Test #1 Review (Units 2-4)

Monday Feb 2nd @2:00PM (Multiple Choice, T or F, Short Answer and Chart of Abbreviations)

What is good management and skills needed?

→ Good management is getting ppl to work together efficiently & effectively to increase client satisfaction and better client retention (meaning they will keep coming back). To do this managers must have the following skills…

• Financial Management → ensuring enough funds to not to bankrupt.

• Facility Development & Maintenance → keeping things clean, stocked & up to code

• Personnel Training and Oversight → making sure staff is trained, supported & efficient

• Regulatory Compliance + Laws & Legislation → following licensing requirements and protocols (CVO)

What is the management process?

1. Plan → create goals and strategize how to achieve them

• Example: the goal is to ensure clients come to scheduled apps so the strategy is to then implement automated app reminders to achieve this

2. Organize → a team to successfully make the plan happen

   • Example: create the automated apps recording system

3. Direct → by motivating team members to accomplish the plan

   • Example: Sending out the automated app reminders & having staff meetings to see how the plans are working

4. Evaluate → by measuring and analyzing if the plan was successful

   • Example: Was there an increase in clients making it to scheduled apps

What are the 4 major areas of responsibility for a practice manager?

1. Business Finance & Economics → the money aspect

2. Personnel & Human Resources (HR) → the hiring, training and organizing staff schedules aspect

3. Operations & Building Maintenance → the ensuring clinic is clean, restocked and following protocols aspect

4. Marketing & Client Relations → the getting clients and keeping them while following practice guidelines aspect

What are the requirements for a crash kit?

→ Must contain supplies needed for…

• Airway management

• Venous access

• Emergency drugs

• Dose charts

→ The kit should be…

• Organized

• Readily available

• Portable (cart)

• Put Back if Used

  • Near anesthesia induction area

  • By oxygen & anesthetic machines

→ When storing drugs in the crash cart the bottles must be…

• Clearly labelled

• Stored in a consistent location

Note: Helps staff quickly locate drugs during emergencies

→ Technician must regularly do the following to maintain kit preparedness…

• Review a checklist

• Check quantities

• Check expiration dates

What are the 3 emergency drugs kept in a crash kit?

1. Atropine → Raises heart rate

2. Epinephrine → Increases heart rate & blood pressure

3. Lidocaine → Treats ventricular arrhythmias / local anesthetic

How often does the CVO do an accreditation inspection?

→ Inspections occur q 5 years (± if there is significant changes)

→ Audit (your own inspection) is done @ least q 21-31 days

What are some areas that CVO reviews during an accreditation?

→ Inspectors check compliance w…

• Controlled drug audits

• General & medical records

• Pharmacy

• Radiology

• Anesthesia

• Treatment areas

• Safety & regulation

• Many other hospital areas

Note: ⚠ Failure to comply may result in loss of veterinary license

What are a few things you need to check when unpacking an inventory order?

1. Verify Correct Drug

• Correct product & strength

• Correct quantity

2. Review

• Regular invoice

• Dangerous goods sheet

3. Record Drugs

• In narcotic log book (2 signatures)

4. Place drugs immediately into locked storage

Note: Inventory should be taken monthly to ensure all entries have been made as the DEA drug enforcement agency could ask for records at anytime for inspection.

Can you name a few reasons for discrepancies between recorded controlled drug amount and actual amount measured?

→ ON TEST AS SHORT ANSWER ?

→ Hospitals are accountable for q drop so if there’s errors when recording controlled drugs it becomes a big issue. Some examples of discrepancies which could occur are…

• Math errors when calculating drug dosages

• Small vol loss (0.1–0.2 mL lost in needle hub)

• Inaccurate measurements

• Spillage or leaking vials

• Incorrect or missing record keeping

What is the 80/20 rule?

→ 80% of sales come from 20% of inventory therefore focus on managing high-impact inventory items. Inventory should be considered an asset until sold for revenue.

Can you name some inventory challenges?

→ Common challenges include…

• Fear of running out

• Trying to please all clients

• Too many people managing inventory

• Storing inventory in multiple locations

• Back orders

• Not monitoring expiry dates

• Poor use of clinic software

• Not performing physical inventory counts

What are the challenges if inventory is too high or low?

Inventory levels are too low…

→ ⬇ sales

→ workflow interruptions

→ ⬆ ordering costs (bc of taxes)

Inventory levels are too high…

→ $$ gets wasted

→ capital tied up on shelves

→ ⬆ borrowing & interest costs

What are some examples of actual inventory costs?

→ Inventory costs include:

• Shipping

• Time

• Borrowed Funds

• Expired Products

• Theft

• Storage

Note: Inventory costs at least 10% of total inventory value

What is the definition of re-order point?

→ A reorder point is the level inventory drops to before reordering and is determined by…

• Rate of use

• Time needed to receive new product

Note: Rule of thumb = reorder when one month’s supply remains

What are the follow terms definitions?

• Back Order

• Lead Time

• Purchase Order

• Shipping Bill

• Packing Slip

• Minimum Order

Back Order → item unavailable at time of order therefore order is held so that it can be shipped once available

Lead Time → time between ordering and receiving the order

Purchase Order → list of ordered items @ 1 time

Shipping Bill → document from delivery company that is signed upon receipt of the goods

Packing Slip → list of items sent by supplier

Minimum Order → dollar amount required for free shipping

What are the different ways to organize a pharmacy?

