Tuesday, August 6, 2013

1058. KPI for veterinary surgery video script for interns


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   07 August, 2013  
 
Focus: Small animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits
Key Performance Indicators (KPI) in Veterinary Surgery   
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   07 August, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
Script for interns

HOOK


University life as a veterinary student
- leisurely surgery, lots of manpower
- possibly no lectures on the management of a practice including KPI, productivity and efficiency for a new vet in practice.
  
Video of University campus & graduation in Australia, UK, USA, France, Canada ---- Campus life, spring, summer, autumn, winter. Flowers in Spring, Summer holidays, Studying hard for examinations at the last minute. Lots of caffeine to keep awake during lectures. Youthfulness. Idealism. Change the world. 


Realities of the private practice
- competition is common in any business.  Over 50 veterinary practices in Singapore in 2013 and more being opened. The discerning pet owner now picks and choose. Proximity is important for most if there are no nearby practices.  What is the practice's USP (Unique Selling Proposition) and the owner's perception of the competency of the vets in the practice?

- high rental, labour & drug costs increasing every year.  Landlords and the bureaucrats want more income every year.

- Need to earn sufficient to sustain the practice and invest in upgrading equipment and maintenance
- Performance of the new vet is assessed by the seniors. Getting fired for poor performance is a fact of life for all employees of any business.   


1. What is KPI?
2. Why is KPI important in veterinary surgery?
 

The pet owner's primary concern is anaesthetic death. What has that to do with KPI in veterinary surgery?  The duration of surgery

1. Old and very young dogs are high anaesthetic risk. Taking too long to operate may result in anaesthetic deaths from heart failure. The owner will be unhappy and avoid the practice. Bad-mouthing the practice and advising friends or internet forums not to patronise that practice (video of forums).

2. Waste of resources. More time spent by supporting staff when they need to do other work. More drugs, sutures  and anaesthetic wasted as the vet does surgeries inefficiently and without planning.

3.  Less surgeries can be done/day. Turning away clients to competitors.

4. Less consultations can be done by vet as he or she takes an unreasonably long time to complete the surgery.

5. Less referrals from owners as they are not satisfied with the services and surgical outcomes.


3. How are KPI measured at Toa Payoh Vets?


3 case studies:

Case 1.  KPI - How long it takes to remove one bladder stone from a 10-year-old female poodle?

Case 2.  KPI - How long it takes to remove one bladder stone from a 9-year-old male Jack Russell? Case 3.  KPI - How long it takes to remove one big fast-growing skin tumour from a 10-month-old poodle?
.
CASE 1.
www.sinpets.com/F5/20130615stones_urinary_poodle.htm
Removing one bladder stone in a female poodle

A: Injection of Induction Drugs  2.50 pm
B:  Isoflurane gas first given:     2.55 pm
C: Isoflurane gas stopped:         3.39 pm
D: First skin incision:                3.11 pm
E: Completion of skin stitching   3.41 pm

E-D = 30 minutes of surgical time for a vet with 40 years of experience. 
E-A = 51 minutes for the whole process excluding pre-op preparations
C-B = 44 minutes of isoflurane gas + oxygen used.
 

CASE 2.
Video
Recent case operated. Refer to medical records.


Removing four bladder stone in a male Westie

A: Injection of Induction Drugs 
B:  Isoflurane gas first given:   
C: Isoflurane gas stopped:        
D: First skin incision:               
E: Completion of skin stitching  

E-D =      minutes of surgical time for a vet with 40 years of experience. 
E-A =      minutes for the whole process excluding pre-op preparations
C-B =      minutes of isoflurane gas + oxygen used.

CASE 3. 
Video
Recent case operated. Refer to medical records.

Removing one large skin tumour from a 9-month-old  male Poodle

A: Injection of Induction Drugs 
B:  Isoflurane gas first given:   
C: Isoflurane gas stopped:        
D: First skin incision:               
E: Completion of skin stitching  

E-D =      minutes of surgical time for a vet with 40 years of experience. 
E-A =      minutes for the whole process excluding pre-op preparations
C-B =      minutes of isoflurane gas + oxygen used


CONCLUSION

SAC (Speed, Accuracy and Completeness). These 3 factors are important in surgery. The KPI measures speed mainly. However, Accuracy and Completeness depend much on the vet's knowledge, skill and expertise.

A good surgical and clinical outcome from Accuracy and Completeness will satisfy the pet owner. This results in more referrals for the veterinary surgeon and sustain the practice in the long term. 

Over the past 3 decades, no KPI were formally practised during veterinary surgeries in Toa Payoh Vets.. Since 2010, I have introduced the KPI in the anaesthesia and surgery of all patients operated at Toa Payoh Vets to achieve the my mission of making Toa Payoh Vets one of the top 3 veterinary surgeries in Singapore.

KPI measurements takes time to be accepted by the associate vets as most people do not like change and it is likely that the veterinary professors do not lecture on this topic to the impressionable students.  The reputation and stature of the practice depends on good vets and affordable value for money fees, as perceived by the heartlander pet owner in Singapore. KPI are a very important direction to ensure a consistent and high standard of veterinary surgery at Toa Payoh Vets to sustain the survival of the practice over the years. 

PREVIOUS DRAFT
Script for video - KPI - interns
 
Updates will be on this webpage:
www.sinpets.com/F5/20130807key_performance
_indicators_vet.htm


More info at: Dogs or Cats
To make an appointment: e-mail judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
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All rights reserved. Revised: August 07, 2013

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