How do you manage bookings for surgeries?

Re: How do you manage bookings for surgeries?

John Ellis — Tue, 20 May 2014 16:28:13 GMT

I agree with Michael. At my practice, we pre-op check, book in and then perform our own ops. I would hate to have ops days where I was operating on things I had never seen before. I like the fact that I am operating on animals where I have met the client, checked the animal myself, and discussed costs, op risks etc.

Re: How do you manage bookings for surgeries?

Michael Woodhouse — Tue, 20 May 2014 10:03:42 GMT

I'm confused by some of these responses. Do you not aim for continuity of care in all the practices with lay staff booking things in? Let the same person who saw the mass remove it, someone is away that day and (s)he does the cruciates. New grad can't plate the leg, etc

Re: How do you manage bookings for surgeries?

karen jones — Tue, 20 May 2014 08:08:37 GMT

I have done list of average times each procedure takes and block out on the diary screen what isn't available. The receptionists put each op in blocking the area out on diary. This is the only way I have found of stopping them filling up each space no matter how many vets available , kennel space and my growling at too many ops . We have just lost a small animal vet and the new one can't start till end of June (3 month notice even though only been there for 6 months) and yesterday was nightmare staff need re educating !

Re: How do you manage bookings for surgeries?

Gillian Mostyn — Mon, 19 May 2014 15:17:55 GMT

[quote user="Michael Woodhouse"]In Auz the nurses can induce anaesthesia?`[/quote]

They can in the UK....... as long as they are using a GA drug and dose prescribed by the VS. (And they are a qualified VN.) Obviously shouldn't be using drugs that are' titrate to effect', but drugs such as dom/ket are fine.

I agree - having good and efficient nursing staff is vital to make operating schedules work!

Re: How do you manage bookings for surgeries?

Alastair Franklin — Mon, 19 May 2014 10:13:38 GMT

No - vet nurses in Australia cannot induce anaesthesia. There may be subtle variations in details from state to state, but a vet nurse may monitor and 'top-up' an anaesthetic under the supervision of a vet but cannot induce. There may be a grey area in regards to induction by standardised doses of IM drugs, but induction to effect is a definite contravention of the rules.

Re: How do you manage bookings for surgeries?

Michael Woodhouse — Mon, 19 May 2014 00:38:26 GMT

[quote user="Braden Collins"]We have enough nurses to get the animals onto fluids, induce and prepare while we are doing the previous surgery.[/quote]

In Auz the nurses can induce anaesthesia?`

Re: How do you manage bookings for surgeries?

Braden Collins — Mon, 19 May 2014 00:29:16 GMT

We book our surgery days solidly, not allowing much for emergencies. We book out an appropriate time for each procedure and expect our vets to work until they're done. It means they often work through their lunch if an emergency comes in but we pay them well enough and make it worth their while (their standard week is 32 hours, so even if they work their lunch breaks they only just reach full time hours anyway). We will book up to 6 routine surgeries per day and expect them to be finished and the animals awake by 3pm.

Make sure you are using your nurses well to help things flow, and have enough nurses so that nursing levels aren't your limiting factor. We have enough nurses to get the animals onto fluids, induce and prepare while we are doing the previous surgery. Once the new surgery comes through another nurse monitors the recovery of the previous animal, and the theatre nurse is free to keep helping in theatre. It saves a LOT of time for each procedure. A bit of efficiency like this and we can do 3 bitch spays in 2 hours pretty consistently.

Re: How do you manage bookings for surgeries?

Nicola Cole — Fri, 16 May 2014 19:27:19 GMT

Also tend to leave Monday mornings (and Tuesday after a bank holiday) on the lighter side bookings-wise as tend to acquire more 'extras' after the weekend.

Re: How do you manage bookings for surgeries?

KMurphy — Fri, 16 May 2014 12:19:44 GMT

[quote user="Martin Atkinson"]If they weren't they wouldn't be the sort of clients I'd want anyway![/quote]

We did have one who made a terrible fuss about rescheduling a blood test. His dog hadn't had its breakfast at our request and he couldn't possibly do that to her again another morning!!

Re: How do you manage bookings for surgeries?

Martin Atkinson — Fri, 16 May 2014 12:00:44 GMT

[quote user="KMurphy"]

We're lucky to have generally understanding clients so on very rare occasions we've rebooked a non urgent op to allow for something that can't be put off.

[/quote]If they weren't they wouldn't be the sort of clients I'd want anyway!

Re: How do you manage bookings for surgeries?

KMurphy — Fri, 16 May 2014 11:29:57 GMT

As a single-vet practice, we follow a one bitch spay rule as well and one dental also. Generally the staff check with me before booking an op in if there's already something else in that day so we rarely are overbooked.

