Technicians

21130 – Spray Cleaner Mixing

Result Statement: To assure we have an appropriate concentration for cleaning
surfaces throughout the hospital.

Primary Responsible Position: Kennel Attendant

Participating Positions: Bathers

Why: If we mix it too strong it will damage surfaces, cause fumes
dangerous for the pets and staff to breathe, and waste
money...the same money would could have used to pay our
staff.

If we mix it too weak it will not clean dangerous germs and
possibly cause diseases to pets and staff.

WHEN to Fill Pre-Measured Bottles: Every Monday by 4 PM and documented on the AM checklist.

WHERE are the Pre-Measured Bottles: Under the sink in food prep.

WHERE are the Empty Gallon Jugs: Under the sink in food prep.

WHERE is the Funnel: ` Under the sink in food prep.

HOW to fill the Pre-Measured Bottles: Take the empty pre-measured bottles and fill to the top marked
line using a funnel.


































[151]

How to Make the Mix: Dilute the concentrated cleaner as listed below:
 Mop Bucket: 4 oz. per FOUR gallons of water
 Spray Bottles: 1 oz. per gallon of water
 Parvo Spray/Mop Water: 2 oz. per gallon of water

For Mop Water: Take an 8 oz. pre-measured bottle from under
the food prep sink. Pour 4 oz. (1/2 bottle) of Kennelsol into
mop bucket and fill mop bucket to 4 gallon mark.

For Spray Bottles: Take a 2 oz. pre-measured bottle from under
the food prep sink. Pour 1oz. (1/2 bottle) of Kennelsol into the
empty gallon jug under the food prep sink. Fill the gallon jug to
the top with water. Take this mixture and fill the spray bottles
using a funnel kept in under the food prep sink.

For Parvo Spray or Parvo Mop Water: Take a 2 oz. pre-
measured bottle from under the food prep sink. Pour 2 oz. (full
small bottle) of Kennelsol into the empty gallon jug under the
food prep sink. Fill the gallon jug to the top with water. Take
this mixture and fill only the PARVO spray bottles using a funnel
kept in under the food prep sink.

For parvo mop water fill mop bucket with 4 oz. and only TWO
gallons of water. There is no need for four gallons for this one
room.


Drill/Quiz for “Mop Water & Spray Bottle Mixing”:
1. Why do we have the procedure?
2. What would happen if we just guessed how much to use for spray bottles or mop water? What
if it was too strong? Too weak?
3. When are the individual bottles of Kennelsol kept?
4. When are the individual bottles of Kennelsol filled?
5. Go to food prep. With your trainer watching mix up a gallon jug for spray bottles and fill a
couple spray bottles. Explain what you would do differently to mix up a mop bucket.
6. Get a pass when both you and your trainer are completely confident you will do it this way…and
WANT to do it this way ONLY.
















[152]

21132 – Surgeries by a Mobile Surgeon

When clients need a surgery from a mobile surgeon:
1. The DOCTOR first discusses the expected list of services that will be included with the surgery
with the client WITHOUT listing the price. The best way to do this is to hand write what things
we will be doing (anesthesia, bloodwork, pain meds, recovery, etc).
2. The DOCTOR assures the client fully understands AND AGREES on what we will need to do for
their pet BEFORE the client is turned over to the technician, tech assistant or client coordinator.
3. The DOCTOR adds a follow-up in AVImark of WHO is being delegated and responsible that the
following steps are followed.
4. The TECHNICIAN, TA or CLIENT COORDINATOR then generates and prints a treatment plan of
expected services. Remember we have pre-packaged estimates in AVImark that can be used.
They are all listed under “Turner - ………”
5. The TECHNICIAN, TA or CLIENT COORDINATOR then shows this printed treatment plan to the
doctor for approval BEFORE presenting it to the client.
6. After approved by the doctor the TECHNICIAN, TA or CLIENT COORDINATOR presents the
treatment plan with prices to the client. Inform the client that is an ESTIMATED cost. It could
be a little higher or lower depending on what Dr. Davidson’s current fees are. The overall
cost should not vary by more than 10%.
7. Once the CLIENT APPROVES the treatment plan by signing the TECHNICIAN, TA, RECEPTIONIST
or CLIENT COORDINATOR will work on scheduling:
a. Ask the client if there are any days that would NOT work for them.
b. Call Dr. Davidson 213-479-2716 (or other doctor) to get two things:
i. The date and time he can do it.
ii. His cost.
c. You may have had to leave a message at this point. If so:
i. Add a follow-up to the patient’s record of your message left for Dr. Turner.
ii. Add another follow-up due in 1 day that reads, “Schedule Dr. Turner Surgery”.
You should add more notes that reads we need to “double check that the Dr.
Turner has called back, surgery is scheduled, and client has been contacted.
d. Change the treatment plan to assure the client cost of the surgery itself is 10% MORE
than the surgeon’s fee.
e. Schedule as listed in the “Scheduling Surgery” procedure (client drop off time, etc).


** Note: In AVImark Dr. Davidson’s surgery itself is entered under “Charisse Davidson, DVM”. All
other treatment and items will go under the doctor of record (our doctor).

This is a reference procedure only. There is no drill/quiz.








[153]

21132.4 – Surgery Guidelines


Results Statement: To assure great patient care and client service of offering
appropriate and convenient surgery services among all doctors.








Primary Responsible Position: Associate DVM’s

Scheduling and Surgery Fit-Ins:

 See Surgery Scheduling Guidelines under Receptionist Procedures
 We encourage surgeries to be “fit in” outside of our normal surgery scheduling. It can be very
helpful to both pets and clients. If done too often or improperly it can also cause mistakes,
confusion, and wasted time for many. Surgeries can be “fit-in” to a doctor’s appointment schedule
with the following:
o “Fit-in” surgeries should NOT be common place as it can:
 Limit our available doctor appointment hours for clients
 Have two surgeries going at the same time with limits on space and equipment.
o FIRST try to fit them into your own SCHEDULED surgery time.
o Do NOT create more than a 4-hour period with available appointment doctor.
o Do NOT create a schedule with no doctor available for appointments at 8 AM.
o ONLY do a surgery “fit-in” if it’s needed in order to assure the surgery gets done.’
o Occasional exceptions to the above can be made with good judgment by the doctors or
execs, or both.
o For AVIMARK:
 Schedule the surgery “fit-in” APPOINTMENT AVImark from 7-8 AM during your
normal block-off
 Add a BLOCK-OFF for the surgery itself UNDER YOUR COLLUMN in AVIMARK.
 DO NOT add a block-off on the surgery column
 Make sure you have scheduled enough time to start and finish the surgery in the
planned time. You may need a little extra for the support staff to prep and recover
the patient before the next block of appointments.














