Technicians

TECHNICIAN





PROCEDURES












[1]

TABLE OF CONTENTS
21000 – Technician Position Agreement ................................................................................................... 4
21002v – Anal Gland Expression ................................................................................................................ 6
21004 – Anesthesia Protocols Most Commonly Used ............................................................................... 8
21006 – Appointment Delays ................................................................................................................... 10
21008 - Appointment Flow and Staying on Time .................................................................................... 14
21010 – Appointments Overview for Techs and TA’s .............................................................................. 20
21011 - Autoclave Operation ................................................................................................................... 22
21012 – Blood Pressure ............................................................................................................................ 23
21013 – Brand Preferences ...................................................................................................................... 24
21014 – Brochures Kept in Exam Rooms ................................................................................................. 25
21016 – Catalyst Dx Analyzer – How to Clean ......................................................................................... 26
21018 – Catalyst Dx Analyzer – How to Use ............................................................................................ 27
21020 – Catheter Placement (IV) ............................................................................................................. 29
21022 – Checklists for Technicians........................................................................................................... 34
21024 – Client Acceptance Tips (CAT) ..................................................................................................... 36
21026 – Communication Scripts .............................................................................................................. 39
21028 – Complications and Client Complaints ........................................................................................ 43
21029 - Declaw Principles and Guidelines ............................................................................................... 47
21030 – Declaw Supplies for Dr. Julius .................................................................................................... 48
21032 - Dental Chews Included with Dog Dentals ................................................................................... 49
21034 – Dental Cleanings: How to Recommend ...................................................................................... 50
21036 – Dental Cleanings: Pre-Op Visits: ................................................................................................ 52
21038 – Dental Cleanings: Performing..................................................................................................... 54
21040 – Dental Cleanings: Set-up ............................................................................................................ 56
21042 – Dental Radiograph Sensor .......................................................................................................... 57
21044 – Drop-Offs: What to Do .............................................................................................................. 59
21046v – E-Collars .................................................................................................................................... 61
21048 – Ear Packing ................................................................................................................................. 62
21050v – ECG’s ......................................................................................................................................... 63
21051 – Emergencies................................................................................................................................ 64
21052 – Emergencies with NO DOCTOR .................................................................................................. 68
21054 – Euthanasia House Call Supplies .................................................................................................. 70
21056 – Euthanasia .................................................................................................................................. 71
21058 – Exam Room Efficiency ................................................................................................................ 73
21060 – Exam Room Stocking .................................................................................................................. 79
21062 – Eye Stain Supplies: Dr. Julius ..................................................................................................... 80
21064v – Follow-Up for Techs and TA’s ................................................................................................... 82
21066 – Good Samaritan Cases ................................................................................................................ 83
21068 – Gown Packing for Surgery .......................................................................................................... 84
21070 – Grooms Needing Sedation ......................................................................................................... 85
21072 – Heartworm Positive Dogs ........................................................................................................... 87
21074 – Heating Pads ............................................................................................................................... 89
21076 – Hospital-Use Items ..................................................................................................................... 91
21078 – ID Collars ..................................................................................................................................... 93
21080 – Inconvenience Gift Cards............................................................................................................ 95
21082 – Insulin Administration ................................................................................................................ 97

[2]

21084 – Internet Pharmacies ................................................................................................................... 99
21086v – Lab Sample Processing ........................................................................................................... 101
21088 – Labwork Guidelines .................................................................................................................. 103
21090 – Laser Therapy ........................................................................................................................... 106
21092 – Medicating Boarders ................................................................................................................ 108
21094 – Microchip Registration ............................................................................................................. 110
21096v – Muzzling .................................................................................................................................. 113
21098 – Neuter Feline Supplies for Dr. Julius ........................................................................................ 116
21100 – Out-of-Stock Items ................................................................................................................... 117
21102 – Puppy and Kitten Client Discussions ........................................................................................ 119
21104 – Prescriptions Filling .................................................................................................................. 120
21106 – Prescription Foods for Non-Clients .......................................................................................... 121
21108 – Propofol .................................................................................................................................... 122
21110v – Quality Assurance Checks by Doctors .................................................................................... 123
21112 – Radiograph Image Saving, Storing, & Sending ......................................................................... 124
21114v – Radiograph Submissions via Oncura ...................................................................................... 127
21116 – Report Cards and Release Instructions .................................................................................... 129
21118 – REPRO: Cesarean Sections ....................................................................................................... 131
21120 – REPRO: Cycle Management ..................................................................................................... 132
21122 – Restraint and Control of Pets ................................................................................................... 133
21124 – Room Tech Procedure .............................................................................................................. 144
21126 – Spay and Neuter Supplies: Dr. Julius ....................................................................................... 146
21128 – Special Orders ........................................................................................................................... 147
21130 – Spray Cleaner Mixing ................................................................................................................ 151
21132 – Surgeries by a Mobile Surgeon ................................................................................................. 153
21132.4 – Surgery Guidelines ................................................................................................................ 154
21133 - Surgical Instrument Cleaning .................................................................................................... 157
21134v – Surgery Packs .......................................................................................................................... 158
21136 – Surgery Patient Prep................................................................................................................. 160
21138 – Surgery Release Forms ............................................................................................................. 162
21140 – Surgery Tech Release ................................................................................................................ 163
21142 – Suture and Staple Removal ...................................................................................................... 165
21144v – Tech Releases.......................................................................................................................... 166
21146 - Travel Sheets ............................................................................................................................. 168
21148v – Treatment Plan Creating ........................................................................................................ 171
21150 – Treatment Plan (Clip Board) Placement ................................................................................... 174
21152v – Treatment Plan Reviewing ..................................................................................................... 175
21154 – Uricult Urine Culture In-House ................................................................................................. 177
21156 – Urinalysis In-House ................................................................................................................... 179
21158 – Walking Dogs ............................................................................................................................ 181
21160 – Vaccine Protocols and Requirements ...................................................................................... 184
21162 – Vets Purchasing or Borrowing from Us .................................................................................... 189










[3]

21000 – Technician Position Agreement
POSITION TITLE: Veterinary Technician

SUPERVISOR’S POSTION: Lead Technician

RESULTS STATEMENT: To provide high quality technical veterinary services as per our
veterinarians’ instructions to clients who are satisfied and referring
others in abundance.



TACTICAL RESPONSIBILITIES:
1. Doctor Average Client Transaction (ACT) for the doctor you are working
with. This stat is an indication of how well clients understand and are
willing to follow the doctor’s recommendations.
2. Doctor Volume of Services Delivered (VSD) for the doctor you are
working with. This stat is an indication of the amount of services both
you and the doctor provide for the pets.
3. Overall Client Satisfaction Percentage from the clients that have
received veterinary services from the doctor you are working with. This
stat is found through our internet reviews checked daily and
Demandforce client surveys completed daily and analyzed monthly.
This stat should stay above 97%.
4. Number of Client Referrals from clients that received vet care you were
involved with. This stat is an additional indication of us exceeding
expectations (adding value) to the lives of our clients. It is analyzed on a
monthly basis. Ideally it would be at or above 50%, meaning 50% of
new clients come directly from referrals by our existing clients.

STANDARDS:
1. All work will be performed in accordance with hospital policies.
2. All work will be performed in accordance with the technician
procedures.
3. Supervisor will be notified of any issues to be resolved or deadlines that
cannot be met WELL IN ADVANCE of the due date.


TWO RULES: Non-negotiable and Consistent
1. Always offer the BEST quality care.
2. Always assure client satisfaction (or refer to mgmt..)












[4]

SIGNATURES:



Sta
Statement of the position holder: tement of the position holder:
I
I accept the accountabilities of this position and agree to produce the results, perform the accept the accountabilities of this position and agree to produce the results, perform the
work, and meet the standards set forth in the Hospital Policies and General Procedures. ork, and meet the standards set forth in the Hospital Policies and General Procedures.
w


D
Date: _________Signature: __________________________Printed Name: _____________________ate: _________Signature: __________________________Printed Name: _____________________










Statement of the position holder’s supervisor:
I agree to provide a working environment, necessary resources, and appropriate training to
enable the accountabilities of this position (result, work, standards) to be accomplished.

