Pre- and Postoperative Communication Protocols

Brenda Tassava, CVPM, CVJ, VLCE, VetSupport, New Orleans, Louisiana

ArticleLast Updated March 20185 min readPeer Reviewed
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Most veterinary professionals would agree that they strive to deliver the same care for their patients that they want for their own pets. One practice owner recently said his goal is always to meet the highest standards of care for his patients because his clients place their trust in him and the practice.1

From the pet owner’s perspective, surgery is never routine. In veterinary practices, surgical patient care involves much more than the surgery itself. From the preanesthetic examination to monitoring of vital signs, IV catheter placement, fluid therapy, patient heat support, anesthetic monitoring, and recovery and pain management, the veterinary team has a great deal of responsibility. Strong, clearly written protocols for each step help ensure consistent delivery of patient care.

For a postoperative patient, high-level care begins during admission with the informed consent process. A truly informed client must understand each diagnostic or treatment procedure as well as the costs. Failing to explain services (eg, the importance of IV catheter fluid therapy, the level of monitoring a patient receives during the practice visit, the need for postoperative pain management) and their costs may mean the owner declines services his or her pet needs, and the practice loses as much as $156 per patient.

Admission Form

Every practice needs a surgical admission protocol that begins with the surgical admission form. (See Surgical Admission Protocols.) The AVMA posts a list of policies and guidelines for recommended patient care that can be helpful. (See Resource.)

This form, the foundation of a consistent protocol, should include answers to the following questions.

  • How should the client be contacted after surgery?

  • Will an IV catheter be placed?

  • Will IV fluid therapy be administered?

  • Will medications for pain management be delivered?

  • Will the patient be hospitalized overnight?

  • Will the patient require anything additional to recover at home?

Knowing how the veterinary team can contact the client while his or her pet is hospitalized is most important and should be included in every standard admission protocol. Today in the United States, busy pet owners are more likely to text than talk,2 so forget the game of phone tag. One study showed 75% of millennials prefer texting because they believe it is less invasive and more personal, and it makes them feel valued.3 All clients will likely be frustrated if they are not offered communication choices.

Surgical Admission Protocols

Once the admission form has been developed, the protocol should include the following information.

Recommendations, Not Options

Before getting the client’s informed consent (ie, when he or she gives permission for the pet’s medical treatment), be sure he or she understands the purpose, benefits, and potential risks of the treatments, and present the treatments as recommendations rather than options. Many practices present IV catheter placement, fluid therapy, and pain management as optional on their surgical admission form, which undermines the importance of these facets of care. Instead, strengthen a patient’s care by including in the protocol all the treatments and procedures the veterinarian recommends as well as the purpose, benefits, and any potential risks. Here is an example:

Dr. Jones’ Recommendations for Spot: IV catheter placement and fluid therapy. IV fluids during anesthesia are the first line of defense against low blood pressure and potential damage to the vital organs (eg, heart, brain, kidneys). Venous access during an emergency or critical event while Spot is under anesthesia will allow us to administer medications more rapidly and give Spot the best opportunity for a speedy recovery. These treatments will cost $98.

At-Home Recovery

Postoperative recovery extends beyond the veterinary practice walls. Depending on the surgery, a patient may require cage rest, pain management, surgery site protection, and walks on a leash only. However, no matter the type of surgery, the protocol for communicating these needs to pet owners must be the same for every patient to ensure consistent care. 

The protocol should always set out any special instructions clients should be given about their pet’s postoperative at-home care. These instructions should include the following.

  • When a pet owner should call the practice if recovery is not going as expected 

  • How the client should give pain medication, which must be clearly labeled, at home

  • Why and how a device (eg, Elizabethan collar, soft collar, T-shirt) should be used for protection against infection if the pet licks the surgery site 

  • A checklist the client can use at home that will help the veterinary nurse evaluate the patient at progress examinations

Client Callback

The protocol should always include callbacks, which are an integral part of the patient’s postoperative recovery at home. Clients should be contacted at consistent times (eg, 2 days after going home, 1 week after) to prevent minor problems from increasing in severity and to give the client peace of mind knowing the veterinary team will follow up regularly.

Conclusion

Protocols are an integral part of a practice’s ability to provide consistent information to clients. Without protocols, team members likely will present widely varying recommendations, treatment plans, costs, and communication methods, which can lead to confusion and misunderstandings that may result in failure to provide the recommended care to the patient. When the veterinary team takes the time to develop practice protocols, everyone benefits—especially the patient.