[154]

Surgery Patient Prep:

 Surgeries should be prepped by techs by completing one patient at a time completely before
starting the next patient or inducing as directed by the doctor.
 Surgery prep by techs take priority over bath packages or healthy drop off patients
 We must have the first patient under anesthesia within 30 minutes of scheduled surgery time. The
surgery doctor must supervise techs to make sure this happens. (only ICU cases or emergencies
should prevent this). Surgery patients take priority only behind emergencies and ICU/Critical
patients.

Order of Surgeries:

 Doctors should start the patient with the longest surgery time followed by the next longest, etc.
This allows us to be able to work-in shorter surgeries after if needed.

After Surgery:

 The surgery doctor calls every client when patient is recovering after anesthesia/surgery to let the
owner know everything went well. A “Follow-up” is added to the record in Avimark.
 Unless otherwise directed by the doctor, in general, routine surgery patients will be offered food
and water by mouth within 6 hours of recovery and discontinuing IV Fluids.

Mobile Surgeons:

 Surgeries or services completed by a specialist will be entered in under “Dr. Davidson/Dr. Fager” in
AVImark.
 The doctor of record will only get production from the other services.
 The associate doctors will not be compensated for the production or fee of the surgery or procedure
itself.

SURGERIES ON PERSONAL PETS OF DOCTORS:
 Owner of the pet can decide who the doctor of record will be. They can control the case
themselves or transfer case to another doctor if needed in order to avoid the personal and
emotional involvement in the care.
 Fees are based on the standard doctor discounts set up in AVImark. Dr. Julius or medical
director may make some exception or overrides based on the service needed and cost to the
hospital.
 It is approved for doctors to use clocked-in staff for assistance with procedures or surgeries.
 Pre-operative lab work - Same as with regular clients. We have a two month requirement but
final judgment is always with the doctor of record. This judgment should be in line with what
we recommend to routine clients.
 Scheduling – routine surgeries should be scheduled within the routine regular blocked off
surgery time. This keeps payroll under control as the doctor will need to use support staff to
help with the surgery.




[155]

 Anesthesia – all decisions are made by the doctor of record, even if during another doctor’s
blocked off surgery time (Owner doctor may not have available surgery days on his/her
schedule).


Drill/Quiz for “Surgery Guidelines”:
1. Do we do surgery fit-ins?
2. Give your trainer an example of when would be good to do a surgery fit-in? When would NOT
be a good time?
3. When techs are prepping surgeries should they do one patient completely before moving onto
the next?....or should they do all the catheter placements, then ECG’s, then all drugs?
4. How long (maximum) after you start your surgery block should he first patient be under
anesthesia?
5. If there are multiple non-critical patients dropped off for vaccines and ear infections, but also
there are surgery patients dropped off which should the techs be working on FIRST?
6. When you have multiple surgeries and/or dentals which should you start first?
7. Who calls the client after surgery? What do you do after you call?
8. Do associate DVM’s get production on the surgery fee of mobile surgeons?


















































[156]

21133 - Surgical Instrument Cleaning

Result Statement: To ensure patient safety by assuring instruments are clean and ready to
be wrapped for the autoclave.





What TO do: All instruments must be cleaned soon after each surgery. No blood
should ever dry on the instruments.
1. Scrub the instruments with a brush to remove all debris
2. Rinse all instruments with running water
3. Soak the instruments in instrument milk for 5 minutes
4. Lay the instruments completely flat on a surgical towel to dry

What NOT to do:
1. Instruments should never be left soaking.
2. Don’t wrap a pack until the instruments are COMPLETELY dry. This
will cause the instruments to rust.



Drill/Quiz for “Surgical Instrument Cleaning”
1. Why do we have this procedure?
2. How does it help you? How does it help the pets?
3. When are the instruments cleaned?
4. What would cause the instruments to rust?
5. With your training clean at least two surgical instruments. Get a pass when it is done
correctly as written.


























[157]

21134v – Surgery Packs


Results Statement: To ensure patient safety by properly wrapping and sterilizing surgery
packs.





Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

Resources Needed: Blue towel, a surgical wrap, the surgical instruments, an indicator strip,
a piece of indicator tape, gauze, and drape

How:
1. Frist finish the surgical laundry, scrubbed the tools, and applied the
instrument milk.
2. Place all the tools together, unclamped, from large to small (large/small
Metzenbaum scissors, curved Mayo scissors, tissue forceps, needle
driver, large curved hemostats, large towel clamps, small curved
hemostats, small towel clamps)
a. The rat-tooth forceps, Brown Adson forceps, scalpel, and spay
hook will be set separately
3. Lay out a blue towel in a diamond shape
4. Arrange all the instruments in step one from large to small and where
one of the finger loops of all instruments create a ‘tunnel.’ String the
spay hook through that tunnel to keep the instruments together.
5. Set the combined tools in the middle of the blue towel, making sure it
doesn’t fall apart.
6. Place the rat-tooth forceps, Brown Adson forceps, scalpel, AND an
indicator strip on the bottom-side of the placed tools.
7. Place a 2-inch stack of gauze on top of the placed tools. Then place the
needle boat (with two curved needles) on top of the gauze. For safety
purposes place a small amount of gauze where the needles are to
indicate to the user of the pack that’s where the sharp needles are
located.
8. Place a drape WITHOUT the rubber-band on top of that.
Now we’re ready to wrap.
9. Pull the corner closest to you, while holding down the contents of the
pack and pulling the blue towel tight, and fold over accordion-style. (tip:
use your elbow to keep the contents from moving as you pull the towel
tighter)
10. Rotate the pack 90 degrees making sure you maintain the tightness of
your fold.