Date: _________Signature: __________________________Printed Name: _____________________











































[5]

21002v – Anal Gland Expression

Result Statement: To assure anal glands are completely empty and normal all on patients.
When found to be abnormal or not able to be properly emptied the
patient is referred to our technicians and possibly to a doctor after.




Primary Responsible Position: Bather

Participating Positions: Kennel Attendants, Techs, TA’s, Groomers, and Doctors.

How to Express Anal Glands:
1. Muzzle the dog with the proper size of muzzle. See “patient
handling” in the main “policies” section of our hospital manual.
2. Place small dogs on the exam table, larger dogs will stay on the
floor.
3. Have a staff member (ASSISTANCE IS REQUIRED!) hold the dog with
one arm around the chest and their other arm under the belly.
4. Assure the pets rear-end is aiming out to the end of the table so it’s
comfortable for you. Don’t even start if the pet is not in a good
position.
5. The staff member performing procedure will put on latex gloves.
6. Place lube on finger generously and to the outside of the anus.
7. Use free hand to lift tail
8. Insert index finger of the gloved hand in anus and feel for anal
glands. They will feel like a pea or larger at 4 and 8 o’clock.
9. Once you feel the glands, squeeze them outward using index finger
and thumb while holding and open paper towel over the entire area
before squeezing.
10. Both anal glands must be confirmed empty. Some are much harder
to express than others. Be careful and get help if needed.
11. When glands are completely expressed, throw away the glove with
the paper towel inside the glove and the glove tied in a knot. If
there is any anal gland material not sealed in the glove the trash is
taken to the back so it does not leave odors in our working area.
12. Clean the dog’s bottom with waterless shampoo and paper towel. If
being bathed immediately after, this area can be thoroughly
cleaned during the bath.
13. When patient is returned to the owner there should be
ABSOLUTELY NO ANAL GLAND ODOR….EVER!
14. Spray the anal area with perfume.








[6]

Drill/Quiz for “Anal Gland Expression”:
1. On a clock face what times are the anal glands located?
2. What do the anal glands feel like?
3. Do you get help when doing anal glands? Can you do them by yourself?
4. How do you have the dog positioned before you start? Should the dog be muzzled? Every
time?
5. What if there is very minor lingering anal gland owner when you bring the dog back to the
owner? Is that okay?
6. Demonstrate to trainer you can proper express anal glands on two pets.


































































[7]

21004 – Anesthesia Protocols Most Commonly Used
Results Statement: To improve efficiency and simplicity for staff by documenting most
common anesthetic protocols used by our doctors.



Primary Responsible Position: Technicians

Anesthesia Medications Used:
DR. JULIUS
Canine
Under 7 years:
Neuter - Glyco/Butorphanol/Telazol
OHE- Glyco/Hydromorphine/Telazol
Dental- Glyco/Butorphanol/Telazol
7 years and older:
Neuter- Glyco/Butorphanol/Propofol
OHE- Glyco/Hydromorphine/Propofol
Dental- Glyco/Butorphanol/Propofol
Feline
Under 7 years:
Neuter- Glyco/Butorphanol/Telazol
OHE- Glyco/Hydromorphine/Telazol/Fentanyl
Patch
Dental- Glyco/Butorphanol/Telazol
Declaw -
Glyco/Butorphanol/Telazol/Lidocaine/Bupivicai
ne/Fentanyl Patch
Over 6 years:
Neuter- Glyco/Butorphanol/Propofol
OHE- Glyco/Hydromorphine/Propofol/Fentanyl
Patch
Dental- Glyco/Butorphanol/Propofol
Declaw -
Glyco/Butorphanol/Propofol/Lidocaine/Bupivic
aine/Fentanyl Patch

DR. KELLEY
Canine
Neuter- (+/-) Ace/Buprenorphine/Propofol
OHE- (+/-) Ace/Buprenorphine/Propofol
Dental- (+/-) Ace/Buprenorphine/Propofol
Feline
Neuter- (+/-) Ace/Buprenorphine/Propofol
OHE- (+/-) Ace/Buprenorphine/Propofol
Dental- (+/-) Ace/Buprenorphine/Propofol



[8]

No need for drill/quiz on this procedure. “Anesthesia Protocols Most Commonly Used” is for
reference only.











































































[9]

21006 – Appointment Delays
Results Statement: As part of our core values of “planning” and “professionalism” we make
a promise to our clients that will not have to wait. This creates more
value for our clients and makes us much more unique than other vets!
This can happen because as team members following policies we show
up to work on time and “plan” for those appointments LONG BEFORE
THEY ARRIVE.



Primary Responsible Position: Associate DVM’s

Participating Positions: Reception, Techs, TA’s

Definition of Delays: Delayed appointments are defined as any client not being seen within 5
minutes of their scheduled time.

UN-avoidable Delays: Occasionally there are valid reasons why appointment delays are
inevitable. The ONLY reasons there should be a delay (more than 5
minutes beyond scheduled start) are:
1. We had an earlier emergency
2. Urgent cares must wait
3. We had a more critical pet
4. the client arrives late.

Any reason OTHER THAN the above is due to our lack in planning or
managing or client and patient flow: See next page



































[10]

EMERGENCIES: within up to four hours prior to current time. See “Emergencies” procedure
o ALL OTHERS WAIT: With emergencies all other appointments and surgeries all go “on-
hold”. We do NOT have enough scheduled support staff to be handling emergencies
AND regular appointments at the same time for one doctor.
o WATING CLIENTS ARE GIVEN OPTIONS: The staff joins to together to inform ALL waiting
client and upcoming appointments of this delay. The client is given options.
o UPCOMING CLIENTS ARE CALLED: ONLY Receptionists, Department Heads, or Execs (not
techs or TA’s) will use good judgment to call upcoming appointments that are likely to
be delayed. The doctor will give estimate of how long the delay may be. The doctor will
over-estimate. Clients will be offered options (longer wait, reschedule for later,
reschedule for another day if NOT sick or injured).
 Note: Good judgment on these calls are critical. For example, if a doctor is in
emergency surgery we may be forced to reschedule a vaccine appointment for
another day. An itchy dog appointment may need to be seen today regardless
because the pet is uncomfortable or painful.
MORE CRITICAL PATIENT:
o This is a priority/triage over the appointment (critical ICU patient, in-hospital
emergency)

URGENT CARE: See “Urgent Cares” procedure
o In this case ALL “regular” appointments are seen on time. The urgent care is the only
delay client/patient with a wait.
CLIENT ARRIVES LATE:
o If the client arrives late and we feel there is a possibility that we cannot finish in time to
start the next appointment on time:
 We POLITELY offer to work them in while the other appointments are seen on
time……OR….
 They can reschedule for the next available time...OR…
 They may be able to drop off.


























[11]

 When are delays AVOIDABLE: Examples or poor “planning” on our part causing delays would
be:
 Surgeries taking longer than expected - We should be scheduling
surgeries for LONGER than expected.
o Note: Doctors NEVER leave or delay a surgery on a patient
under anesthesia unless it’s due to an emergency. This is
part of appropriate triaging.
o For example: A doctor would never have spay waiting
under anesthesia for the doctor to start because that doctor
is doing an appointment, phone call, or exam.
 Surgery cases that become critical – see above. This falls under
appropriate delays above.
 Our staff did not show up to work on time – see hospital policies
 Our staff did not review the records PRIOR to client arriving – see
appointment procedure
 We did not have records or treatment plans ready – See
receptionist procedures when booking.
 We did not get records from previous vets – See receptionist
procedures on getting records PRIOR to client arriving.
 We were on the phone with another client on a long conversation –
We should be able to POLITELY explain we need to see our
appointments on time and will have to call them back. If we are on
the phone too long due a critical patient it would fall under a valid
reason for a delay above.
 The last appointment took too long – We should have moved this to
and “advanced” appointment and kept the “basic” appointments on
time.
 Etc, Etc, Etc……..Too many poor excuses to list here that would
make our clients wait unnecessarily.



























