Raising the bar: Establishing standards of care (Part 1) (Proceedings)

Irving Townsend - - "We who choose to surround ourselves with lives even more temporary than our own live within a fragile circle, easily and often breached. Yet, we still would live no other way."

Recent studies consistently report that 75 - 80% of pet owners think of their pets as children

      Where dogs stand in the household:

               • Member of the family - - 76%

               • Dog is one of most important things in life - - 67%

               • Dog is better companion than other family members - - 53%

               • Health of dog equal to own - - 49%

               • Dog's death equal to that of friend or relative - - 60%

Raising the bar

Recognize the opportunities for raising the standard of medical care, improving patient quality of life, and enhancing the family-pet relationship

      Remember C=R+A+FT

      Get over complacency (78% of vets)

      Avoid sticking our collective heads in the sand:

               • "My clients do as I tell them..."

               • "Not in my clinic..."

               • "There is no compliance problem in veterinary medicine..."

               • "It's not my problem..."

               • "Pet care is all up to the client..."

Help "parcel" client education to prevent information overload

               • Stop overestimating client concerns about money

               • Veterinarians and practice teams have much more influence than they think

               • Shrink the "recommendation gap" by training the entire team always to make the recommendations that reflect the best healthcare options for every single patient

Better medicine IS better business

               • Realize that better patient care is important

               • Care enough to do something about it

               • Advocate on behalf of a being who cannot advocate for itself - - for what it "needs and deserves"

Ask the following questions:

               • What is our standard of care?

               • How do we define our standard of care?

               • What sources do we use to define/determine our standard of care?

Tools for Raising the Bar

           1. Accreditation by the American Animal Hospital Association www.aahanet.org

               Accreditation standards make a GREAT place to start in formally adopting standards of care

           2. AAHA and other guidelines

                     - Don't reinvent the wheel

                     - Look to the experts and use their knowledge to your advantage

                     - Most guidelines are "open access" documents for the profession's consumption and use

                     - AAHA Senior Care Guidelines for Dogs and Cats (2005)

                     - AAHA Dental Care Guidelines for Dogs and Cats (2005)

                     - AAFP Feline Vaccine Advisory Panel Report (2006)

                     - AAHA Canine Vaccine Guidelines, Revised (2006)

                     - AAHA/AAFP Pain Management Guidelines for Dogs and Cats (2007)

                     - AAFP Senior Care Guidelines (cats) (revised 2008/published 2009)

                     - AAFP/AAHA Feline Life Stage Guidelines (2010)

           3. Veterinary Anesthesia and Analgesia Support Group (www.vasg.org)

                "Practical Information for the Compassionate Practitioner"

           4. Veterinary Information Network (VIN) (www.vin.com)

                          a) Veterinarians

                               - Interactive message boards

                               - Searchable library & database

                               - Continuing education

                               - Conference procedings

                          b) Academicians

                               - Faculty

                               - Interns & residents

                               - Recent graduates

                               - Veterinary students (free membership)

                          c) Veterinary Support Personnel Network (VSPN)

                               - Veterinary technicians and assistants

                               - Receptionists

                               - Office managers

                               - Other support staff

                               - Membership to VSPN is free

                               - Interactive message boards

                               - Libraries/databases

                               - Continuing education

                               - VSPN Notebook - - handbook of practical and useful information

           5. International Veterinary Academy of Pain Management (IVAPM)

                               - Christine Longaker - -"Pain is inevitable. Suffering is optional."

                               - Two or more members in a practice, receive "hospital discount"

                               - Communication via list-serve with posted questions/comments; discussions about medications, case management, new technology, etc

                               - IVAPM website provides information for both veterinary professionals and pet owners

                               - Members can access a library of previous discussions conducted on the list-serve

                               - Cutting-edge pain management information

                               - Deeply discounted subscription to "Veterinary Anaesthesia and Analgesia" (official journal) - - Very practical journal

                               - Access to pain experts from around the globe and from every discipline

                               - Can post questions to the list and most members open to messages "off list"

                               - Certification available for veterinarians, veterinary technicians - - "Certified Veterinary Pain Practitioner" (CVPP)

                               - Certification available for physical therapists and physical therapist assistants with certification in canine rehabilitation - - "Certified Animal Pain Practitioner" (CAPP)

Decide what is important:

               • What are the core values of the practice?

               • What are the core team values?

               • What mutual values are shared by the team?

               • Values create culture as they are always on display

      Decide where the practice is going

      Decide what the practice stands for

               • Any vision is intangible and must be translated into an emotional message...

               • Inspire your people to be believers!

If you don't know where you're going, you'll probably end up somewhere else...