[158]

11. Repeat step eight again making sure the contents remain tight.
12. Rotate the pack 180 degrees to fold the opposite side from which you
just folded and repeat 8.
13. Rotate a final time to where the final flap is pointing towards you and
repeat step 8. This is when you make sure you make the pack real tight,
then insert the flap under all the previous folds keeping a small part of
the flap exposed so the user can easily open the pack.
Now we have a final round of wrapping using surgery wrap.
14. Layout a surgery wrap in a diamond shape. Place the pack that you just
wrapped in the middle of the pack. Repeat the folding as you did with
the blue towel on each corner. (steps 8-12)
15. Place a strip of indicator tape to hole the pack together. Write the date
in which you created the pack, the color of the instruments (ex. Blue
pack), and your initials.
16. We’re ready for the autoclave.
17. Wrapped packs need to be re-autoclaved every 6 months, Peel packs: 1
year (both per the CDC and Texas A&M Vet School).

Drill/Quiz for Surgery Packs”:
1. Why do we have the procedure? What would happen if the staff each did it differently? For
you? For the doctors? For the pet?
2. With your trainer watching go un-wrap, disorganize, and re-organize and wrap the pack. Place
in autoclave when done. Get a pass when only both you and your trainer are comfortable you
can complete it as written (open book) and WANT to complete it this way.








































[159]

21136 – Surgery Patient Prep

Results Statement: To provide great surgery patient care by preparing surgery patients in a
way that is consistent and best for the client, patient, technicians, and
the doctor

Primary Responsible Position: Technician

Participating Positions: Tech Assistants, Doctors

Labeling (CRITICAL!):
1. Bring animal to ICU cages – ensure hospital collar is on patient and
cage card is on cage – place patient in cage until ready to begin
prepping.
2. Check patient clip board to ensure all paperwork has been signed
and a current weight has been entered.
3. Check Avimark account to ensure that charges are posted and any
declined services are listed appropriately.
4. Write patient and procedure on the surgery board
5. Write reminder to “Remove Catheter” on tech board.

Prepping Patients:
1. Start by prepping the LONGEST or BIGGEST SURGERY PATIENT
FIRST!
a. We do this because it’s best to get the longest surgery done
first. If we get behind later it’s easier to re-arrange the
schedule to “fit-in” shorter surgeries later if needed.
2. PREP ONE PATIENT AT A TIME AND COMPLETELY BEFORE MOVING
ONTO THE NEXT!
a. We do this because it allows us to get started on the first
surgery EARLIER. Otherwise it takes longer to start any
surgery.
3. Obtain TPR – enter under medical notes
4. Complete ECG per the “ECG’s” procedure – Highlight “ECG” on
invoice and click on “More Stuff” – enter results
5. Place IV catheter per the “Catheter Placement (IV)” Procedure.
6. Place patient back in proper cage
















[160]

AVImark & Medications Prep: If below steps not followed exactly a patient could die.
1. On the “Surgery Form” (in the manual under “Forms-Misc”):
a. Check off that you have done the above steps (TPR and ECG
results are also written on this form)
2. Give doctor the “Surgery Form”. He/She will highlight the drug
protocol.
3. Draw up the drug dosages in the exact amounts the doctor listed.
a. Do this at the counter in front of the associate’s office
window, not other locations are allowed!
b. Do this ONE SYRINGE AT A TIME (prevents mixing up drugs).
c. LABEL each syringe AS YOU GO WITH A PIECE OF TAPE ON
THE SYRINGE (Sharpie markings on the syringe can be read
to be the wrong letter or rubbed off and given wrong. This
could be fatal if given wrong.This is to be done at the
counter in front of the Dr’s office window. These drugs and
syringes are not to be moved from this area until given to
the patient.Put patient’s name on the syringe and the first
letter of the drug on the top of the plunger. These syringes
may also be labeled with tape tabs so long as the quantity
can still be seen in the syringe.
4. In AVImark, go to patient’s invoice, highlight the “Anesthesia” line.
5. On the right side of the screen click on “Inventory Used”, select the
proper drug, double click, enter the amount.
a. If you do not do this step we WILL RUN OUT OF DRUGS and
will be breaking the legal regulations on patient records.
6. Do NOT prep the next surgery yet. Check with your doctor to see if
he/she is ready to start surgery. If not, prep your next surgery.

Drill/Quiz for “Surgery Patient Prep”:
1. Why do have this procedure so specifically written? What happens if we did not? For the
patients? For YOU?
2. Why is it critical to everything labeled properly, including the ID collars? Name two bad things
that may happen if we did not have proper labeling.
3. Which patient do you prep first? What if the doctor tells you differently?
4. Do you prep one patient completely at a time or for example, just do all of the catheters first?
Why or why not?
5. Go to the treatment room with your trainer. Draw up 0.12 cc of sterile saline. Label it. Show
your trainer how it’s labeled and where you would put it in AVImark. Get a pass ONLY when you
have done this correctly and understand the gravity of what could happen to our patients if you
did not.








[161]

21138 – Surgery Release Forms

Results Statement: To ensure clients have accurate, written, and complete information they
need to care for their pet properly after brought home from surgery.





Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

How:
1. On patient record, highlight the surgery performed (i.e. spay,
neuter, dental).
2. On the right hand of the screen select “Form”.
3. The appropriate form will pop up the release instructions.
4. On the form fill out the following:
A. Medications as directed by the doctor.
B. “Check” the appropriate box for sutures.
C. “Check the appropriate box for feeding instructions.
NOTE: THERE are two pages on each. One is to go home with the
client and the other is for us to keep with the owner’s signature.
5. Review to be sure information accurate and spelling is correct.
6. Save the document by clicking the floppy disk in the top left corner
of the screen and close window.
7. Print the form by highlighting the surgery performed, then right
click, choose form and print.
8. The “print document” screen will appear. Be sure that the animal
you are working with has a check mark next to his/her name, then
click “print”.
9. Put this form ON THE CAGE WITH THE MEDS, not on the clip board.

Drill/Quiz for “Surgery Release Forms”:
1. Go to AVIMark under “Practice Client”. With you trainer watching (not helping), print a surgery
release for that patient with Rimadyl 25 mg 1 t PO SID X 5 days and a return for recheck in 10
days.
2. Get a pass only when you can do this correctly in 5 minutes or under. Practice as many times as
you need.







