Practice Standards - written protocols?

RE: Practice Standards - written protocols?

KathW — Thu, 30 Jun 2016 08:30:24 GMT

[quote user="J G Wray"]

Have a read of the E myth Veterinarian by Gerber and Weinstein

[/quote]

Looks interesting - I will, thanks.

RE: Practice Standards - written protocols?

KathW — Thu, 30 Jun 2016 08:26:51 GMT

Having to show evidence that protocols are being followed makes sense but it's another layer of bureaucracy that will not be appreciated by our vets.

Would need to be built into the pms ideally. If someone has to tick boxes on forms after a consulting session or audit cases once a month and sign to say protocols have been followed it's more work for someone - then who goes to discuss with vets why they haven't followed protocols?

RE: Practice Standards - written protocols?

J G Wray — Thu, 30 Jun 2016 07:26:05 GMT

Why stop at written diagnostic protocols?

Have a read of the E myth Veterinarian by Gerber and Weinstein

RE: Practice Standards - written protocols?

Nhombokisheni — Thu, 30 Jun 2016 01:13:04 GMT

I want to believe the standard protocol should reflect historical evidence unique to your practice i.e. reflect what is common in your area, procedures linked to available resources/equipment (put down what your able to do for that particular case....avoid generalizing), guide to referrals etc.

I want to believe evidence of use for cases it's your notes.....they show all the steps, findings etc.

With some you may have to create a form with boxes to tick by staff, with a vet signing periodically as verifier.

RE: Practice Standards - written protocols?

Gareth C. — Wed, 29 Jun 2016 23:10:18 GMT

We were looking at the hospital standards and you need a written protocol for washing up utensils and witten proof it's been followed!

RE: Practice Standards - written protocols?

KathW — Wed, 29 Jun 2016 22:43:28 GMT

This is something I've been asked to look at too - on my list for tomorrow!

Has anyone any thoughts on the exotics WDP

or how how specific the treatment protocols should be - skin,eyes , exotics etc.

We have the PROTECT poster filled in and pinned up which is a starting point I suppose.

RE: Practice Standards - written protocols?

Michael Woodhouse — Wed, 29 Jun 2016 22:06:13 GMT

If you look at the PSS manual then it says:

A Written Diagnostic Protocol
(WDP) is utilised for skin disease.
These should have been drawn up
following clinical team discussion
and considering the evidence base.
This will encourage clinical
discussion and consistency but
should not interfere with clinical
freedom.
Assessors will look for evidence
that the WDPs are used and their
use is monitored.

I'm not sure Martin's example covers team discussion and evidence base.

My reading is that it is looking for a standard protocol that is up to date and evidence based. Are you all using the same first line antibiotic, when are you doing cultures, does the evidence support allergy blood testing etc etc etc.

We are looking at joining the PSS. We've done a few farm ones and had someone go off and wrote a protocol, do a literature search and then discussed it as a practice meeting and made some changes. It's slow but good fun.

RE: Practice Standards - written protocols?

Martin Atkinson — Wed, 29 Jun 2016 16:56:11 GMT

[quote user="Francisco Gomez"]wow Martin! if we take the 'skin scrapes' your list works for pretty much everything! [/quote]Exactly, which is why its a load of bull but hey who cares if it ticks boxes and gets brownie points.

RE: Practice Standards - written protocols?

Francisco Gomez — Wed, 29 Jun 2016 16:54:53 GMT

wow Martin! if we take the 'skin scrapes' your list works for pretty much everything!

RE: Practice Standards - written protocols?

Martin Atkinson — Wed, 29 Jun 2016 16:49:25 GMT

Is this for practice standards scheme? We recently had to draw up an operating and isolation protocols as part of the process to be accepted as a nurse training practice. If its the same sort of thing then it is mind numbingly basic, there is not a hope in hell that it would be practical to write a protocol for every eventuality, less than one sheet will do.

The thing is that you already do this, its just a case of putting the process into words with a bit of management speak/buzzwords to make it sound more impressive!

As you mentioned skin cases as an example I would suggest something like this:

Standardised Problem Orientated Protocol for Dermatological Cases

Take a full history, the depth of which will depend on the severity of the case.
Perform a full clinical examination and formulate a problem list.
Create a complete list of differential diagnoses,
Formulate an appropriate diagnostic process.
Take skin scrapes/hair samples/acetate strips/blood tests as appropriate.
Create a revised differential list.
Formulate an appropriate treatment plan according to the diagnostic tests and differential diagnoses.
Set a timescale for reassessment and review of treatment.
If treatment does not go according to plan, review and revise your problem list, investigation plan and treatment at each stage.
If completely stuck go back to the beginning and start again.

Once you get into the swing of it you find yourself talking like this in normal conversation.