VetScript THE OFFICIAL MAGAZINE OF THE NEW ZEALAND VETERINARY ASSOCIATION
OUT OF THE BAG: Shaking up cat management
PROTECTING THE BREED: Groundbreaking scheme
S E P T E M B E R 2 0 16
THE TRUST FACTOR: What does your brand say?
A problem Vet Confessionals: making a difference
FEATURE
GOING FOR
GOLD Great clinical skills can only take a veterinary practice so far. Achieving high-quality outcomes also requires excellent teamwork and systems, which is where the NZVA’s BESTPRACTICE accreditation comes in to play. Jacqui Gibson reports. IF ACHIEVING THE gold standard of veterinary practice were a competitive sport among New Zealand veterinarians, the South Island would have the North Island licked. Last month, Rangiora Vet Centre became the country’s fourth practice to achieve the industry’s highest standards in veterinary practice.That brings the score to South Island 3, North Island 1. The team at Rangiora joins an elite club of veterinary practices that have attained NZVA standards known as BESTPRACTICE Hospital Standards. In the club are Rangiora Vet Centre in Canterbury, Halifax Veterinary Centre in Nelson, Humanimals in Dunedin and Massey University’s Veterinary Teaching Hospital in Palmerston North. Hans Andersen, a Halifax veterinarian, says it’s great that southerners are leading the charge, but the ultimate goal is to see more practices join the gold-standard ranks, regardless of where they’re located. “There’s a need for a cultural change within the veterinary industry,” says Andersen, Chair of the NZVA committee overseeing the industry’s BESTPRACTICE accreditation programme.
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“We’ve seen it happen in medicine. They’ve grasped the importance of looking beyond the brilliance of the individual to the performance of the whole team within a practice. “And that’s what our BESTPRACTICE programme is all about.” The accreditation programme has two levels – clinic-level accreditation and hospital-level accreditation. To achieve clinic-level accreditation, a practice must meet 15 standards covering everything from anaesthetic safety to legal compliance, and undergo an audit every two years. For hospital-level accreditation, a practice must meet a further set of standards specifying a higher level of skills and requirements for equipment and facilities. Currently, 54 veterinary practices have achieved clinic-level accreditation and four have hospital-level accreditation, representing around 13% of practices. That’s a decline from a high of 71 that was achieved four or five years ago. Andersen says the figure clearly shows there is still some way to go to meet the NZVA’s goal of having 50% of practices accredited to at least clinic level by 2030.
PHOTOS: ELIZABETH PITCORN, AMANDA TRAYES
FEATURE
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FEATURE
BESTPRACTICE ACCREDITATION: WHAT’S IN IT FOR ME? 1 Improves all aspects of your business.
2 Results in better-quality care for patients.
3 Says to others you value best practice. 4 Cuts back on errors, waste and risk. 5 Helps compliance with the law and industry regulations.
6 Boosts staff morale and teamwork. 7 Attracts and retains staff and reduces staff churn.
8 Improves communication with employees and customers.
9 Provides an objective, independent view of your business. Rangiora Vet Centre’s Rebecca Weight.
BARRIERS TO ACCREDITATION So what does he think are the main barriers to accreditation? Why are New Zealand veterinary practices dragging their heels? “Partly it’s about being too busy,” says Andersen. “Achieving accreditation takes time. It takes investment. There’s paperwork involved. You have to set up new systems and undergo regular audits. “Again, it comes down to this lingering perception that simply having good professionals with strong knowledge and skills is sufficient today. As vets, we’ve always believed quality is implicit in what we do. But great clinical skills can only take you so far. “A really good veterinary practice has to have good systems, too. Achieve both and you’re more likely to deliver a high-quality
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service and achieve the best possible outcomes for your patients.” THE CASE FOR ACCREDITATION Rangiora Vet Centre’s Rebecca Weight believes all New Zealand veterinary practices should be heading towards at least clinic-level accreditation. Rangiora Vet Centre is a privately owned mixed practice employing more than 50 full-time and part-time staff. As Rangiora’s Companion Animal Clinical Director, Weight led the successful bid for companion animal hospital-level accreditation, which was announced in August. “When I arrived in 2006 the practice already held BESTPRACTICE clinic-level accreditation, but the team was ready for a bigger challenge.”