[162]

21140 – Surgery Tech Release

Results Statement: To provide exceptional client service by efficiently conveying all
needed info to clients going home with pets who had surgery.
We do this the same with all staff and in WRITING for all clients.
They will forget most of what is only said verbally.



Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

How:
1. Check patient to be sure the IV catheter has been removed.
If not, remove it and wrap catheter site with vet wrap.
2. Gather all medications, belongings needed to be send home
with patient. All the forms and meds should be on the cage-
front bin, NOT with the clip boards. DON’T GET THE PET YET.
3. Escort the owner to the exam room referring to them BY
NAME.
4. Review the Release Instructions pointing the items
discussed and READING the medication labels to the owner
out loud.
5. Have the client sign one copy of the Surgery Release Form.
KEEP THIS COPY. The client takes the other one home.
6. Ask the owner if they have any further questions.
7. Let client know that you will be back with the patient.
8. Double check the patient. Be sure the surgery site is clean,
intact, the pet smells good, and brushed out.
9. Take pet to the client in the exam room. Show client the
surgery site.
10. Again, ask if they have any questions. If not, walk them to
reception and offer them help to their car, if needed.
Remind the client to call if he/she has questions and what
time we close.
11. Turn the signed copy of Surgery Release Form to the
receptionist to be filed.
12. Be sure to note in AVImark any questions or concerns the
client had and the response that was given so it can be
followed up on.
Drill/Quiz for “Surgery Tech Release”:
1. Why do we have the procedure? What happens if not exactly this way?
2. With a previous actual client’s record print the forms. With your trainer acting as that client in
the reception area go through all of the above steps pretending you have the med. Get a pass
when it’s done properly in less than 5 minutes.



[163]

[164]

21142 – Suture and Staple Removal

Results Statement: To assure the highest quality of care and convenience for clients, staff,
and doctors when sutures are removed.

Primary Responsible Position: Technicians

Participating Positions: Doctors, Tech Assistants

When: 10-14 days after surgery (unless otherwise directed by doctor)

Who: Technician (unless otherwise directed by doctor)
A doctor is not needed on routine suture removals.

How:
1. Pet is taken to the treatment area away from the owner (unless a
special circumstance).
2. Using proper restraint to fully visualize the entire suture site before
starting to remove.
3. Check the area of anything unusual (swelling, non-healing, oozing,
etc.)
4. If something looks unusual DO NOT REMOVE THE SUTURES. Get a
doctor.
5. If a doctor is not available or not in the building. Coordinate it with
the client so that a doctor can look and decide when they will be
removed.
6. Sutures are removed with suture scissors. Staples with staple
removers.
7. The surgery site is cleaned routinely so the area looks presentable
to the client.
8. The pet is returned to the owner.

Special Circumstances: There will be certain cases where the doctor wants to check the surgery
site before sutures are removed. In these cases, the client will be
SCHEDULED IN ADVANCE for a 10-minute recheck exam and suture
removal on the doctor’s AVImark schedule. It most all cases these
rechecks will be no-charge to the client.

Drill/Quiz for Suture and Staple Removal:
1. Why do we have this procedure?
2. Who removes the sutures? Where will the pet be for this? On routine cases, do you need a vet
for this?
3. What is done if a doctor wants to see the surgery site when sutures are removed?






[165]

21144v – Tech Releases

Results Statement: To assure great client service by consistently and thoroughly
releasing dropped off or hospitalized pets who had vet services
with written instructions.

Primary Responsible Position: Technicians

Participating Positions: Tech Assistants

Which Patients/Clients: ALL patients who are going home after having medical services
performed. This includes post-surgery patients, drop-off patients, and
any patient here for boarding or grooming AND medical services.
How: Gather all medications, patient belongings, and review the printed
Release Instructions. They will all be on the cage-front bin.
1. Take all medications and belongings with you into the exam room
WITHOUT the pet. Escort the client in to the exam room.
2. Review Release Instructions and medications with client. Be sure
they understand the information and answer any questions they
may have. READ THE MEDICATIONS TO THEM OUT LOUD.
3. If Post-Surgical go release see “Surgery Tech Release” procedure.
4. Let the client know that you will be back with the patient
momentarily. Retrieve the pet and give it a once over looking for
the following:
a. Check that any wounds are clean and have fresh bandages.
b. Ensure that the pet smells good and is brushed out.
c. Check feet for cleanliness.
5. Take pet to the client in the exam room and reassure client if it took
longer than normal.
6. Show client the surgery site or wound if applicable.
7. If patient received a groom, and the owner has concerns about it
call for the groomer now.
8. Again, ask if they have any questions. If not, walk them to reception
and offer them help to their car.
9. Remind the client to call if he/she has questions or concerns and
what time we close.
10. Escort the client to reception and turn them over to a receptionist
by name.
11. Turn the Surgery Tech Release Form to the receptionist to be filed.
12. Thank the client for allowing us to care for their pet.












[166]

Drill/Quiz for “Tech Releases”:
1. Why do release patients this very specific way? What happens if everyone does it differently?
For example, what if some staff take the pet, belongings, and forms into the exam room at the
same time?
2. With your trainer acting as the client go through the entire process using a fake or old release
instruction. Get a pass only when you can do it thoroughly and within 5 minutes.






































































[167]

21146 - Travel Sheets

Results Statement: To maintain great patient care, client service, and financial
viability of the practice. Travel sheets do this by having a one-
page representation of all we do we every patient on every visit.






Primary Responsible Position: Technicians

Participating Positions: All On-The-Floor Staff

Why: Travel sheets help with all of the following:
 Avoid not completing requested services
 Avoiding missed charges
 Avoiding overcharging clients
 Monitoring client wait times
 Tracking where new clients first heard of us
 Assuring new client/puppy/kitten packets are given out
 Assuring clients are offered and informed of pet insurance
 Assuring clients are informed about our mobile app/loyalty
 Avoiding having to use “Tech Sheets”


Without using these travel sheets, we have tens of thousands of
dollars in missed charges every year. We charge clients for
things they did not get which frustrates clients and wastes many
hours for staff

We don’t properly track where clients first heard of us. We
don’t properly track clients wait times during appointments.

