This case example shows how the team at Newnham Court Equine implemented a surgical safety checklist to improve patient safety. Completion of the checklist is monitored through regular auditing.
This award-winning case example shows how post-operative neutering complications were monitored using the National Audit for Small Animal Neutering. Complications were cut down by half by assessing hygiene and post-operative care guidelines.
This case example shows how Sandra Hunt and her team at The Laurels performed an audit to see if post-operative temperatures were being taken in practice. Once they had identified their in-house benchmark, they then set out to improve, and re-audit to measure their improvement.
This case example shows how Kay Lockwood, from Riversbrook Veterinary Group, performed an audit to see if feline patients were receiving local anaesthetic nerve blocks when having dental extractions.
This case example shows how Holly Warrilow RVN performed several audits over short periods to identify whether patient temperatures were being taken during the peri-operative period and to implement improvements to benefit patient care within the same period. Holly was awarded Highly Commended in the 2020 Knowledge Awards for her QI initiative.
This audit was inspired after the practice purchased a warm air circulating blanket for anaesthetic procedures, prompting the team to perform a process audit to ensure that the equipment was being utilised, and an outcome audit to see if the equipment was having a positive effect on patient care and recovery.
The team at Vets Now identified room for improvement in the care of dystocia cases. A working group was created to support clinicians with decision-making and improve patient welfare by using audit and benchmarking data to inform guidelines and resources relevant to care provided by Vets Now Ltd. The level of engagement in the audit highlighted team-wide commitment to improving patient outcomes.
Donview Veterinary Centre, part of the VetPartners group, demonstrated a strong learning culture and a dedication to improvement through an initiative aimed at improving post-operative temperatures. Working together, the team performed audits and used the results to assess where they can improve, successfully implementing change to create measurable improvements.
Anderson Moores Veterinary Specialists introduced a Notice to Anaesthetists (NOTAN), a notice inspired by the aviation industry that highlights any changes that might have safety implications. The NOTAN was introduced after a team survey identified gaps in knowledge about the latest information on anaesthesia practice, protocols, and equipment.
Eloise Collins used checklists, auditing, benchmarking, team meetings and journal clubs to help improve patient care and outcomes and to improve practice culture. Eloise helped to create psychological safety amongst the team through her open and honest approach. The application showed how an improvement culture involving the entire team creates positive change
Filham Park used clinical audit to review their use of the dental x-ray machine, identifying gaps in x-ray provision and providing clients with appropriate estimates. Training was implemented to improve skills and confidence, leading to an increase in service provision on repeat audit, and increased client satisfaction.
Paragon Referrals focused on the protection of critically important antimicrobials by bringing together an Antimicrobial Stewardship Team, creating guidelines based on the Plan Protect Prevent mantra and running in-house CPD. The team found improvements in prescribing culture, communication and a more open environment when discussing the appropriate use of antibiotics.
Tonia Simms from The Farm Vets at Hampden Veterinary Hospital (VetPartners), explored the use of antibiotics in surgical calf castrates. Tonia created a risk assessment and policy to reduce the routine use of prophylactic antibiotics. The actions of the team following the introduction of the interventions led to an increase in morale and confidence around not prescribing prophylactic antibiotics without compromising welfare.
White Lodge Veterinary Surgery, CVS, carried out a prospective audit to review the use of antibiotics, with a focus of antibiotic use in cat bite abscesses. With the introduction of checklists and in-house CPD they were able to treat 86% of their patients successfully without antibiotics without compromising welfare.
David Charles, who was working at Scarsdale Vets, part of the IVC Evidensia Farm Vets group at the time of the project, carried out an audit across a number of practices within the UK to collect baseline data on ovine lambings and caesareans. David introduced training and how-to guides, used SMART goals and put several recommendations on the provision of analgesia, selection and use of antibiotics and the use of adjunctive medications in place for the team to follow. The strong adoption of the recommendations across the practices resulted in a reduction in prophylactic antibiotic use, with improved use of local anaesthetics and the provision of analgesia.
Leanne McLeod from Earlswood Veterinary Hospital introduced a hypothermia audit with a focus on pre-warming patients before general anaesthesia. By introducing new protocols for the provision of passive warming from pre-medication, her team reduced the incidence of hypothermic patients from 100% to 16%.
Active Vetcare, CVS, focused on re-finding Joy in Work by carrying out a baseline survey to discover how the team felt about working at the practice. They introduced ‘What Matters to You?’ training and followed the Joy in Work framework. They introduced a Joy in Work Board, a Joy-O-Meter and a suggestion box. The team felt more engaged and were being listened to and the practice had a productive approach to addressing issues.
Hayley Potter from Old Golf House Vet Group introduced a ‘What Matters to You?’ initiative to improve workplace wellbeing with Joy in Work resources used to aid the change. The introduction of wellbeing meetings brought about several interventions to help boost morale and Net Promoter Score (NPS) score.
CVS South 4 Region used ‘Plan, Prevent, Protect’ to devise strategies to reduce antibiotic use, including team training and guidance documents. The team achieved an impressive 70% reduction in the use of long-acting antibiotics in the treatment of bite wounds and superficial skin infections in cats, without compromising patient welfare. This improved their overall responsible use of Highest Priority, Critically Important Antibiotics (HPCIAs), achieving a 65% reduction in their average use.
The Group Hub Clinical Leadership Team, CVS, carried out a clinical audit into blood pressure in cats on a national scale. The team created a wide range of guidance documents and provided team training. The nationwide initiative led to an increase in blood pressure monitoring, enabling earlier identification and treatment of hypertension in cats aged 7 years or older.