To the extent that you are able, differentiate between the patient's needs in the acute stage (1-3 days after the injury) and the patient's needs in the following week or two, after the acute symptoms have subsided. (It's fine if you are not sure now, as you will research this information later.)
      
      
   3. With your teammates, come to a consensus about William Rand's most important health needs at this point. Develop a team list of these needs.
      
      
2. Decide whether each component of treatment is necessary in order to address the needs you identified. For each component, record your answer in the second column of the template. In order to decide whether each component of treatment is necessary, ask yourself the following questions:
   
   
   1. Am I familiar with each component of treatment?
      
      
      • If you are unfamiliar with any of the terms, research to find out what they mean.
        
        
      • Find out why each component is generally important in treating patients with sports injuries, and when it is usually used.
        
        
   2. Is each component necessary for William Rand?
      
      
      • Refer to DATA as well as any other external resources for information on treatment options for William's condition.
        
        
      • Does this component of treatment appear to be recommended for the management of William's condition?
        
        
      • For which phase(s) of treatment is this component recommended?

      Note where you found any relevant information, as you will be exploring the same information in more detail in step 3.

   3. Using the information gathered above, is each component necessary to include for William Rand at this time?
      
      
      • As you fill in each table, make sure that the component is appropriate for William during the specified time frame (approximately 1-3 days following the injury, or 4-14 days following the injury).
        
        
3. For each component of treatment, fill in the third column of the template: What is the rationale in regard to this component of treatment? Explain your thinking behind each component. In order to fully respond, think about what you included and why; and also, what did you choose to exclude and why?
   
   
4. Check your work to be sure that you completed everything in the template that was required. Edit your work with the help of your teammates so that your ideas are clear and organized. In reviewing your overall plan, ensure that the plan addresses all the patient's medical needs.
   

Meeting to Exchange Feedback

1. Meet with your cohort (made up of all teams participating in the rotation) to discuss your findings and ideas. Your mentor will assign your team one or more sections of the form at the beginning of the meeting. Your team will present your key ideas and lead the discussion of that section.
   
   
2. After incorporating any feedback you may have received during the discussion, submit your work to your mentor. Be sure to save all of your work, regardless of whether you submit it to the mentor.

There are no new Tips/Traps for this task. For guidance on revising a differential diagnosis, refer back to Tips and Traps for Case 1: Tennis Twist. The Critique of Differential Diagnosis task is relevant here.

Diagnosis and Treatment Archive - Sports Medicine

Diagnosis and Treatment Process
This document describes the process that health care professionals typically use to diagnose and treat their patients.

Orthopaedic Glossary
This glossary defines many of the terms used in this rotation.

These two links are supplements to the glossary:

Anatomical Terms of Location FAQ

Joint Motions FAQ

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