10 Gives competitive advantage in the market.
She admits that getting started seemed overwhelming. “I could see it was going to be a tough mountain to climb. “Halfway through though, the light switched on and I completely changed my mind. I could see everything we were putting in place – the improved systems and procedures, better infection control, the updated induction and customer complaints procedures – all these things and more should’ve been priorities. We absolutely needed to do them. But it took this process to make them happen. “We’ve finally done it and made our practice much better as a result.” For Peter Marshall, part-owner of Hauraki Veterinary Services, the key is to see the NZVA standards as just one part – albeit an important one – of running a successful veterinary business.
FEATURE
Marshall’s mixed practice of around a dozen staff has been clinic-level accredited since 2005. “We jumped on the opportunity to join the programme more than a decade ago to set ourselves apart and to aspire to something bigger and better.” Mostly, he says, it’s helped his practice to set up new policies and procedures, be compliant with the ever-growing raft of legislation and regulations affecting the industry and keep his business documentation up to date. At audit time, everything’s reviewed and checked again within a context of ongoing improvement, he says. “It’s not rocket science and at the start we found we were doing a lot of this stuff already. But we weren’t keeping good records or communicating it to staff very well.
“We set up a new isolation unit in that first year. We don’t use it often, but it’s invaluable when we do. We also improved our HR practices for attracting and retaining new staff. We’ve actually had new graduates apply to work for us because they saw we were BESTPRACTICE accredited.” NZVA Head of Veterinary Services Callum Irvine believes this is a trend that veterinary clinics can expect to see more of in the future. “For this generation of graduates, working in an environment that meets hospital standards will be the norm. They’ll have experienced it first-hand at Massey. They’ll have seen its impact on quality and they’ll come to expect it when they graduate and walk out the door into the real world. Massey’s recent hospital-
Peter Marshall, Hauraki Veterinary Services.
GET ACCREDITED IN SEVEN EASY STEPS!
STEP 1
Contact NZVA administrator Trish Thorpe for information and to start the process. Call Trish on 04 471 0484 or email trish.thorpe@vets.org.nz.
STEP 2
Sign up. Fees are $760 for clinic-level accreditation and $1,255 for hospital-level accreditation.
STEP 3
Receive a BESTPRACTICE accreditation programme information pack. It contains the standards, a checklist, audit instructions and documentation, articles on the benefits of BESTPRACTICE accreditation and more.
STEP 4
Be assigned a personal advisor from the BESTPRACTICE accreditation programme committee. You can contact and question them throughout the process.
STEP 5
Decide how best to discuss and meet the standards within your workplace. Contact your advisor for ideas and feedback. Talk to other clinics who’ve been through the process for an idea of what worked for them.
STEP 6
Undergo an independent audit (once you’ve completed all the paperwork and made all the necessary changes). Contact Trish to set up the audit date.
STEP 7
Brag about it! Why not? You’ve done it. You’re now BESTPRACTICE accredited. It’s time to let everyone else know what you’ve achieved. Order some new branded material from Flagmakers. Write a press release for your local paper. Have an open day for your clients or offer them free coffee and cake for a week. Outline the benefits in your client newsletter. Have a staff party!
VetScript September 2016 – 29
FEATURE
KEEN TO HELP OTHERS BECOME ACCREDITED? The NZVA’s 10-person committee chaired by Hans Andersen oversees the BESTPRACTICE accreditation programme and is responsible for improving the standards over time and helping practices attain accreditation. Four positions are open to veterinarians within accredited clinics and hospitals. “Becoming a member is a somewhat informal process,” says Andersen. “You simply need to express interest and be prepared to represent one of three key areas of the standards – hospital, companion animal or mixed practice – or have a strong knowledge of agricultural compounds and veterinary medicines. If you’re interested in joining the committee, get in touch.”
NEW PROMO MATERIAL COMING SOON The NZVA is currently designing a proposed new line of branded material for BESTPRACTICE accredited clinics and hospitals. The intent is for accredited clinics and hospitals to use it to promote their business to the public and help raise awareness of the importance of highquality veterinary care. NZVA Head of Veterinary Services Callum Irvine says, “The branded material will have two key features to represent quality – the blue cross, signifying highquality animal care, and a bold red tick, which is the mark of approval.” The proposal will see clinics being able to choose from a range of collateral including: double-sided flags footpath signs floor mats car stickers bunting. Information on ordering will be available soon and 10% of all branding proceeds will go to the Elizabeth Veterinary Benevolent Fund.