We often forget to give new client/puppy/kitten packs. We
often forget to discuss loyalty rewards and our mobile app. We
often forget to discuss the benefits of good pet insurance.

All of these are CRITICAL to our success and our clients’
experience with us.










[168]

How: All treatment plans & forms are printed as usual.

Receptionists:
1. Add a blank travel sheet the FRONT of each upcoming pet’s
clipboard (on top of treatment plans and forms).
2. HIGHLIGHT if the client will need a packet (top right)
3. Circle Y or N on whether or not the pet has insurance (client
asked when booking – see procedure)
4. HIGHLIGHT items and services are expected to be done
(from treatment plan)
5. WRITE-IN any services or items expected that are not pre-
printed.
6. At new client Check-in: fill in where they FIRST heard of us.
7. At Check-Out:
a. AFTER asking referral questions (see referral
procedure) double check the CIRCLED items on
travel sheet to make sure they match what is in
AVImark.
b. Write in the time and your initials in top middle
under
“Recept Dbl Chk”
c. Itemize the invoice verbally and check the client out
(see check-out procedure).

Technicians and/or TA’s (receptionists if checking in):
1. Record the time you start and initial under top middle
“Dr/TA Start Time”.
2. Visit with the doctor using this form as our previous tech
sheet.
3. Meet with the DOCTOR: The doctor verbally dictates.
a. Use this sheet as our previous “tech sheet”
b. Write in/circle what things are needed (treatments,
items, follow-ups, release instructions, etc.)
4. Write in the time and your initials top middle “Tech Start
Time”.
5. Make a treatment plan, print it, and meet with the CLIENT:
a. Review and get approval on treatment plan as
usual.
6. CIRCLE items and services that are approved and WILL BE
DONE or HAVE BEEN DONE.
a. Don’t forget the packets, app, & insurance trial.
7. Complete the services, fill the meds, make the release
instructions, etc….all the same as before.
8. Escort the client to a receptionist referring to the
receptionist BY NAME.
9. Write your time and initials in the top middle “Back to
Recept”.



[169]

Quiz/Drill for Travel Sheets:
1. Why do we have travel sheets? What kinds of things do they prevent/help?
2. How does it help us to know what times start things for doctor visits? How does that help YOU?
3. How does it help us to know where new clients first heard of us? How does that help YOU?
4. Receptionists: Using demo pieces and a travel sheet go through the following with your trainer:
a. Find an actual pet’s record that is due to come in tomorrow. Fill out a travel sheet for
this client with the parts of your position.
b. Using demo pieces and filling out the travel sheet go through what you would do when
the client arrives
i. For boarding check-in
ii. For doctor visit
c. Using demo pieces do the same for when the client checks out.
5. Techs and TA’s: Using demo pieces and a travel sheet go through the following with your
trainer:
a. Find an actual pet’s record that is due to come in tomorrow. Fill out a travel sheet for
this client with the parts of your position.
b. Using demo pieces and filling out the travel sheet go through what you would do when
the client is called for an appointment.
i. Go through all of the steps of going up to get the client, doctor dictating,
reviewing treatment plan, etc.
6. Go through the steps as many times as necessary to easily be able to fill your portion of a travel
sheet in less than 4 minutes.
a. Techs: This travel sheet should not take you any longer than using our previous “tech
sheets”. It is the same information, just on a different form.








































[170]

21148v – Treatment Plan Creating

Result Statement: To create an accurate treatment plan for various
pet’s planned/recommended services and items.

Primary Responsible Position: Receptionist

Participating Positions: Doctor, Tech, TA

Why not called “Estimates”: “Treatment plan” is more appropriately named as opposed to
something you may get at an auto repair shop.

How to Create a Treatment Plan:

1. Go to the patient’s chart. Review what is due in the reminders list as
well as review what the dog has been to us for recently. (if they have
been in at all)
2. Viewing the patient’s account in AVImark, you will go to the “estimates”
tab on the right upper side of the screen.
a. Right click in the Estimates box, and select “New”
i. Put a general description for the estimate in the
“description” line. ie. Exam, vaccine updates, limping,
bath, etc.
ii. Select the doctor who is seeing the pet, from the drop
down menu on the upper right.
b. A window will pop up; right click in the center of the window.
Select “new”.
i. Note: shortcut is F2 for a new entry on the estimate.
c. To search for items to enter on the estimate, type in the
description or the code to the item. (items are anything from:
exams, inventory items/products, or vaccines.
3. You can also right click and select “Choose”  “Estimate…”
a. You can select one of many options for packages you wish to
choose from. ie. senior wellness w/ vaccines, canine or feline
annuals, dental pre ops, etc.
b. See the cheat sheets below for items needed for different
common appointments.
i. Also make sure to add any item necessary from the
reminder list.
4. Once you have completed all the items necessary for the appointment
and due items from the reminder list, select the “print” button. (The
estimate will print and the window will automatically close.)
5. If the estimate is for the follow day(s), make sure you go to the
appointment on the calendar and note “estimate made and printed”.





[171]

COMMON TREATMENT PLANS: In most all of these cases it is faster and easier to go to
“Estimates” and “Choose”….not “New”. It will keep you from
forgetting certain things.

Ear Infection:
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days then use:
Code 2304- Recheck Exam w/in 24 days.
 Code 7040 - Cytology - ear with stain / Unless has had an exam within the last 24 days then use:
Code 7212 - Recheck ear cytology - w/in 24 days
 Code 2496 - Ear Cleaning - Medical SIMPLE
 Code 51139 - Oti-PAK E (per cc) (Okay to leave as quantity 1)

Urinary Tract Infection:
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days then use:
Code 2304- Recheck Exam w/in 24 days.