[12]

What to do if we have delays:
It is absolutely CRITICAL that proper client communication is
done when we have a delay. If at all possible we call the client
BEFORE they arrive.

In EVERY SINGLE CASE WE INFORM THE CLIENT OF:

1. THE CAUSE OF THE DELAY
2. THE OPTIONS THEY HAVE
a. They can wait
b. They can reschedule
c. They can drop-off their patient and we will call
when done (get doctor, exec or manager approval
first).
This gives the client the CONTROL of what THEY would like us to
do. In almost every case they will understand why there is a
wait on not be upset. We are not dictating to them what they
HAVE to do.

This also gives the client the opportunity to KNOW WHY and
UNDERSTAND how the delay was not under our control. It is
totally okay to tell the client some details of why another
patient had an emergency and needed to be seen first. We
inform the client how we would do the same for their pet if it
was in the same situation. There is not HIPAA or privacy laws
that keep us being able to share this info. People appreciate the
info.

This communication sets us apart and “disarms” client from
complaining. It shows courtesy, care, and respect for their time.
It also shows that we have our patients as our top priority at all
time.

Drill/Quiz for “Appointment Delays:
1. What is defined as an appointment delay? How long?
2. What are some things that make delays UN-avoidable?
3. When we have an emergency:
a. What happens to all other appointments, drop-offs and surgeries while we stabilize the
emergency and present the treatment plan to the owner?
b. What do we do with the waiting “on-hold” clients during this time?
c. What do we do for the upcoming clients that may be delayed? Who does this?
4. What are examples of delays that are avoidable?
5. What do we do when appointments are delayed?
6. Why do we do it this way? What would happen if we did not?







[13]

21008 - Appointment Flow and Staying on Time

Result Statement: To achieve great client service and on-time appointments by assuring all
key staff members know their roles and work well together.







What TO do: Keep the priorities in mind of what comes first. Patients and clients are
served in this order
1. Emergencies
2. Critical/ICU Patients
3. Scheduled Clients Waiting
4. Surgeries (if already under anesthesia they move up)
5. Urgent Care & Advanced Appointments
6. Drop-Offs

 Start and finish each appointment ON TIME (90% of the time).
 Start and finish each surgery ON TIME (90% of the time).
 Doctors and support staff must be capable of completing their parts
of appointments and surgeries within their portions of the
scheduled times.
 Inform management if surgeries and appointments routinely cannot
be started and completed as scheduled. More training, support, our
schedule guidelines will need attention.


What NOT to do:
 Schedule any appointments and surgeries during the SAME times.
You can’t be in two places at once
 Unblock surgery block-off time more than 48 hours in advance.
 Seeing patients in the wrong priority order listed above.
 Make your own schedule late when there is another or staff
member available that could handle it.














[14]

“BASIC” Doctor Appointments: Non “exam room efficiency” days or one-room per doctor
Receptionist
1. Proper schedules appointment length
2. Properly confirmed appointment for client to arrive as scheduled
3. Records ready PRIOR to client arriving.
4. Patient is weighed and entered into AVImark check-in
5. Page overhead “CL Doctor ______, (pause)… CL Doctor _________” within 3
minutes of arrival
6. Assure TA greets this client within 2 minutes of page
7. Check-out receptionist checks-out the client per receptionist procedure.
Tech Assistant:
1. “Rounds” with tech, TA, and Doctor: Review appointment schedule and
speak to both tech and doctor so you are prepared to know the patients
name and pertinent history AT LEAST 10 MINUTES BEFORE….AND THE NEXT
THREE UPCOMING APPOINTMENTS. This includes the first appointment of
the day and after lunch.
2. Arrives to reception area within 2 minutes of page
3. Grabs clip board with records/documents/treatment plans
4. Greets patient first, then client BY NAME, introduces him/herself BY NAME
with eye contact and escorts them to exam room.
5. Doctor is waiting in exam room
6. Assists doctor for exam
7. Obtains “TPR” when appropriate (in some cases it can be done after exam in
treatment).
8. Enters “subjective” notes and TPR into AVImark while in exam room.
9. Assists tech with needed services and items AFTER acceptance of treatment
plan with TECH
10. Starts the next appointment with doctor while the tech finishes and releases
this one.

































[15]

Doctor:
1. “Rounds” with tech, TA, and Doctor: Review appointment schedule and
speak to both tech and doctor so you are prepared to know the patients
name and pertinent history AT LEAST 10 MINUTES BEFORE….AND THE NEXT
THREE UPCOMING APPOINTMENTS. This includes the first appointment of
the day and after lunch.
2. Waits for patient, client, and TA in exam room as the TA goes up front to get
the client
3. Greets patient first, then client BY NAME and introduces her/himself BY
NAME with eye contact and preferably with a handshake.
4. Asks clients for their PRIMARY concern first and reason for their visit.
5. Completes exam while also discussing any additional concerns from client or
issues found during exam. Narrates the exam while performing.
6. After the exam the doctor addresses exactly what they plan to do for their
PRIMARY concern first, then each additional concern WITHOUT DISCUSSING
FEES. This often times is best time by hand-writing items on blank piece of
paper in a list.
7. Gets a good idea of client’s acceptance of the recommendations/plans
WITHOUT COST FIRST. If cost is the reason for non-acceptance we have
ways to work with the client to be able to afford or plan for things they
want to do but is not financially feasible today.
8. Asks the client if they have any other questions or concerns.
9. Completes a report card (when appropriate) and reviews with the client
10. Meets with TECH outside the exam room and dictates a “tech sheet” or
“travel sheet”.
11. Enters notes into the medical record BEFORE moving onto the next
appointment.
Technician:
1. “Rounds” with tech, TA, and Doctor: Review appointment schedule and
speak to both tech and doctor so you are prepared to know the patients
name and pertinent history AT LEAST 10 MINUTES BEFORE….AND THE NEXT
THREE UPCOMING APPOINTMENTS. This includes the first appointment of
the day and after lunch.
2. Meets with doctor outside exam room and completes tech sheet with
treatment plan, services, meds, etc.
3. Presents treatment plan without the doctor present (already discussed and
verbally approved with doctor without prices). Gets final verbal approval
and acceptance
4. If client unexpectedly objects to items recommended they inform the
doctor prior to starting the procedures.
5. If unexpected objections arise due to cost we can start the other procedures
and have the client visit with our client coordinator or exec for financial
arrangements
6. Performs the services as appropriate either in treatment or exam room with
the assistance of the TA.
7. Releases patient with proper release form or report card




[16]

“ADVANCED” Doctor Appointments: Unexpected things happen that could cause us to not be able to
see the next scheduled appointment within 5 minutes of
scheduled time.

Tech, TA, or DVM:
1. Inform the client:
a. The reason that the appointment has become advanced.
Example of what to say:

“It looks like we are needing to do a few more things for (pet name) than we had planned and scheduled
for today. In order to keep our other appointments on time today we will need to have (pet name)
dropped off for the services and we will call you when he/she is ready.

You are also welcome to wait up front (will be wait) OR schedule these services for another day (if not
critical and owner will still for sure do them). What is best for you?”

b. OVERESTIMATE how long you think it will be. Double the length of
time you think it will take.
c. We will continue to work on their pet while still seeing next
appointment on time
d. They will need to wait in another exam room or in our reception
area.
2. Tech or TA moves the client to another exam room, reception area, gets
documentation needed for drop off.
3. Tech, TA, and doctor keeps client informed every 5-10 minutes while they
wait.





































[17]

EXAM ROOM EFFICENCY: The room tech does EVERTHING in exam room (assist doctor, present
treatment plan, release. The treatment tech and TA perform lab tests
and any service in treatment. See detailed procedure.