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Dunedin’s Humanimals placed BESTPRACTICE accreditation uppermost in its five-year growth plan.
standard accreditation is a game changer in that sense.” Massey University Veterinary Teaching Hospital became a BESTPRACTICE accredited veterinary hospital in August last year. The hospital gained accreditation across all services – companion animal, equine and production animal. Irvine believes practices wanting to attract and retain the country’s best young talent should keep that in mind when weighing up the pros and cons of accreditation. “It’s never been a better time to get started. Not only will accreditation make your practice more appealing to students coming through, you’ll also be in a better place to make the most of their best practice knowledge and experience,” he says. Marie Hennessy, Practice Manager at Humanimals in Dunedin, agrees it’s better to be a leader in the move to BESTPRACTICE accreditation than get left behind. She says achieving clinic-level then hospital-level accreditation was part of the company’s five-year growth plan. “We’d started working with a business coach and developed some big goals. We’re one of Dunedin’s largest practices and we really wanted to be up there among the country’s best quality vet practices,” she says.
That was the motivation from the getgo and Humanimals never wavered. HOW HUMANIMALS ACHIEVED ACCREDITATION To achieve accreditation, Humanimals started with a team meeting and made Hennessy the project manager, then discussed each standard to figure out what they needed to do to meet it. They sought advice and practical templates from network experts, such as academics at Otago Polytechnic and Massey, as well as industry experts and tradespeople. They met regularly to troubleshoot and report back on progress, using a checklist to keep everyone on track and accountable, and made wall posters communicating their goals and progress to clients and staff. Accreditation involved setting up new policies, procedures and making some significant changes to the building they lease. For example, they upgraded their kennel and cattery areas over three months and set up an easy-access filing system for all their new documentation. “See the accreditation process as a business improvement project,” advises Hennessy. “Get a project manager and identify and discuss what you need to do with your team. Break it down into chunks. Allocate tasks and deadlines. Be focused – that’s what we did, and it worked for us.”
FEATURE
OUT OF THE BAG
A revolutionary national strategy that will change New Zealanders’ expectations of cat ownership is about to send fur flying. Matt Philp reports.
GARETH MORGAN IS a master at setting cats among pigeons. In 2013 the Wellington-based economist and public commentator suggested that New Zealand should be cleansed of domestic cats, labelling them as “sadists” responsible for decimating native fauna. Predictably, cat lovers and animal agencies took the bait, with the SPCA’s Bob Kerridge calling Morgan’s vision “hare-brained and offensive”. Fast forward three years and those same warring parties are about to release a joint proposal for a revolutionary national cat management strategy at the New Zealand Companion Animal Council annual conference in Wellington on 21 September. The strategy is the result of a lengthy collaborative exercise facilitated by the NZVA. Head of Veterinary Services Callum Irvine was the association’s point man on the exercise, a role that you’d imagine would have taxed the diplomacy of an MFAT megastar. But in fact, according to Irvine, the various organisations involved in the National Cat Management Strategy Group were mostly in agreement
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from the start – including the Morgan Foundation and the SPCA. “Gareth Morgan has a way of capturing the conversation, and he set out to get the country talking and to acknowledge that something needed to be done,” he says. “But, sitting around a table, it became obvious that what everyone wanted was for ‘every cat to be on a lap’, as the Morgan Foundation says – meaning, for cats to be responsibly owned.” At press time Irvine wasn’t in a position to release the full conclusions of the group, which also includes Local Government New Zealand, the New Zealand Companion Animal Council and the NZVA’s Companion Animal Veterinarians, with DoC and MPI on board in advisory roles, but among its recommendations are that cats should be microchipped and registered on a national database. To that end, Irvine and Geoff Simmons of the Morgan Foundation addressed the Wellington City Council on behalf of the National Cat Management Strategy Group before the council made its landmark decision for compulsory microchipping of cats, citing
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“THERE ARE MANY ISSUES AROUND CAT MANAGEMENT THAT NEED TO BE ADDRESSED, AND IT’S A MUCH BIGGER PICTURE THAN SIMPLY PREDATION.”
its reasoning for this recommendation. “Identification is a fundamental tool of animal management at a community level and in order for any management strategy to work it is imperative that every cat has an owner, is cared for appropriately and is identified through a microchip, which is the only reliable and unalterable form of identification available,” says Irvine. The group also believes that the cat population is too large and has proposals for ways to reduce it. The numbers are striking, with something like 1.4 million owned cats in New Zealand and a feral cat population that some estimate to be at least 2.5 million strong, along with a couple of hundred thousand strays. Irvine says that fears of the new strategy promoting the destruction and euthanasia of masses of New Zealand cats are unfounded. “We all acknowledge there are too many cats and that we need to find solutions, but where the national strategy is coming from is dealing with that through responsible cat ownership and the desexing and identification of cats, and bringing in a legislative framework that more clearly defines our expectations of cat ownership. “By getting the basics right around desexing, stopping the release of cats into the environment and managing the stray cat population through various measures – one of which will be euthanasia, but there will be others – over time, we can reduce the impacts of cats.” Those impacts involve much more than the predation of native birds and other species, the concern that brought the so-called ‘cat crisis’ into focus for many New Zealanders.