New pet but the owner wants the pet checked with their Veterinarian (Us):
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days then use:
Code 2304- Recheck Exam w/in 24 days.
 Code NEWCLIE : New Patient - Complimentary Exam

Vaccines: See vaccine protocol list. Every dog/cat is a different case.
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days then use:
Code 2304- Recheck Exam w/in 24 days.
 Depending on what vaccines each pet needs, you will add the due vaccines and lab work. (see
vaccine protocol procedure for guidance)


Limping:
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days then use:
Code 2304- Recheck Exam w/in 24 days.
 Code 5570 : Radiograph - Per Study (any # of views) – This will expand when selected, leave
expansion.
 IF the pet has had x-rays within the last 24 days for any reason, use the following charge instead:
 Code 5591 : Radiograph - Post op or Follow-up (24d) – This will expand when selected, leave
expansion.

Post Ops:
 Code EXAMPOST: Exam - Post Op Courtesy














[172]

Pre-Ops:
 For Dentals ONLY: (be aware these are discounted prices)
 Code 2482: Pre-op Exam/Consult – included at $0.00
 Code 9910: Biohazard Fee (OSHA) at $___
 Code 4180: ECG – Preoperative at $___
 Code 4360: Pre-Op Screen / CBC - SA050 at $___

 Pre-Ops for other surgeries:
 Code 2482: Pre-op Exam/Consult – included at $0.00
 Code 9910: Biohazard Fee (OSHA) at $___
 Code 4180: ECG – Preoperative at $___
 Code 4360: Pre-Op Screen / CBC - SA050 at $___

“Bumps or Masses”:
 Code 2301- Comprehensive Exam / Unless has had an exam within the last 24 days
then use: Code 2304- Recheck Exam w/in 24 days.

How to Post and Charge for Pre-Op Spay and Neuter BW and ECG (before the day of surgery):
o Create Treatment Plan as stated above
o Highlight ECG line item by left clicking on the mouse
o Hit the space bar
o Highlight Pre-Op/CBC Line Item by left clicking on the mouse
o Hit the space bar
o Highlight Biohazard line item by left clicking on the mouse
o Hit the space bar
o Click Post
o Click No when prompted to deactivate the estimate
o Click Ok
o The ECG, Pre-Op BW, and Biohazard Fee will post to the chart
o NOTE: These prices are discounted for spays and neuters.


Drill/Quiz for “Treatment Plan Creating”:
1. Why do we have this procedure?
2. What happens if you don’t know how to do this correctly? What happens for the client? For the
pet?
3. Go to the appointment calendar for TWO days from now.
a. Find three patients and make accurate estimates for them either using the “new” or
“choose” feature in AVImark. Do this in front of your trainer.
4. Get a pass when you can do three accurately in less than 5 minutes each. Do as many as it
takes to get it right.








[173]

21150 – Treatment Plan (Clip Board) Placement

Results Statement: To assure client service and patient care by properly placing clip boards
in correct areas to ensure patients get the care approved and
requested.





Primary Responsible Position: Technicians

Where: ALL treatment plans for drop offs requiring a treatment, including
grooming and boarding patients, will first go in the treatment basket
kept just to the right of the surgery prep area computer just outside the
associate doctors’ office.

Who: Only a tech, TA, or doctor is allowed to write the treatment on the
board.

When Completed: When the treatment is complete, the technician or TA will put the chart
in the correct place (in boarding, in grooming, or To-Go-Home box to
the right of door going into pharmacy.

Drill/Quiz for “Treatment Plan Placing”:
1. Why do have specific places for placing the treatment plans? What would happen if they were
put in different places?
2. Show your trainer where they are kept?
3. Who writes the treatments on the treatment/surgery/tech boards?


























[174]

21152v – Treatment Plan Reviewing

Result Statement: To assure great patient care by assuring all treatment plans printed for
tomorrow are accurate. They have the appropriate best
recommendations for each pet.





Primary Responsible Position: Technician

Participating Position: Tech Assistants

When: All tomorrow’s treatment plans will have been double and triple
checked (THREE SETS OF INITIALS) before the staff leaves each note.
THERE IS NO EXCUSE FOR NOT COMPLETING THESE TREATMENT PLAN
REVIEWS EVERY DAY, EVEN ON BUSY DAYS.
Why: These treatment plans are our recommendations for each pet so they
have the best health. If they are not accurate it wastes time for the
client, staff, and patient. It creates a lack of trust from our clients. It
gives a perception that we make recommendations generically, don’t
care, don’t know what we are doing, and/or are more concerned about
money. When this procedure is not followed it is a really bad!!
How:
1. Tech or TA gets treatment plans for the following day/s to review at
the front desk.
2. Go into the correct account
3. Look at all reminders – See if patient is due for anything. (i.e.: fecal,
K9early, senior wellness, vaccines.)
4. If the printed treatment plan is not correct in ANY way, make
changes according and PRINT A NEW ONE. If you are unsure about
something, please ask.
5. Once corrected please print out a new plan and keep the old plan
behind it. – That way we can see what changes have been made; for
training purposes.
6. Review any Doctor notes from previous visit to see if that Dr.
recommended anything. (For example; if the appointment is a
recheck, then look to see what we are rechecking and apply charges
to estimate. (Recheck ear appointment: recheck exam, biohazard,
ear cytology, ear cleaning, and oti-pack). This allows us to have a
baseline of what we might be doing.
7. Once treatment plan has been updated or has been checked, please
print, and INITIAL at the bottom of the page in the MIDDLE SPACE.
(Make sure to write legibly so we can read your initials.)
8. Place clipboard back in correct bin for the next day.



[175]

Triple Check by Managers: As a triple check , managers will check all treatments and initial on the
THIRD SPACE before leaving for the day.

Drill/Quiz for “Treatment Plan Reviews”:
1. Why do we do this? What happens if we don’t?
2. When do you do this? What if you were extremely busy? Can you do it first thing tomorrow?
3. Pick at least one patient coming in tomorrow. Go through this treatment plan reviewing the
recommendations. Place your initials when the treatment plan is accurate.
4. Get a pass when both you and your trainer are certain you will do this every day without
fail…and you understand the importance of it.
































































[176]

21154 – Uricult Urine Culture In-House


Results Statement: To provide a cheaper faster urinary culture option for clients.

