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Raising the bar: Establishing standards of care (Part 2) (Proceedings)


Protocols create consistency of experience - - for the team, for the client, and for the patient

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

Train, train, train - - then train some more

      Protocols create consistency of experience - - for the team, for the client, and for the patient

Team training tools

           1. Lifelearn, Inc

               • CD's, DVD's, client handouts, etc.

               • www.lifelearn.com

               • 519-767-5043

           2. ACT

               • Animal care training

               • www.4act.com

               • 800-357-3182

           3. American Animal Hospital Association

               • Live webinars

               • Can use during team meetings

               • Archived for access when it is convenient for you!

           4. Advanstar

               • DVM 360 (www.DVM360.com)

               • Live and archived webinars (free!)

           5. Merial

               • www.vetmedteams.com (partial list)

                     - Fleas from A - Z

                     - Ticks from A – Z

                     - Zoonotic Diseases 101

                     - Zoonotic Diseases 102

                     - Companion Animal Dentistry 101

                     - Companion Animal Dentistry 102

                     - Canine Heartworm Disease

           6. Novartis

               • Separation Anxiety, Multi-modal Management of OA

               • Adequan's Role in OA

           7. Purina

               • www.purinavets.com/technicians

           8. Virbac

               • www.virbacuniversity.com

                     - Fundamentals of Heartworm Disease

                     - Pet Dental Care, 1 - 4

                     - Hypothyroidism

                     - Atopy 101

                     - Principles of Topical Therapy

           9. Greenies

               • www.vet.greenies.com

                     - Client Compliance w/ Oral Health

                     - The Importance of Feline Oral Health

           10. IDEXX

               • www.felinehealthchampion.com

                     - Building Your Feline Dentistry Practice

                     - Testing for & Managing Retrovirus-Positive Cats

                     - Heartworm Infection in Cats

               • www.idexxlearningcenter.com

                     - Fecal Analysis

                     - Tick-Borne Diseases 101

                     - Canine Pancreatitis

Bob Boylan - - "Weed out the non-believers - - they are neither wrong nor dumb if they don't agree with you. They're just on the wrong boat going in the wrong direction."


               • Pre-acquisition counseling to help a family make a good "fit"

               • What is their lifestyle?

               • What are their time/work commitments?

               • Are there children? If so, how many and what ages?

Pet acquisition

               • Outline wellness and vaccine visits

               • Provide basic wellness behavior guidance

               • Discuss the timing of the neuter & ovariohysterectomy

               • Talk about nutrition

               • Lay a good foundation for the adult years

               • Vaccine/wellness visits - -

                     - Create a "big picture"

                     - Schedule the next visit before the client leaves

                     - Create a "check list" for the veterinary nurse and veterinarian of topics for each visit

               • Wellness behavior

                     - Clients (pet owners and potential pet owners) DO NOT KNOW that the number of behavior-prompted euthanasias exceeds the number from all medical-related causes added together!!! We have a moral obligation to change that!!!

                     - Dogs have three most basic and fundamental needs (after food and shelter) - -

                           a) Exercise

                           b) Discipline/Structure

                           c) Affection

               • Wellness behavior tools:

                     - Premier Pet Products

                          Richmond, VA



               • Need for and timing of neuter or ovariohysterectomy

                     - Use "ovariohysterectomy", not "spay"

                     - Articulate comfort and safety concerns that drive anaesthesia and pain management choices

               • Preanaesthesia Lab Work

                     - It is better to risk losing a client who does not want what is best for the pet than to risk losing a pet to something we can predict or prevent

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

               • Nutrition:

                     - 3 things influence health, wellness, and longevity

                           a) Genetics

                           b) Environment

                     - 100% of our patients need to eat something every single day!!!

                     - Specific nutritional recommendation for every single patient at every single visit

                     - Product, measured portion per meal, number of meals per day

                     - Recommended products available

                     - Every single member of the veterinary healthcare team should know precisely what the usual nutritional recommendations are in order to reinforce the doctor's recommendation and answer any client questions (Speak with one voice...)

The adult years

               • Continue to focus on the importance of nutrition

               • Encourage 2 wellness visits and exams per year

               • Maintain good parasite control and prevention

               • Focus on compliance

               • How can you help your clients stay on task with all the many things they can and should do in order to keep their pet as healthy as possible?

               • Remember the three "R's":

                     - Remind

                     - Recall

                     - Reschedule

               • Computers are a wonderful thing... so use them!!!

               • Monthly "courtesy" call/e-mail/etc. for parasite prevention delivery

               • How much food are you dispensing? How long will the supply last? "We're putting together our order, may we set aside a bag/case for you?"

               • 85% of dogs and cats 1 year of age and older have periodontal disease at a level needing an intervention...

               • 3% of dogs getting what they need and deserve... 1% of cats - What's wrong with this picture?

Seniors/chronic disease

               • Compassionate care often means caring beyond a cure...

               • Help your clients understand the specifics of caring for a special needs pet, including nutrition

               • Examples include: renal disease, diabetes mellitus, osteoarthritis, cancer

               • At this life stage our vigilance becomes even more critical

               • Every member of the healthcare team must participate in weaving the safety net for these patients

               • Reinforce messages to clients frequently

               • Compliance study revealed that most clients want information about managing their animals' conditions nutritionally

                     - 59% of pets visiting the veterinarian had a condition that would benefit from nutritional management

                     - 12% actually reaping that benefit

               • Ongoing monitoring a must... educate clients early and often about its importance


               • Remember to practice medicine as a form of friendship

               • Your relationship can (and should) transcend the life of the pet

               • Your handling of euthanasia can make or break your relationship with clients who have lost a pet

Compassionate care clinic culture in action (heart of compliance)

               • Clinic culture permeates the practice

               • Compassionate care and advocacy are guiding values that influence a practice's mission

               • What are the implications when everyone on the practice team pays attention to his or her role in communicating culture to the client?

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Aaron Smiley, DVM
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