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“There’s the nuisance effect of cats wandering into other people’s yards and defecating. There are significant public health issues associated with the impact of toxoplasmosis on human babies in utero, the immunocompromised and the elderly. “And there’s the impact of cats on the sheep and goat industry, which is enormously significant because of toxoplasmosis. So there are many issues around cat management that need to be addressed, and it’s a much bigger picture than simply predation.” There are benefits to cat ownership too, of course. “We’re a nation of cat lovers, and as vets we know that cats are enormously beneficial for people. But that doesn’t mean we can ignore the responsibilities,” says Irvine, who sees the new cat management strategy as a catalyst that will “reset” New Zealand society’s expectations of cat ownership. “In this country we have this very laissez-faire attitude to cats. We abandon them, or we think if we have a cat that it can live and act by its own free will. We don’t have an understanding as a nation about the responsibility of cat ownership. “We have a terribly low rate of primary care for cats in this country,” he continues. “Many cats aren’t desexed. Many people don’t meet the fundamental needs that responsible ownership entails, which is lifelong care of the animal, including ensuring that it’s vaccinated and that there’s parasite control and appropriate nutrition.” By contrast, dog ownership is covered by clear regulations and explicit obligations. “If we had dogs wandering all over the streets, defecating and fighting other
IMAGE: ISTOCKPHOTO.COM
FEATURE
animals, society would be up in arms. Yet our other great companion animal species is allowed to impact on society without any restrictions at all. “We hope to see fundamental changes to cat ownership, in terms of owners having to accept responsibility,” he adds. “It isn’t okay to have a cat wander off your property and for you to have no overarching responsibility for its impact.” Hence the proposal to microchip cats. “We’d like to see every owned cat in this country microchipped, so that when that animal is found it can be repatriated, and if it is having an impact or nuisance effect then we can identify who owns it and begin a process of education.” Education is key, he says, but it must be reinforced by legislative change. The group has been briefing the relevant ministers and the prime minister’s office, and everyone seems to be enthusiastic. “The challenge will be taking it to the next step.” But then the entire matter of cat management is challenging. Of all the animal issues with which Irvine gets involved, none is as polarising as cats, he says. For that same reason, the NZVA’s
role on the cat question underscores its commitment to taking the lead on issues in which animal, human and environmental concerns collide. “Society is really crying out for people to take leadership and firm positions on these issues. Those positions have to be backed by evidence, but they also have to acknowledge that it’s not simply about the science – it’s also about hearing society’s expectations, the concerns of other groups, and trying to find a balance. “Because we are respected by the community and because we are a science-based profession, we have a real opportunity to lead and to find solutions at a national level. Cat management is a first example, but we really hope to do it more often in other areas.” Meanwhile, veterinarians have much
to look forward to if the national cat management strategy is successfully implemented. No one enjoys having to euthanise stray cats or seeing the frustration of agencies such as the SPCA dealing with a seemingly endless supply of unwanted kittens and cats that in most cases will never be rehomed. As the public comes to better understand the expectations of responsible cat ownership, it’s hoped that there’ll be far less of that, says Irvine. “We hope too that people will go to their veterinarians seeking advice and support in ensuring their cats are well looked after. That’s not just about desexing cats, but about their lifelong care. Ultimately the profession can only benefit from a public that views and treats its cats in a different way.”
“ULTIMATELY THE PROFESSION CAN ONLY BENEFIT FROM A PUBLIC THAT VIEWS AND TREATS ITS CATS IN A DIFFERENT WAY.”
The National Cat Management Strategy Group is a group of national organisations including the NZVA, the New Zealand Companion Animal Society, the Royal New Zealand Society for the Prevention of Cruelty to Animals, the Morgan Foundation, Companion Animal Veterinarians and Local Government New Zealand, with observers from the Ministry of Primary Industries and the Department of Conservation.
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VetScript September 2016 – 45 ETHICAL AGENTS VETERINARY MARKETING