→ There are 4 main ways a pharmacy could be organized…

1. Alphabetically

2. Therapeutic Use (our school does this i.e ear meds)

3. Dosage Form (grouped together i.e corticosteroids)

4. Level of Use (monthly preventions wouldn't be at front of shelves compared to ones used daily)

Practical setup:

• Tablets near counting area

• Liquids near sink

• Injectables near syringes

What are some common inventory strategies?

→ Carry the right assortment

→ Keep stock low

→ ⬆ turnover

A vet practice spends $600,000 on drugs and supplies during the year. At the beginning of the year the value or inventory on hand was $120000 and $89000 at the end of the year. What is the inventory turnover? Is the turnover rate acceptable given industry standards?

→ Answer…

Step #1: Average Inventory Formula = ($120000 + $89000) ÷ 2 = 104500

Step #2: Turnover Rate Formula = $600000 ÷ 104500 = 5.7 times per year ✅ (bc >4)

→ Inventory turnover is…

• the # of x’s inventory is used & replaced / year

• therefore ideal turnover is 4–12x / year

• ideal turnover time is 45–60 days

→ Math formulas…

Step #1: Average Inventory Formula = (Beginning inventory + Ending inventory) ÷ 2

Step #2: Turnover Rate Formula = Total Inventory Purchased ÷ Average Inventory

Step #3: Write Answer = You MUST Include Unit (Times Per Year)

→ An acceptable inventory turnover rate is…

• > 4x / year

• ⬆ Turnover = better inventory efficiency

What are some reasons for using tamper tape?

→ Tamper tape is used to seal drug bottles to prevent unauthorized access and to indicate if a bottle has been opened or altered. After the drug vol is measured and recorded, tamper tape is applied so that if the seal remains intact, the recorded amount can be trusted without re-measuring. This supports accurate controlled drug records, audits, and accountability.

What is the general understanding of CDMV and VP purchasing groups?

→ Both are major groups in southern Ontario to purchase from depending on your location…

• CDVM (Canada Veterinarian Distributer) is located in Quebec

• VP (Vet Purchasing) is located in St. Marys Ontario

What are the guidelines/rules for medical records?

Medical records must be…

• Accurate and up to date

• Documented every time a pet visits or a client calls about the pet

• Written in pen, with entries initialed

• Free of blank lines between entries

• Corrected with a single line through the error, initialed (no white-out)

• Numbered pages

• Include all signed consent forms

• Kept for a minimum of 5 years

Note: Medical records are legal documents and may be subpoenaed in court.

What are the CVO’s guidelines for medical records?

Medical records must contain…

1. Patient ID (species, age, sex)

2. Client ID (address, phone number)

3. Emergency contact info

4. Date of each visit

5. Complete medical history (vaccines, heartworm, etc.)

6. Current wt

7. Exam findings and lab recommendations/results

8. Record of professional advice (when and to whom)

9. All medical and surgical tx

10. Copies of all reports

11. Final assessment

12. Itemized fees and charges

Medical records must also be…

• Legible

• Organized and systematic

• Initialed or coded to identify who made the entry

• Retained for 5 years after the last entry (or 2 years after the vet stops practicing)

What are the 6 critical components of the medical records as outlined by the CVO?

→ ON TEST AS SHORT ANSWER ?

1. Problem List

2. Allergies

3. History

4. Diagnosis

5. Treatment Plans

6. Appropriate Treatment

Note: These are the main things inspectors focus on during CVO inspections.

What is medical record ownership?

→ Medical records belong to the veterinarian, not the client

→ Clients pay for services, not the files

→ Information cannot be released without veterinarian consent

w vet approval records can be…

• Forwarded to another clinic

• Photocopied for the client

• X-rays released (requires a signed consent form and return date)

What are the confidentiality rules of medical records and exceptions plus why?

Hardcore rules…

→ Medical records are governed by PIPEDA (Personal Information Protection and Electronic Documents Act)

→ All staff are bound by medical confidentiality that no medical, financial, or diagnostic information may be discussed with anyone

Exceptions and why…

Information must be disclosed for

• Reportable diseases (Rabies, Lyme, West Nile, etc.)

• Animal bite investigations

  • Rabies vaccination history may be given to police or public health

  • Protects public health and safety

Note: Breaches of confidentiality are a breach of trust and put the veterinarian at risk of lawsuit

What is SOAP?

SOAP is a structured format for progress notes…

• S = Subjective → What the owner reports (history, concerns)

• O = Objective → Measurable findings (TPR, exam results, labs)

• A = Assessment → Diagnosis or differential diagnoses

• P = Plan → Diagnostic plans, treatments, medications, follow-ups

What are the names of the logbooks used?

→ ON TEST AS A SHORT ANSWER ?

• Radiography Logbook

• Surgery/Anesthesia Logbook

• Narcotic/Controlled Drug Logbook

Can you name a few consent forms?

• Surgery consent

• Euthanasia consent

• Tx/Dx consent

• Boarding consent

• Extra-Label Drug Use consent

• Early Release consent form

• Patient Info Release (records or x-rays)

What are the legal requirements of an informed consent form?

An informed consent form must…

• Be in writing

• State the owner was advised of possible negative consequences

• Not guarantee success

• Be signed by the owner or advocate (not a minor)

• Become part of the medical record

• Be retained for @ < 5yrs