URGENT CARE: See above under “advanced”. It is the same although we discuss how
we will fit them in and THERE WILL BE A DELAY. We likely will not
know how long that delay will be. There are times when the delay will
be until ALL appointments are completed during that block. They
always have options of 1. Rescheduling 2. Waiting or 3. Dropping off
(with approval).

EMERGENCIES: The doctor and needed support staff drop all other patient care and
client service and triage/stabilize this patient as necessary then moves
back to their regularly scheduled appointment explaining reason there
was a delay.

Receptionists, techs and TA’s communicate with any clients that may
have delay and why. They are given options – see above.


Drill/Demonstration for “Appointment Flows and Staying On Time”:
1. Explain in your own words what the result statement means to you.
2. Why do we have this procedure this way? What would happen if we didn’t?
3. Explain what doctors, techs and TA’s do to “round” before appointments. When do you do it?
Before the first appointment of the day? How many appointments in advance? Why do we do
this? How does it help you?
4. With your trainer acting as a client explain what you say when an appointment becomes
advanced. Do not move on to the next step until you say this comfortably and friendly.
5. Demonstrate to your trainer using demo pieces or Lego people of how you would handle EACH
type of appointment in YOUR position





























[18]

[19]

21010 – Appointments Overview for Techs and TA’s

Result Statement: To maintain properly scheduled appointments with client
arriving on time and seen within FIVE MINUTES of their
appointment time. The only times appointments are not
started on time is with 1. Urgent Care Visits or 2. Emergencies
that delayed our regular appointments.


Primary Responsible Position: Associate DVM’s

Participating Positions: Receptionists, Techs, and TA’s

THREE basic types of appointments:

1. Regular: These can be grouped into various types
i. “BASIC” Doctor Appointments - started and finished AS SCHEDULED unless we
have had an emergency within 4 hours prior.
ii. “ADVANCED” Doctor Appointments - unplanned events/services causes it to
take LONGER than scheduled. This could be from an extra problem found on a
pet, extra tests, waiting on records, etc.
Example of what to say:
“It looks like we are needing to do a few more things for (pet name) than we had planned and scheduled
for today. In order to keep our other appointments on time today we will need to have (pet name)
dropped off for the services and we will call you when he/she is ready.
You are also welcome to wait up front (will be wait) OR schedule these services for another day (if not
critical and owner will still for sure do them). What is best for you?”
iii. GROOMING: Started and finished on time as promised. If vet services are
included, it will save both us and he client time if these are scheduled and
“express TA” appointments.
iv. TECH INTAKES OR RELEASES: Started and finished on time as promised. These
could be regular tech visits or “express TA” scheduling.
v. BOARDING DROP-OFFS: These are NOT scheduled as client appointment
UNLESS vet services are included. If so it will save us and the client time if they
are scheduled as an “express TA” appointment which would make this fall under
Techs as in “d” above.
2. Urgent Care:
These are basically our fit-in appointments. These are non-emergencies when
we don’t have appointments available but patient needs to be seen now (based
on patient needs OR client request). Clients are informed that there WILL BE A
WAIT.
3. Emergencies:
The doctor and support staff for this case DROPS EVERYTHING NOW! This does
not mean that EVERYONE drops everything, only the staff needed for this case.
In some cases, we may have more than one emergency at a time. ALL other
appointments for that doctor WILL BE DELAYED.



[20]

Drill/Quiz for Appointments Overview for Techs and TA’s:
1. Explain the difference between an advanced vs. a basic appointment. What do you do with
advanced?
2. In your own words and your trainer acting as a client explain what the client can do when we
have an advanced appointment. Don’t move to the next question until it comes out
comfortably and friendly AT LEAST TWICE.
3. Explain what an urgent care is. What would you do if you are working on an urgent care and
your next appointment shows up on time?



































































[21]

21011 - Autoclave Operation

Results Statement: To assure all surgical equipment is 100% sterile for surgeries.









Primary Responsible Position: Technicians

How:
1. Open cap on top to check water level. The water should be up
to the visible line(Distilled Water Only).
2. Open door and turn knob to” fill “. Wait until water covers
metal plate on the bottom of the chamber.
3. Insert tray containing packs/ instruments to be sterilized.
4. Close door and turn knob to “sterilize”.
5. Turn Timer to 20 minutes.
6. When timer “dings”, turn knob to vent and wait until temp has
dropped to “0” before opening door.!!! Caution objects will be
hot!!!





































[22]

21012 – Blood Pressure

Results Statement: To assure accurate blood pressure measurement in less
than 10 minutes on any patient.





Primary Responsible Position: Technicians

How:
1. Measure left front leg to pick appropriate size cuff. The appropriate
sized cuff width should span about 50 % of the circumference of the
leg.
2. Place in right lateral recumbent if possible for most accurate
readings. If patient is stressed when laid on his/her side, then do at
a sitting position because stress will elevate blood pressure readings
3. Turn on monitor
4. Press the NIBP button to start running blood pressures.
5. Results show up, write them down, and wait one minute.
6. Press NIBP again, and repeat for 5 times total (may need to do more
if results are erratic).
7. Throw out numbers that are 30-40 % off and obtain more accurate
numbers.
8. Enter blood pressure charge in computer, and then enter blood
pressure results under more stuff.
9. Figure average (add all 5 numbers, then divide by 5).

Drill/Quiz for “Blood Pressure:
1. This is a technical procedure. Your trainer on this one should be a trained tech or doctor.
2. Go to the surgery or treatment room with access to the blood pressure machine at a time when
someone else is not needing it for a patient.
3. Run at a least two blood pressures on your trainer using their finger or wrist with appropriate
sized cuff.
4. Get an average and show your reading to your trainer.
5. Get a pass and sign off when both you and your trainer are sure you can complete this
accurately.
6. Show or explain to your trainer where you would enter this result into AVImark.
7. What do you do if one of the readings is 50% different than the other four?













[23]

21013 – Brand Preferences

Results Statement: To assure great patient care by recommending the best!

Primary Responsible Position: Doctors

Participating Positions: All

Why: This is how we assure our products are safe, effective, and IN STOCK.

What to Say: “Our doctors have CAREFULLY selected products and pet foods we
keep fully stocked. We do this so you can be comfortable knowing
your pet is on the safest, highest quality, and most cost-effective
products. We also do this because it is impossible for us to remain
stocked with every brand.

If your pet requires something different let us know. We can easily
get it for you.

You can also order all medications and pet foods directly through our
mobile app, in most cases with free shipping”

Our Preferred Brands:

Condition: Product : Company:
HEARTWORMS, FLEAS & TICKS
Hw/Flea/Tick (K9 and feline): Revolution Zoetis
Hw/Flea/Tick (oral): Tri Heart & Simparica -or- Sentinel Merck & Zoetis
Hw Only: Tri Heart Merck
Heavy Tick Problems: Seresto Collar legacyvet.com only

PET FOODS:
Dental Diet: Dental - Royal Canin
Atopy Hydrolyzed Royal Canin
Cancer/Recov/Neonate a/d Hill’s
Diabetes (K9) w/d Hill’s
Diabetes (fel) DM Purina
Food Allergy Trial Hydrolyzed Royal Canin
GI Disease (Acute) GI Low Fat Royal Canin
Inflam Bowel Disease (K9 +fel) Hydrolyzed Royal Canin
Maint. Dog &Cat Food: Pro Plan - Purina
Osteoarthritis j/d Hill’s
Overweight (K9 and fel) OM Purina
Puppy/Kitten Food: Pro Plan - Purina
Renal Disease (K9 and fel) NF Purina
Urinary Stones SO Royal Canin



[24]

21014 – Brochures Kept in Exam Rooms
Results Statement: To assure great client education and convenience for our employees by
having each exam room kept fully stocked with EXACTLY the same
brochures in EXACTLY the same places




Primary Responsible Position: Technicians

Participating Positions: Tech Assistants and Inventory Manager

How Many: Bundles of 10 for each brochure. Rubber band around each bundle

In Drawers:
- Anesthesia Brochures - Lets work together to help your cat
- Bark Busters brochure
- Bordetella - Metacam brochure
- Canine Parvovirus - Trupanion Insurance
- Chondroflex - Pets Have Teeth Too!
- EAC business card - Revolution Cat
- Fecal Testing - Revolution Dog
- FeLV/FIV Brochure - Senior Wellness
- Frontline Dog/Cat - Senior Wellness Report Cards
- Heartgard Cat - Tri heart Dog
- Home Again - Vaccine Guide Dog/Cat
- Legacy Vet Hospital - Vet First Choice
- Leptospirosis

On counter (in clear brochure holders with at least 5 of each at all times):
- Purina OM - Purina EN
- Purina NF - Purina Pro Plan

Brochures/Reports/Models on Demo Shelf:
- Early Detection Results Page - Parasites Pictures or Diagrams Page
(laminated) (laminated)
- Senior Wellness Results Page - Heartworm Model
(laminated)

This is a reference only procedure for stocking exam rooms. No quiz needed.