Of course, emergencies do happen. We're lucky to have generally understanding clients so on very rare occasions we've rebooked a non urgent op to allow for something that can't be put off. Clients tend to appreciate that one day it could be their pet that needs the urgent attention so it's not been a big problem. We only do this if we're really swamped though!

Re: How do you manage bookings for surgeries?

Martin Atkinson — Fri, 16 May 2014 10:32:36 GMT

[quote user="Julie Innes"]

As a sole vet, I have this problem at times! now we have a 1-bitch-spay-a-day rule, and woe- betide anyone who breaks it without checking with me first! It leaves room for the unforeseen ex-laps/ xrays/ work-ups/ that ALWAYS seemed to happen when we had 2 bitch spays plus other ops! If I book in a big op, I will usually put BIG OP in the box, as although all of my staff have had some sort of nurse training sometimes it still seems to escape their notice that a mammary strip is a bit more time consuming than a lipoma removal!

[/quote]Ditto. I would also have a two cat spay, three cat castrate and one dental rule. However it is rare that I'm so busy that we can't manage but sods law is of course that the day we are is the day an emergency will come in. I hate being busy anyway so i tend to spread things out.

One way is to book routine pre-op checks for morning surgery and tell the owner to bring them in starved so if we have a slot we will keep them in but if we're too busy they will have to book another day. This applies particularly to cat neutering charity work of which we do a lot because they have a nasty habit of no-showing and cocking up the whole schedule.

Re: How do you manage bookings for surgeries?

Julie Innes — Fri, 16 May 2014 09:00:17 GMT

Re: How do you manage bookings for surgeries?

Michael Woodhouse — Thu, 15 May 2014 23:22:55 GMT

Ops here are run past a vet first. It's the vets that book in 75% and if reception take a call they will run it past one of us. Takes a couple of seconds.

Re: How do you manage bookings for surgeries?

Utlendigur — Thu, 15 May 2014 22:47:29 GMT

We have a few similar rules eg we're a bit short on large dog kennels so that limits the number of big dogs we can have in, no more than 2 dentals (3 at a push) because obviously only one machine, similarly with xrays, no more than 2 large bitch spays etc. The nurses are also fairly good at booking things sensibly and keeping an eye on the lists, and putting "no more big ops" if it starts to look full - probably because they also want lunch! Where it falls down is the receptionists who are not so good at asking the right questions or looking at the notes (despite years of pleading) - so "xray hips" turns out to be 80+kg of St Bernard for BVA hip and elbow score, "dog cast" turns out to bilateral abdominal cryptorchid which the vet requested be booked as a long op in big capital letters at last appointment - and also the clients who book an animal in for a minor op but appear at the admission appointment with a long list of "while he's asleep" extras.

Re: How do you manage bookings for surgeries?

Nicola Cole — Thu, 15 May 2014 22:01:27 GMT

We've always had a similar system to the one above ie. work out realistically how much can be achieved in one morning for the number of vets plus build in some leeway. Then inform receptionists of limits for eg number of dog ops. I generally find if you are operating all morning then the number of cat neuterings etc isn't such an issue but if someone books in 3 bitch spays plus other things you're a bit sunk! Also the nurses would periodically check the ops lists for the upcoming week and if certain days were looking busy they would block out the rest of the morning and mark it as 'no more please!'

Re: How do you manage bookings for surgeries?

Louise6732 — Thu, 15 May 2014 21:58:57 GMT

We've tried a few things but what seems to have worked best is having a dedicated time slot for each ops vet (ours is on average 4.5hrs) and you allocate a time for each procedure, but be careful not to under estimate, a bitch spay takes about an hour on average of theatre time, but we allow 90mins, for IV cath placement first/prep time, and the recovery time as the nurse will be occupied with this before I can move onto the next thing. We have a guide chart for receptionists for common things eg neutering, hip scores and vets keep an eye on the days and adjust as necessary. We sometimes are very busy but we are rarely run over, only if an emergency comes in.

Louise

Re: How do you manage bookings for surgeries?

scatty — Thu, 15 May 2014 21:26:27 GMT

How about working out how many vets there are to do the work, then working out an average time it takes to do each routine procedure - e.g. allowing up to one hour for a bitch spay. Who is booking in the work - the receptionists? Maybe have a book of rules in reception to set out limits as to how many of each routine op you can do per morning e.g.up to 2 dog castrates, 2 cat spays etc etc. Then, hopefully no one will book in beyond the limit and allow some leeway for emergencies. This isn't an official system of sorts but we have this arrangement at work and it normally works (ish)!