Primary Responsible Position: Technicians

Video:
http://www.uricultvetusa.com/index.php?option=com_content&view=article&id=9&Itemid=5

Procedure:
See attached titled “Urocult Vet Quick Procedure Guide.



























































[177]

Next Steps:
1. You are looking for two things:
a. Colony Density – 1,000 to 1,000,000 – see chart on taped to inside of
cabinet door in pharmacy above the lab machines.
b. Name of Bacteria – see chart on taped to inside of cabinet door in pharmacy
above the lab machines.
2. Enter the results into AVImark by highlighting Uricult in-house urine culture in on
the patients record then clicking “more stuff”
3. Place a written note in the correct doctor’s lab results box with the name of the
patient and the results.

800.330.1522800.330.1522
To Order Supplies:
http://www.vetlab.com/Uricult.htm
800.330.1522 • Fax 305-232-8421
800.330.1522 • Fax 305-232-8421
Vetlab Supply 1-800.330.1522





















































[178]

21156 – Urinalysis In-House














































































[179]

[180]

21158 – Walking Dogs
Results Statement: To provide exceptional care, safety, and comfort for pets by routinely
exercising and giving pets the chance to relieve themselves.


Primary Responsible Position: Kennel Attendant
Participating Positions: Technicians and Technician Assistants
HOW many: Walk one dog per person at a time.
WHEN we Walk Dogs: See the “Kennel AM Checklist” and “Kennel PM Checklist”:
 7 AM - Morning walks begin (Mon – Fri), 8 am on Sat & Sun.
o Daycare dogs after regular walks
 1 PM Mid-Day walks for every dog again
o Daycare dogs after regular walks
 4 PM Luxury boarders are walked again
o Daycare dogs after regular walks
 6 PM Evening walks for every dog again, 4 PM on Sat & Sun
 Even if the boarder has gone to the bathroom in their cage, they still
need to be walked at its designated times.
 If you notice whining or barking uncharacteristically, then it
probably needs to go to the bathroom and will need to be walked
ASAP.

ORDER of Walking Dogs: See “Order of Kennel Duties” procedure:
1. Luxury Suites
2. Small & Large Kennels
3. Runs
4. Boarders kept in ICU.
5. ICU or hospitalized patients are walked on a different customized
schedule by techs or TA’s.
6. Doggie Daycare Off-Leash Time


WHERE we Walk Dogs: All luxury and regular boarding patients are walked ONLY in the larger
main (east) section of the fenced in areas…and ON LEASH AT ALL TIMES!
Dogs approved and admitted for doggie daycare can be off-leash but
ONLY in one of the 3 smaller fenced in areas. See “Doggie Daycare”
procedure.

















[181]

HOW we Walk Dogs: A cinching/choke leash or harness is required at all times the dog is
outside the animal enclosure. This is required both inside, outside,
front, and back. This is for the safety of all pets and preventing using
losing possession of a pet. Not following this step can lead to
immediate termination of employment. See hospital policies.
The only exception for this leash requirement is for doggie daycare with
specific dogs, at specific times in specific areas. See procedure “Doggie
Daycare”.
REPEAT: Unless a patient has been approved and admitted for doggie
daycare THEY ARE NEVER WALKED OFF LEASH! This is to prevent
losing possession of pet, keeping pets safe from each other, and
reserving this extra benefit for our doggie daycare service which can
be added to all boarders with approval by the client
When you walk a dog with a cinch lead/collar, walk the dog on your
dominant side. Make sure that the ring which acts as an anchor is at the
base of the dog’s neck and close up to the ears for effective control.
If the patient/boarder pulls on the lead. Give a quick, firm tug sideways
on the lead. If
you pull straight
back, the dog
will pull against
you. Instead, by
giving a quick
tug to the side,
you knock
him/her slightly
off balance and
get their
attention.
When walking a
boarder outside,
it should be
walked long enough to urinate and defecate, AT LEAST 3 MINUTES.
When the patient is placed back in it’ enclosure, remove the leash and
mark the “Boarders Med Sheet” for the appropriate actions for that
date and time. See separate procedure.
If the patient is having diarrhea, or blood in urine, straining, notify the
technician and veterinarian, by placing pet’s information on the
treatment board. There is no need to go find and interrupt the techs for
this unless the pet seems very sick.
If needing a fecal/urine sample:
 Mark it on the Boarder Med Sheet that you collected it.
 Post a follow-up for fecal with your date/time stamp that fecal
has been obtained.
 Place boarder’s fecal and/or urine sample in appropriate
container.


[182]

 Label the container with patient’s information (Pet’s name and
last name of owner).
 Place the sample(s) in the lab on the counter in front of the
centrifuge.
 Write it on the tech board in treatment that you obtained the
sample. This alerts the techs to fill out the paperwork.

Special Cases or Aggressive Pets: Ask the technician or veterinarian how they recommend the patient
to be walked, and follow their instructions. Do not risk the safety of
the pet or your own safety!




Drill/Quiz for “Walking Dogs”:
1. Describe the result statement and how it would pertain to this procedure
2. What time do you start the morning walks and in what progression?
3. How many dogs can a person walk at a time?
4. How many times a day do Luxury boarders have walks and at what times?
5. Do you allow the boarder to be off lead outside in the exercise yard? Why or why not?
6. When is the only exception to using the leash? When? Where?
7. What do you do when a boarder needs a sample for processing?
8. Why is it important to mark the boarder sheets after pet has gone to the bathroom?
9. What could happen if we only use the owner’s regular collar and lead?
10. How long do you walk each pet? What is the minimum?




































[183]

21160 – Vaccine Protocols and Requirements

Result Statement: To assure patient safety for all pets by knowing and following the doctor
recommendations for pets while appropriately service clients without
any surprise costs


Primary Responsible Position: All doctors, execs, department heads, receptionists, Techs, and TA’s

Puppies: Every 3 weeks until 4 months old, Exam on first visit, Recheck on follow-
ups if within 24 days.

1. 5-8 weeks:
o DA2PPV (without lepto)
2. 9-11 weeks:
o DA2PPV (without lepto)
3. 12-14 weeks (or older and overdue for vaccines)
o DA2LPPV (with lepto)
o Bordetella – 1 year
4. 15-18 weeks
o DA2LPPV (with lepto) – ONE YEAR (same vaccine as 3 year)
o Rabies – ONE YEAR (same vaccine as 3 year)

Puppy Boarding: All puppies can be boarded if current on vaccines AND
IF NOT completed with all puppy shots. If all puppy shots are not
complete they must:
 Have a bordetella vaccine NOW
 Be walked on the smaller concrete section of the boarding are, NOT
on the grass.