[25]

21016 – Catalyst Dx Analyzer – How to Clean
Results Statement: To assure great patient care by maintaining the catalyst so it can
virtually always be ready to run tests without failing.

Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

How to Clean: Look in the Idexx Manual. There are great pictures and instructions.

































































[26]

21018 – Catalyst Dx Analyzer – How to Use
Result Statement: To assure great patient care by assuring the team knows how to
accurately run this machine. The team member obtains accurate results
in AVImark and to the doctor with the first try and in less than 20
minutes.


Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

How:
 Place test code under Patient Name in AVIMARK so it will assign a
requisition to the patient record
 Get LaserCyte CBC tube and Lithium Heparin Whole Blood Separator
 Draw 3 cc of blood
o Place 1 cc in the CBC tube
o Fill the Lithium Heparin Whole Blood Separator to the first line
o Place any remaining blood in a Tiger Top Tube
 Put CBC tube and gray CBC5R tube in LaserCyte.
o Close lid properly or you will get an alert on the VetLab station
screen
 At the VetLab station choose patient by touching the screen
o Next touch the gray run icon below the patient list.
 Choose the test to be processed by touching the green LaserCyte and
Catalyst icons at the bottom of the screen
o Touch other icons if running more tests
 Choose whether running test on whole blood (Lithium Heparin Whole
Blood Separator) or serum by choosing from the drop down box in the
middle of the screen
o NOTE: In sample cup, place enough serum to the first line on
the cup, make sure there are no bubbles in the cup
 Touch the red “Run” icon at the top right corner of the VetLab station
screen. This will send the patient information and the tests being
processed to the Catalyst
 The LaserCyte should start running at this time
 Go back to the Catalyst and select the patient that you are processing
labwork on from the patient list on the left side of the screen.
 Press select at the bottom middle portion of the screen.
 Choose sample type at the top of the screen and then choose if a special
slide (e.g. Phenobarbital) is going to be used.
 Press red “Next” icon on bottom right of the screen. This will open the
sample and slide door on the left
 Place the sample cup at the top of sample drawer assembly





[27]

 Place the slides ( from pre-made cartridges located in the lab freezer) in
the cartridge holder at front of the sample drawer assembly. NOTE: DO
NOT TOUCH THE CIRCLE IN THE MIDDLE OF THE SLIDE
 Slide cartridges must be loaded in the following order
o Lytes
o Chemistry
o Thyroid
o The slide needs to be on top or last one loaded
o When running a Thyroid Test, load a slide wash
cartridge in the top drawer at the far right of the
Catalyst

 Next press run at the bottom right of the Catalyst screen
 When the tests are completed, they will automatically download in the
patient file in AVIMARK
 Lab Results will also print on the printer (located bottom cabinet to the
right of the sink in Pharmacy

Did not Download?
 Press records in the middle of the screen on the Vetlab station
 Select and press the patient name
 Select View records at the top right of the screen
 Press Transfer results

Results Won’t Print?
 Follow the steps above (Download Failure into Patient File)
 Select “Print” instead of “Transfer Results”


Drill/Quiz for “Catalyst Dx Analyzer – How to Use”:
1. Why do we have this procedure?
2. What would happen if you didn’t know how to do it right?
3. What would happen if it took longer than 20 minutes?
4. Watch your trainer do one while you watch.
5. You do one yourself without help or verbal help only. Keep going as many times as it takes to
get one done confidently within 20 minutes. Do this on actual patients so we do not waste
supplies while doing this training.


















[28]

21020 – Catheter Placement (IV)


Results Statement: To provide the highest quality patient care be efficiently placing IV
catheters in a standard way by all staff.






Primary Responsible Position: Technicians

Participating Position: Veterinarians

Locations for IV Catheters: One of four most common veins:
1. Cephalic Vein - This is by far the most common vein to use. It runs
along the top of the foreleg of dogs and cats.
2. Femoral Vein – inside the thigh above the knee/stifle.
3. Lateral Saphenous – This is on the outside of the ankle/hock. It is
mostly used when the cephalic vein is unusable, but can be used at
any time.
4. Medial Saphenous – This is on the inside ankle/hock. It is mostly
used when the cephalic vein is unusable, but can be used at any
time.

Prep the Catheter & Supplies: Choose your catheter size based on what vein you will be using and the
size of the animal/vein. In general, choose the largest size that can be
reasonably placed in less than 10 minutes, preferably less than 5.

Dehydration and/or age can require smaller catheters.

Get your tape all set with all the pieces you need taped to the edge of
the counter easily reachable but not where it will get rubbed by the pet
or a person.

Fill the catheter and hub with heparinized saline (see separate
procedure).



















[29]

Hold the Leg Properly: TAKE YOUR TIME AND GET COMFORTABLE ON THIS PART. Have your
assistant hold the animal and gently roll the vein from the inside to the
outside and pushing DOWN, occluding the flow of blood by hold off the
vein at the elbow.

The assistant’s hand that is holding the vein should be behind the elbow
pushing the elbow FORWARD and IN FRONT of the shoulder. A
tourniquet can also be used for holding off the vein.

If the animal is not properly held DO NOT START. The holding is the
cause of many failures in placing catheters.


Placing the Catheter
Step 1: Shave enough hair so the vein can be visualized (Figures
1 and 2). Depending on practice protocol, shave the area over
the vein only, or the entire circumference of the leg. Shaving
around the entire circumference helps ensure that hair and
bacteria do not physically contaminate the insertion site when
the catheter is taped.

1
Step 2: Nonsterile medical gloves should now be worn ; wearing gloves
before this step may result in the gloves touching the shaved
hair.








FIGURES 1 AND 2 Shave the patient’s hair to visualize the vein.



























[30]

Step 3: Prepare the site in a manner similar to surgical preparation
(Figures 3 and 4). Place an antibacterial solution (2%-4%
ChlorhexiDerm or povidoneiodine) on sterile gauze and
1-3
alternate with a rubbing alcohol gauze. The antibacterial
solution should maintain contact with the skin for a full
2
1
minute. Avoid palpating the insertion site following the scrub.

If the leg is not prepped properly an infection can be introduced
into the veins and the rest of the body. The scrubbing step is not
necessary with catheters placed for euthanasia unless the client
is watching.








FIGURES 3 AND 4 Prepare the site with an antibacterial
solution on sterile gauze and a rubbing alcohol gauze.

Step 4: The catheter should not be touched when the package is
opened. Discard any catheter that touches anything other than
prepared skin.

Step 5: Before inserting the catheter, place any necessary restraint
devices (eg, muzzle, towels, Elizabethan collar) on the patient.
At this step, the team member placing the IV catheter and the
team member restraining the patient have equally important
responsibilities. One team member restrains the patient,
positions the leg, and holds off the vein to occlude the vessel
(similar to a tourniquet); the vessel dilates and fills with blood
to allow placement of the catheter. The other team member
prepares to place the catheter. The team member restraining
also ensures team safety throughout the procedure (Figure 5).
Most patients will try to pull their leg back when they feel the
catheter.







