David Donovan

Walton Vale Vets For Pets, Liverpool, United Kingdom

Objectives

Walton Vale Vets For Pets is a small animal general veterinary practice. It was noticed that local anaesthesia was infrequently used in dental surgeries. Patients then suffer more and must be given additional general anaesthetic and pain medication. The additional anaesthetic and pain medications have more risk, is stressful for patients, and more costly for owners. Patient care would be improved if local anaesthesia was used more frequently.

Methods

We utilitsed the IHI Model for Improvement. We gathered 20 baseline data points before change cycles and then ongoing data collection through iterative change cycles. Baseline data indicated that 2 out of 10 patients undergoing dental surgery received local anaesthesia. The objective was to increase the number of patients receiving local anaesthesia during dental surgery to at least 7 out of 10 patients.

Key interventions included:

• Developing and disseminating a best practice dental process to include administration of local anaesthesia
• Local anaesthetic administration training
• Ensuring local anaesthetic was prepared for dental surgeries
• Introduction of a physical barrier to performing dental surgery without prior administration of local anaesthesia

Results

Significant change during the project with 9/10 patients receiving local anaesthesia by the end of the QI process.

Statement: Impact/ Clinical Significance

The QI project significantly enhanced the administration of local anaesthetic to patients undergoing dental surgery. Adaptations to cycles were required as email communication and posters as a method of influencing change had poor responses. Cycles with personal communication demonstrated a greater change. Speaking to people had a much more positive response and open discussions allowed queries or concerns to be addressed to help make change more effective.