Fecals: LAST TWO fecal exams must be negative before going to yearly

De-wormings: 2 routine de-wormings 2-3 weeks apart from a vet. We
use Drontal Plus

Heartworm and Flea/tick Prevention: single dose every 3 weeks until
last puppy visit. ALWAYS get 6 month or more on last puppy visit.

** There are changes based on certain parasites, certain vaccines
previously given, weight of puppy, diseases, etc. The DOCTOR may
make changes to the above protocols based on many of these factors.











[184]

Adult Dogs: ANNUAL EXAMS ARE REQUIRED WITH DA2LPPV, LEPTO, OR RABIES.

On YEAR ONE dogs come in for:

1. DA2LPPV
2. RV
3. BV
4. Fecal test
5. Hw test
6. Blood panel (K9 Early Detect if 1-6 yrs, Sr.Well if 7 or over)
7. ANNUAL EXAM WITH DA2LPPV and/or RV.



On YEARS TWO AND THREEE dogs come in for:

1. LEPTO* - WITH ANNUAL EXAM
2. BV
3. Fecal test
4. Hw test
5. Blood panel (K9 Early Detect if 1-6 yrs, Sr.Well if 7 or over)
6. ANNUAL EXAM IS WITH THE LEPTO VACCINE

*Dogs that have had a routine exam in the last 24 days do NOT need
another exam to get the 2-3 week BOOSTER lepto vaccine







































[185]

Kittens: Every 3 weeks until 4 months old, Exam on first visit, Recheck on follow-
ups if within 24 days.

1. 5-8 weeks:
a. FVRCP
2. 9-11 weeks:
a. FVRCP
3. 12-14 weeks (or older and overdue for vaccines)
a. FVRCP
b. Feline Leukemia – First/12-14 weeks
4. 15-18 weeks
a. FVRCP – ONE YEAR (same vaccine as 3 year)
nd
b. Feline Leukemia – Adult/2 – ONE YEAR (same vaccine as 3
year).
c. Rabies – ONE YEAR (same vaccine as 3 year)

Fecals: LAST TWO fecal exams must be negative before going to yearly

De-wormings: Two routine de-wormings 2-3 weeks apart from a vet.
We use Drontal

Heartworm and Flea/tick Prevention: single dose every 3 weeks until
last kitten visit. Cats or kittens that NEVER go outside and do not have
dogs in household do not flea prevention. Some clients may want it
because they cannot pill their cat and revolution is topical. This extra
protection is great.

** There are changes based on certain parasites, certain vaccines
previously given, weight of puppy, diseases, etc. The DOCTOR may
make changes to the above protocols based on many of these factors.



























[186]

Adult CATS: ANNUAL EXAMS ARE REQUIRED WITH FVRCP, LEUKEMIA, OR
RABIES.

On YEAR ONE CATS come in for:

 FVRCP
 RV
 Feline Leukemia
 Fecal test
 Blood panel (Feline
Wellness 1-6 yrs, Sr.Well if 7 or over)
 Note: Heartworm
testing on normal cats is NOT necessary but comes with
some routine panels
 ANNUAL EXAM
WITH FVRCP, Leukemia or RV.



On YEARS TWO AND THREEE dogs come in for:

 Feline Leukemia - WITH ANNUAL EXAM
 Fecal test
 Blood panel (Feline Wellness if 1-6 yrs, Sr.Well if 7
or over)
 Note: Heartworm testing on normal cats is NOT
necessary but comes with some routine panels
 ANNUAL EXAM IS WITH THE Feline Leukemia
VACCINE































[187]

Drill/Demonstration for “Vaccine Protocols and Requirements”:

Using the “practice client” in AVImark you will print estimates for the following visits:

1. A puppy comes in at 12 weeks with no vaccine or vet visit history. Print an accurate estimate for
what they need.

2. A kitten comes in at 5 months old with no vaccine or vet visit history. Print an accurate
estimate for what they need.

3. A 5-year old dog is due for Lepto shot. He had an annual visit last year and got RV, DA2LPPV, BV,
Hw, Fecal, and K9 Early Detection. Print an accurate estimate for what he needs.

4. An 11-year old cat is due for a Leukemia shot. He had an annual visit last year and got RV,
FVRCP, Feline Leukemia, Sr wellness, fecal, and Revolution. Print an accurate estimate for what
they need.

5. Do cats need flea prevention if they are kept indoor 100% of the time and no other animals in
the household are kept indoors also? What about heartworm prevention?

6. Do dogs need an exam with a lepto shot?

7. If a puppy or kitten comes in within 3 weeks of last booster do they pay for a recheck exam or
full exam price?







































[188]

21162 – Vets Purchasing or Borrowing from Us

Result Statement: To maintain a supportive and cooperative relationship with
other vet hospitals in our community. We do this by
selling/borrowing/purchasing supplies or products with other
vet hospitals. We do this while not profiting and not losing
money from this arrangement.

Primary Responsible Position: Receptionist
How:
 Set up the purchasing vet hospital as a client in AVImark.
 When a purchase is made:
o The transaction is treated the same as a client.
Payment is expected at time of purchase and an
invoice is given.
o The product will be sold at our cost, NOT the retail
cost.
 When a product is borrowed:
o The product is entered in AVImark, charges posted,
an invoice is given, input a follow up to call in 5
days. A balance will show on the account.
 When the product is returned:
o It will be returned on their account, leaving a zero
balance and adding product back into inventory.


Drill/Quiz for “Vets that Purchase/Borrow From Us”:
1. Why do we have this procedure this way? What would happen if we did it differently.
2. Using AVImark with “practice client” as a pretend vet hospital show your trainer how you would
sell a bottle of baytril to another vet hospital. Make sure you charge them accurately for our
cost.
3. Do the same but the vet hospital now just wants to BORROW the bottle and bring us a full bottle
tomorrow.
4. Reset all inventories to zero or remove all the purchases so that our inventory is now correct for
Baytril (if you don’t do this the above).
















[189]