FIGURE 5 Restrain the patient while placing the catheter.




[31]

Step 6: Grasp the hub of the catheter firmly with the dominant hand,
using at least 2 fingers and taking care not to touch the catheter
itself. With the other hand, firmly grasp the patient’s leg below
the area where the catheter will be placed to prevent leg
movement during placement.

Step 7: The area for catheter insertion should be at a point that is as
close as possible to the foot to allow for any subsequent
attempts to use the same vein. Do not palpate the vein and do
not touch the prepared insertion site.

Step 8: The slanted part of the needle tip, or bevel, should point
upward so that the opening can be visualized. Insert the
catheter at a 10° to 30° angle to breach the skin (Figures 6 and
3-5
7). A flash of blood should be visualized in the catheter hub
(Figure 8). At this point, carefully level the catheter parallel to
the vein and slowly advance forward (Figures 9 and 10)
approximately 2 mm to 3 mm to ensure that it is fully seated
within the vessel.

















FIGURE 6 The catheter must be inserted at a 10°-30° angle to
breach the skin.

















[32]

Step 9: If blood is still flowing into the catheter hub and it has advanced
smoothly to this point, advance the catheter off only the stylet
and into the vein without moving the stylet. Using one finger
(usually the index finger), push the catheter off the stylet only
and all the way into the vessel (Figure 11).







FIGURE 11 The catheter is pushed off the stylet and all the way
into the vessel.

Step 10: Flush the catheter with 0.9% NaCl when it is fully inserted up to
the hub into the vein, tape it, and wrap it securely. Heparinized
6
saline is not necessary. Cap the end of the catheter with a
sterile injection plug, extension set, or T-set.

Step 11: Tape the catheter in place with three pieces of tape, one on
catheter hub, one on t-port, one over the whole setup.
Step 12: Wrap YELLOW vet-wrap around the catheter leg to indicate a
catheter has been placed. Leave the injection port open so we
can see it and use it.
We use yellow for “caution” letting us know the catheter is still
in.
Step 13: Consider an Elizabethan collar for patients that may be prone to
removing the catheter from their leg.


Drill/Quiz for “Catheter Placement (IV)”:
1. Why do we have a specific way of placing catheters? Why do we all need to do it in a similar
way? Think of supplies used, assistants holding, patient safety, etc.
2. Show your trainer where we keep catheters, heparinized saline, tape, and vet wrap.
3. Using a model, catheter, tape and vet wrap show you trainer how up place a catheter. Pretend
you get the flash of blood, thread it, tape it, etc.
4. In front of your trainer and with an assistant actually place a catheter on a patient. Get a pass
when both you and your trainer are relatively comfortable you can do this…and do it the way we
have it written.














[33]

21022 – Checklists for Technicians

Result Statement: To ensure we have a record that the responsibilities of each and every
position is being completed as required, and to a minimum standard,
each day, in many cases twice daily.
This accomplishes two things:
1. Technicians have a one-page representation and reminder of all
routine responsibilities
2. Executive Director/Owner are able to see that routine kennel
responsibilities are completed on a daily basis and to standard
Steps to Complete a Checklist:
 Print the “Tech AM Checklist or Tech PM Checklist” found under
“Forms – Misc” in the procedure manual. KEEP a minimum of one-
week supply and place them in the proper folder in the mailbox
area.
 Each staff member will get the correct checklist immediately (within
5 minutes) after clocking in for his/her shift.
 Keep this checklist in your primary work area in the treatment room
counter closest to the tech board and refer to continuously
throughout your shift until it’s 100% complete
 Each staff member will complete the checklist before the end of
his/her shift.
 Each task will be completed as written in the Procedure manual.
Write YOUR initials next to each task after the task is complete. If
your initials are on the line you are responsible for it having been
completed!
 Initials are REQUIRED ON EVERY LINE. Your initials simply indicate it
has that END RESULT, even if not needing to be done that day (like a
surgery task on non-surgery day).
 The staff member will sign (and print name if signature isn’t legible)
the checklist when submitting the completed list. YOUR SIGNATURE
at the bottom is YOUR ASSURANCE IT ALL HAS BEEN DONE.
 If the checklist is incomplete or if items are initialed but not done it
can be grounds for termination. This is how we assure all the
patients have been taken care of properly!




















[34]

Where to Turn in: After each checklist is 100% complete (with mgr signature) they will
be turned in to your Department Manager’s mailbox.






Approval by Managers: Each staff member must have their completed checklist reviewed
for completeness by a manager, or person in charge, (not a
colleague or other non-supervisor) before leaving for the day.
If a manager is not working at the end of a shift you must write on
the checklist that this is the case and initial it.


What the Managers Do: The manager reviewing the completed checklist will randomly pick
at least THREE tasks to physically check for accurate completion and
initial next to the task. Managers: Don’t initial without checking as
you, the manager, will be also be accountable.
o Discrepancies will be immediately corrected prior to leaving
your shift.
o The on-site manager will be responsible for reviewed
checklists after they sign-off.

Drill/Quiz for “Checklists for Technicians”:
1. Why is it important to complete the checklist? How does it make your job better?
2. What would happen if we did not have checklists?
3. What would happen if we did not require every item to be completed before leaving?
4. What would happen if managers did not double check the checklists?
5. Who keeps a stock of checklist printed for their area? How many will they keep printed?
6. Who is responsible for completing a checklist?
7. May a staff member leave without completing his/her checklist?
8. Who reviews the checklist? When? Why?
9. Where are the checklist put after they are reviewed? By whom?
10. Who reviews the checklist? When? Why?
11. Where are the checklist put after they are reviewed? By whom?


















[35]

21024 – Client Acceptance Tips (CAT)


Results Statement: To help assure the health of pets by HELPING clients to
make informed decision and steps for their own pets.
When compliance is high the client saves time and
money. The pet is healthier. We get to do more of
what we love and be financially rewarded.



Primary Responsible Position: Associate Vet

Participating Positions: Technician and Client Coordinator

Overview: Unless certain steps are taken to allow the client to get
a full UNDERSTANDING of what we recommend and
how it HELPS THEM they will often decline. This way of
helping clients has proven to be the most effective and
efficient.

If, at any time during the process, the owner accepts
and says yes (make sure they know the cost before) to
our recommendations there is no need to go further
with explanations. This often happens with clients that
already trust us. If you continue to talk about it will
likely get more confusing and waste their time.

If a client LIKES you, they are more likely to listen. They
will know you like them by first listening and
understanding them. Use empathy (Feel, Felt, Found)
BEFORE education.

We are selling the invisible. Always use demonstration
pieces (pictures, models, results, etc). When a client
can see what they are paying for, it is easier to
understand how valuable it is.


















[36]

Compliance Steps to Take:

Before the client arrives:
1. STAY ON TIME or communicate unavoidable delays properly (see “Appointment
Delays”). A client that has been waiting too long does not want to hear about more
services and more expenses. They want to go home.
2. KNOW THE PET and their record. Review the records at least 3 appointments in
advance.
3. GET YOUR TEAM PREPARED: See “Appointment Flow and Staying on Time”.

When you FIRST meet with the client:
1. AUTHENTIC caring. Demonstrate to them that are truly here to help them and their
pet.
2. ASK QUESTIONS. Ask them what they may have concerns or questions about
BEFORE you tell them anything.
3. Address THEIR concerns first, not yours. Ease their mind with the reason THEY
came to us before you discuss anything else.

