Evaluated on 10/29/2009
Dear Ms Salinger and Team,
Congratulations on such a successful AAHA evaluation and thank you for your commitment to continuous improvement not only for your practice but for the entire veterinary community. You can be very proud of your practice and the excellent care you provide to your clients and their pets. AAHA accreditation demonstrates that you’re willing to take that extra step toward hospital excellence. You are to be applauded for your success.
The following were noted as outstanding components of your evaluation:
- You have well-written standard operating protocols.
- The staff exhibited admirable teamwork.
- The practice exemplifies good implementation of the AAHA standards of excellence.
- The hospital is sparkling clean and fresh smelling, an important criterion to new and existing clients!
Below, we have presented your scores in table version. Please remember that the standards include many items that veterinary hospitals implement to different degrees. Our common goal is to provide continuously improving, quality patient care.
|AAHA Standards Section||Maximum
|Emergency and Critical Care||930||530||810||Passed|
|Housekeeping and Maintenance||1280||1130||1220||Passed|
We have taken the liberty of making suggestions based upon your evaluation. The following list should be understood as items that are areas for improvement as measured against the standards. Many of these were discussed during the evaluation and would be useful for the practice and practice team. We hope you will consider them and institute the items that you believe will benefit the hospital.
- AN25: Cardiopulmonary resuscitation training (CPR) is assessed on a semi-annual basis and updated as needed. corrected- online classes
Recommendation: Staff meetings are a great time to train the entire team on canine and feline CPR. Group training makes everyone aware of his or her individual responsibilities and the importance of everyone’s role during an emergency. It creates synergy, which can have a positive impact on team interaction during these stressful events.
Housekeeping and Maintenance
Your team does an excellent job maintaining the practice at an appropriate level of cleanliness. A sparkling clean and fresh smelling hospital is an important criterion to new and existing clients. Their commitment to the facility is a visual demonstration of the quality of care they provide.
- HM09: Linen storage minimizes contamination from surface contact or airborne sources. corrected
Recommendation: Clean linens should be placed in closets, cabinets or storage bins to prevent their potential contamination from airborne sources. Storage bins are available at most discount or department stores.
- LA18: Practice team member laboratory proficiency testing and appropriate corrective action is documented at least annually. correction- documentation kept
Recommendation: Proficiency testing ensures accurate test results. Ideally, each team member would perform testing on a sample that is also sent to a diagnostic laboratory for analysis. A comparison is made between the team member’s test and the outside laboratory result. The team member’s performance is recorded and any corrective action is documented. In lieu of sending the sample to an outside laboratory, a doctor or other highly skilled team member might read the comparison test. Although not as scrutinizing, this method would provide some review of basic proficiency.
- LA27: Practice team members wear disposable gloves when processing laboratory specimens or handling patient body fluids.
Recommendation: Disposable gloves are basic personal protective equipment and should be worn whenever handling any laboratory specimen such as feces, urine, aspirates, and swabs.
For quality assurance purposes, periodically audit some medical records. Choose a complex case, print the electronic record, gather all the hard copy notes and any additional information related to the case. Review these materials to determine if the appropriate information was recorded. Would you be comfortable if this record were reviewed by a legal or medical review board?
- PM01: Pain assessment using a standardized scale or scoring system is recorded in the medical record for every patient evaluation.corrected- pain stickers added to all charts
Recommendation: Identifying and implementing a pain scale will allow the veterinarians and practice team members to objectively score a patient’s level of pain. Most practices effectively using a pain scale have developed a 0 to 5 numerical scale. During a staff meeting, review available pain scales and discuss the pros and cons of each, deciding which symptoms correspond with each value. To begin using the pain score, consider adding it to examination stickers/templates, anesthetic forms, dental forms, hospitalization sheets, etc. This will help remind veterinarians and practice team members to always evaluate a patient’s level of pain.
- PC61: The practice utilizes a written plan for improving client compliance. Corrected
Recommendation: Research has identified that client compliance with practice recommendations is overstated in most hospitals and that there is considerable opportunity to improve pet health and practice income by improving client compliance. Having a written plan to increase and measure client compliance is vital to the success of any program you introduce. You can access resources to assist you through the AAHA website. AAHA Press has new publications based on the 2009 AAHA Compliance Follow-up Study titled Compliance: Taking Quality Care to the Next Level and Six Steps to Higher-Quality Patient Care. You can also access the AAHA 2009 Compliance Survey Executive Summary and a free copy of the 2003 study, Path to High Quality Care: Practical Tips for Improving Compliance, on the AAHA website under the Resources tab/ AAHA White Papers & Studies. Additionally, if you are a Care Credit member, they will provide a complimentary copy of a CD about compliance by Dr. Robin Downing.
- SX29: Ultrasonic cleaning, lubricating, and routine maintenance per manufacturer’s instructions are performed to improve longevity and maintain optimal performance of all instruments. Corrected- ultrasonic cleaner added, rest was already being done.
Recommendation: Surgical instruments are expensive and proper cleaning and use extends their life. The recommended method for cleaning surgical instruments prior to sterilization includes these steps. 1) Rinse the instrument with cold water immediately after use, 2) Scrub it in warm water with a soft brush and neutral pH solution, 3) Place it into an ultrasonic cleaner using the proper solution for 15 minutes, and 4) Thoroughly rinse and dry the instrument. Instruments with a working hinge or lock should be treated with an instrument milk or spray lubricant. The action of the ultrasonic cleaner will remove debris from tight grooves, and interior surfaces, areas that manual cleaning does not reach.