Lily Proctor

Vets for Pets Harrogate, Harrogate, United Kingdom

Objectives

We are a group of locally owned primary care small animal practices. This project focuses on a problem identified by the practice team.

We used an objective scoring method to confirm the problem was worthy of our investment of time. This took into consideration our sphere of influence, the benefit to patient and personal interest. This helped to overcome subjectivity that typically colours our judgement.

Diagnostics confirmed that our existing consent forms routinely captured only the information considered clinically essential, while important details relating to patient history, financial arrangements, and non‑clinical care were often omitted. This created communication gaps and introduced potential risks to patient safety, workflow efficiency, and client experience.

Methods

We utilised the IHI Model for Improvement including, aims and measurement and repeated cycles of change (Plan, Do, Study, Act). Our inclusion and exclusion criteria was as follows; any patients being admitted for treatment and patients not being admitted respectively.

 We aimed for 20 data points before change cycles and then ongoing data collection through iterative change cycles. For this project the total data points were 49.

The change ideas that were trialled and implemented were as follows:

•  Setting improvement goals with the nurses in their monthly 121 meetings.
• Reminding the clinical team during practice meetings
• Including parts of the information needed on the consent form in the pre-op phone call the day before admission

 By implementing the third change cycle we showed significant change to our baseline data within our run chart.

From the PDSA, the following changes were adopted.

During the pre-op phone call performed the day before admission clients were asked; the patient’s normal diets, any previous drug reactions or anaesthetic complications and to confirm financial means (insurance claims, owner insurance claims or owner funded).

Results

The enhanced pre‑admission process resulted in smoother admissions, more consistent communication, and improved team confidence. Fewer details were missed, and both clients and patients benefited from a more organised, personalised, and reassuring experience.

Statement: Impact/ Clinical Significance

This project has been eye opening for myself as someone very interested in quality improvement but can sometimes struggle to find the time to keep on top of this during busy practice life. The IHI model for improvement is something that will massively change the process of quality improvement for me, it is user friendly and something that I think more people would be inclined to interact with, due to the PDSA cycles and measure for improvements being quick and short to determine.

It enables us as a clinical team to explore and breakdown problems in a way that we might not normally do, and encourages us to engage with the team or clients to assisst with this process.