HOW to recommend:
1. “FEEL, FELT, FOUND”:
a. I know how it FEELS to have a sick pet and if it’s he/she is going to be okay.
b. I have FELT that with my own dog/cat.
c. I have FOUND it helped me to do this test to be sure it was not serious
2. EXACTLY WHAT AND WHY:
a. Explain exactly WHAT (specifically) and WHY you recommend something in
common grade school language. Big words will cause things to be declined
faster than most anything else.
b. Explain the consequences that will likely happen IF THEY DON’T DO THIS.
This is extremely important.
i. For example, if we DON’T do a dental cleaning it WILL get worse,
cause pain, cost more, may cause other diseases, and may shorten
their pet’s life.
c. THREE PARTS ALL CLIENTS NEED:
i. Education: Explain the reasons. How it helps THE OWNER and the
pet.
ii. Demo Piece/diagram: SHOW the client something, even if it’s hand-
written words. It could be a picture, model, brochure, etc.
iii. Finance: AFTER the above someone (non-Dr.) will discuss cost or
payments
3. MAKE IT SIMPLE FOR OUR CLIENTS: Offer the client and easy time and place to get
this done. All the client has to do is say yes. We will make it happen for them!











[37]

Drill/Quiz for Client Compliance Tips:
1. Explain what is meant by “Feel, Felt, Found”.
2. What are the three parts we all need in order to recommend something.
3. If mid-way through your recommendation our client simply says yes should you continue to talk
about it? Why or why not?
4. With your trainer acting as a client go through the following three scenarios using the above
steps to help the client (your trainer) understand WHY they should do what you recommend,
even if they need to make payment arrangements.
a. Dental cleaning on a grade 2 dental disease pet during an annual visit.
b. Heartworm prevention for a dog during an annual visit.
c. Wellness blood panel on an annual visit (early detection or senior wellness).





























































[38]

21026 – Communication Scripts

Results Statement: To describe and recommend services in a way that is SIMPLE,
AUTHENTIC, EFFECTIVE and CONSISTENT among all staff.

Primary Responsible Positions: Technicians, Doctors

Participating Positions: All positions with client contact

First know what you’re talking about: “If you can’t explain it simply, you don’t understand it well
enough” - Albert Einstein










Should I memorize these? It is NOT necessary memorize every script word-for-word, BUT
you must hit the main points. This is necessary to give the
clients the same information from ANY LVH staff member.
These are not truly “scripts”! Each staff member will have their
own style and exact wording depending on that individual and
the situation. Each staff member must be able to communicate
these same messages comfortably in their own way.
In many cases actually memorizing these scripts exactly may
help you and save you time. You will know what’s best by
practicing.


WHERE These Scripts Fit: This is the “Education” portion of the “Client Compliance Tips”
procedure. It comes AFTER the “Feel, Felt, Found”.

WHAT to Say for Each Topic: Wellness or Early Detection Panels:
“Our routine blood panels check things on the INSIDE that
doctors cannot see on the outside. Hopefully everything will be
normal. If so, it will give baseline normal levels for your pet
every year.”

“If something is NOT normal it will give us a chance to fix it for
less cost and before your pet gets sick.”

(Demo Piece: Show an example lab report)


[39]

Heartworm/Flea/Tick Preventatives:
“Heartworms are EXTREMELY common in the DFW area. It’s
spread by mosquitos and is often deadly to dogs and cats.”

“Without heartworm prevention, almost all dogs in our area will
get heartworms. Treatment costs over $1,000 and takes
months with cage rest. There is no treatment for cats”.

“The cost for heartworm prevention is only around $10-20 per
month, even combo products with flea and tick prevention.”

(Demo Piece: Show heart model with heartworms and
brochure for recommended preventative)


Heartworm Tests:
“No heartworm preventative is 100% effective. If your pet has
heartworms we need to know this year, before 2 years go by
and there can be permanent heart damage. It also keeps your
guarantee on all heartworm preventatives we sell.”
(Demo Piece: Show a heart model with heartworms)

Fecal Tests:
“Our yearly parasite screen checks for worms that are ALL
contagious to you and your family. Pets get these from the
ground and dirty shoes or floors. No preventative prevents
everything. 15% of the pets we test have these parasites.”
(Demo Piece: Show the sheet of parasites we test for)

Distemper/Parvo Vaccine:
“Distemper and parvo are viruses that often causes death. They
are complicated and expensive diseases. They are common dog
viruses here in Frisco. This vaccine is guaranteed when given by
us at the correct times.”

(Demo Piece: Brochure titled “A Guide to Vaccines”)

Lepto Vaccine:
Lepto is a bacterial disease spread wild animals. It causes
kidney failure and is contagious to people. Dogs in the DFW
area get this disease every year.”

(Demo Piece: Lepto Brochure)








[40]

Bordetella “Kennel Cough” Vaccine:
“Kennel cough is a VERY common disease all over the country.
It’s like a cold for a dog. It’s spread through the air up to 20
feet. It frequently happens in dogs through fences and on
walks”

(Demo Piece: Brochure of “A guide to vaccines)


Receptionists Surgery Price Quotes:
Receptionists: It’s best to schedule the FREE pre-op exam (and
not quote a price) so the client can come in to get the exact
price. If they need a price by phone quote the BASE PRICE only.

“We need to schedule a free pre-op exam with one of our
doctors. They will get you the exact price for your pet along
with any other possible recommended services to make it as
safe as possible. What day works for you?”

(Demo Piece: See Phone Shoppers Procedure)

Higher Prices than the Client Expects or Is Used To:

See Client Compliance Tips: Use
“FeelFeltFoundEducationDemoFinance.

“I completely understand how that feels when the price is more
than you expect. We’ve had other clients that have felt the
same way. We have found clients appreciate hearing how we
focus on the safest care for your pet.”

Education & Demo: “We offer (services we do that is safer) to
avoid (possible problems).” Show appropriate demo pieces.

Finance: “The required services costs (base price). The
RECOMMENDED services cost (additional costs) extra.

(Demo Piece: Use Printed Treatment Plans AND Demo Models
as Applicable)














[41]

Drill/Quiz for “Client Communication Scripts”:
1. Before you get your trainer to discuss these go through each one practicing what you will say
and how WITHOUT looking at these scripts. These are important. Take your time learning these
until you truly understand them.
2. What happens if we didn’t know or follow these scripts? For the clients? For our staff?
3. Do you have to memorize every script word-for-word? Why or why not?
4. Go through each script with your trainer one at a time. Your trainer acts as the client. Explain
why your trainer should do what you recommend on each topic.
5. Get a pass only after you hit the points in less than 1 minute for each.


































































[42]

21028 – Complications and Client Complaints


Results Statement: To create confidence and efficiency in handling client
complaints and complications with the care of clients’
pets. To handle those complaints with good listening,
empathy, and fairness.





Primary Responsible Position: Receptionists

Key Points:

 Complaints are our chance to IMPRESS! We all have had complaints about businesses. It’s how
the business listens and understands.
 Complaints are almost always caused by miscommunication or a lack of communication.
 Try to determine when or if WE may have failed to properly communicate.
 Complaints should be very RARE.
 ALL complaints should be reported to a manager so we can do everything to prevent them.
 Complaints should be understood enough that they ALL can be solved with common
sense. LISTEN!
 Resolutions should be fair to both the client and the hospital.
 Resolutions should be more in favor of keeping the client happy rather than us.
 If a client does not end COMPLETELY SATISFIED to the point they would refer their
friends it is dangerous to all of our jobs!





























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CLIENT COMPLAINTS

What You Do:
 Look at the problem from the CLIENT’S point of view first.
 Don’t take complaints personally, even if a client makes a personal comment. It’s
not about you.
 Try to handle it at your level first.
 Use good judgment and that it is within reason.
 Receptionists have full authority to discount/refund UP TO $75 if it makes sense.
o Ex: If someone picks up their pet from grooming and are not completely
satisfied with the groom:
 See if the groomer can fix the cut and make them happy NOW
 See if we did not have a clear expectation on the grooming form
they signed. Did the client fully understand before signing? If not, it
is OUR FAULT. Refund the entire groom price. Assure the client will
give us another chance.
 Did we not have them fill out the grooming form completely? If not
refund the entire groom price.
 Did we do exactly what was written and understood on the
grooming form? If we did, then there probably would not be a
complaint!
 Anything OVER $75 needs to go to lead receptionist, other manager, executive,
doctor, or owner.

What the Lead Receptionist Does:

 Lead receptionist has full authority to discount/refund UP TO $150 if it makes
sense.
 Anything OVER $150 needs to go to Director of Medical Services or an
exec….unless it’s over $150 AND it’s obvious.
o Try everything you can to solve the problem NOW. It’s the second biggest
priority we have.
o Let client know that you will have a manager follow up with them.
 Ex: If someone declines bloodwork or a treatment service during
their stay and it accidently gets done, that’s our fault and we can do
a discount for the treatment.
















[44]

COMPLICATIONS IN PATIENT CARE

If we have a patient who has complications following medical or surgical care we will handle it
in one of two ways:


1. If the complication is a result of OUR ERROR: The original service AND ALL remaining
care to correct this complication is completely free to the owner. Everything will be
entered into the patient record under the appropriate doctor with the regular prices
then a “8052 Professional Discount” is entered and the price is changed to a negative
amount under the same doctor to make the total charges as pertains to the
complication are zero. Services unrelated to this complication are charge at regular
prices.

Examples:
i. A patient was given an injection overdose due to someone misreading or
not looking at the syringe.
ii. A patient was dispensed the wrong pills and had a reaction to the
medication.
iii. A patient gets into a fight with another dog in our care because one of
the dogs was not on a leash in the hospital as required.


2. If the complication was NOT UNDER OUR CONTROL and there was no way of us
knowing how could have prevented it: The owner pays only for medications and
products. We discount any exam fees using the “8052 Professional Discount” as above.
Examples:
i. A patient has a suture reaction after a spay.
ii. A patient has a vaccine reaction to vaccines WE GAVE that we had no
prior history of.
iii. A boarder is vomiting despite us giving the proper care, food, monitoring,
etc.

Note: On some occasions patients under our care are not responding to our treatment plans or
are getting worse even with our best efforts. THESE ARE NOT COMPLICATIONS AS DESCRIBED
ABOVE. These cases may require multiple exams, medications, etc, all at regular price.












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Drill/Quiz on “Complications and Client Complaints”:
1. In your own words describe the results statement.
2. Why do we have the procedure? What would happen if we didn’t? How would that negatively
affect YOU?
3. Describe some key points of handling complaints and complications in care.
4. How much can YOU discount if it makes sense?
5. How much can the lead receptionist discount if it makes sense?
Describe the two basic types of complications in care. How do we handle each one?



































































[46]

21029 - Declaw Principles and Guidelines

Results Statement: To assure any declaws that are performed are best for that individual
cat. The decision to declaw a cat and the surgery itself should benefit
the patient








Primary Responsible Position: Veterinarians

Participating Positions: Techs and TA’s
Our General Position: As a general rule we discourage declaws unless the alternatives and
risks of NOT declawing is worse for the cat. We work as a partner with
the client in making and informed decision that both the client and
veterinarian can both be comfortable in knowing it was the right
decision.

Client Communication: Clients need to be informed of the following before they decide:

 Declawed cats have higher risks for chronic pain, inappropriate
urination/deification, and biting among other. These risks are
approximately 3-9X more likely than non-declawed cats.
 In some cases, declaws are helpful to:
o The Patient - more loved, less risk of adoption
o Other Pets - might protect other pets
o The Family - more pleased with cats in the house
 Declaws performed at our hospital are much safer and comfortable
than average because:
o We hospitalize for two nights after declaws (lowers pain
and complications)
o We use extensive pain control measures including local
blocks, pre-op pain meds, post-op pain meds, etc.
o We ideally attempt to schedule declaw surgeries with the
same surgical doctor also present the next day for post-op
care and bandage removal.


No Quiz/Drill needed for this procedure. Procedure is for reference only.






[47]

21030 – Declaw Supplies for Dr. Julius

Results Statement: To assure consistency of patient care and simplicity for our team by
maintaining and accurate list of surgery supplies needed for each doctor
for basic surgeries.







Primary Responsible Position: Technicians

Participating Position: Tech Assistant

Supplies Needed:
 Scalpel Handle  4 Inch Vet
 11 Blade Wrap
 Alis Tissue (Loosened and
Forceps Rewrapped)
 2 Tourniquets  1 Inch Tape
 Tissue Adhesive  Bandage
 4 Inch Elastic Scissors
Gauze (Stretch  Medium Latex
Wrap) Gloves
 2 4x4 Gauze  2 Paper Towels
Pads

Prepping the Feet: Feet to be declawed will need to be rinsed in a mixture of Chlorhexidine
Solution and water (1=1)
Local blocks of Lidocaine and Marcaine are used with all Declaw procedures

Reference Procedure Only. No Drill or Quiz Needed.





















[48]

21032 - Dental Chews Included with Dog Dentals

Result Statement: To improve the dental health of our patients and length
between each dental cleaning. To also improve client
satisfaction by including free dental chews with every dental
cleaning.




Primary Responsible Position: Techs and TAs

When: AFTER every canine dental while preparing release instructions.

How:
1. In AVImark under the patient’s record make sure the bag of
chews included is the correct size for the pet’s current
weigtht. If not:
a. Add 1 bag of correct sized FREE Clenz-A-Dent chews
to the (ITEM: Free Clenz-A-Dent ____ $0.00)
b. Remove the incorrect sized FREE Clenz-A-Dent that
is on the pet’s record.
2. Print a drug label for the free chews with the instructions:
a. “Give one chew daily to help prevent tarter and
dental disease. Refill when empty.”
3. Get the correct size bag from the labeled cabinet above the
cages in the ICU area.
4. Put label on bag and put with patient’s belongings ON THE
CAGE FRONT BIN (not with the record or release
instructions) for release.

Where Are the Chews Kept?:
 Above the cages in ICU in the labeled cabinet.
 DO NOT USE THE CHEWS THAT ARE LABELED FOR SALE UP
FRONT AND IN EXAM ROOMS. IT WILL CAUSE US TO RUN
OUT!!! (Only exception is when you know exactly how to
handle inventory).

Drill for “Dental Chews Include with Dentals”:
1. Why do we give dental chews free with each dental?
2. When do you do this? Is it before the dental or after?
3. Why do we put a label on the bag?
4. Once you have the correct bag labeled exactly WHERE specifically do you put the bag?
5. Show your trainer where the free dental chews are kept.
6. Explain to your trainer, using AVImark, how you will do this procedure.


[49]

21034 – Dental Cleanings: How to Recommend

Results Statement: To keep pets healthier and happier by properly recommending dentals
that helps all involved, the pets, the clients, and our staff. All staff does
this in uniform way that has been more successful for all.

We make it easy for both our clients and the staff.

Primary Responsible Position: Veterinarians

Participating Positions: Technicians and TA’s (including express TA’s)

“No Surprise Pricing”: We offer dental packages that includes everything needed. This
includes (if needed) pain meds, antibiotics, extractions, etc. based on
the level of dental disease. We have 4 package prices that correspond
to the four levels of dental disease.

We offer these “No Surprise Pricing” packages so that we don’t have to
call clients with extra costs when we find things after we have started
the dental cleaning. These calls are disappointing to the clients, keeps
the pets under anesthesia longer (not as safe) and wastes staff time.

To Print Package Info: See “Forms – Misc”  Dental Info Sheet

How to Recommend Dentals: “Feel, Felt, Found” (see Client Compliance Tips)
All client communication MUST START with this. We first understand
how the client feels, others have felt the same way, and we have found
the answer.

Education, Demo Piece, and Finance (see Client Compliance Tips):
Recommending dental cleanings must include these three items AFTER
“feel, felt, found”. They must be in this order.
Education is the reason their pet needs a dental (see Client
Communication Scripts). Use the dental info sheet above or our report
cards with dental pictures.
Demo Piece is a picture or model of dental disease.
Finance is the very last step of showing the cost. The finance part can
only work if the client agrees first they want it for their pet if it were
free.














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