CVS has run a nation-wide clinical improvement project in 35 of its small animal practices to improve the use of ultrasound scans in first opinion diagnosis.
Over the last year the project has led to an additional 3,000 scans being conducted in these surgeries by both its vets and veterinary nurses.
Ultrasound is a commonly used medical diagnostic tool within the veterinary field. It has many applications, including diagnostic work up, disease screening and clinical research. Many patients can benefit from ultrasonography, especially in the case of gastrointestinal diseases – one of the most prevalent mid-level diagnosis in first opinion practice[i].
The CVS clinical improvement project first looked at how effective CVS small animal first opinion practices were at conducting ultrasound scans. It found that a key barrier to conducting them was a lack of confidence – both in using the equipment and in interpreting the images. Colleagues cited a lack of university and college training as a root cause. Echoing this, a recent Canadian industry study looked at the reasons why clinicians were not performing ultrasound, finding a lack of training and skills were key, with a lack of equipment the only reason cited above this[ii].
The CVS ultrasound project therefore aimed to review practice equipment, improve clinician case identification, increase clinical skills and confidence, and to recommend ultrasound in all appropriate cases.
A suite of resources was then produced – for practice vets and nurses – to help them improve ultrasound scan rates. These included; clinical guidelines, approach to cases guidance, and machine guides. This was additionally supported by new client educational resources, created by CVS.
To upskill and develop colleagues, dedicated vet and nurse training sessions were also held. Vet training focussed on case identification and improving diagnostic skills, whilst vet nurse training looked at how to use ultrasound equipment and conduct scans. Training sessions comprised of; one-to-one in practice training by CVS’ hub clinical leads; online tutorial videos; and online ‘Clinical Cuppa’ webinar sessions, which involved case examples and interactive case discussions. In addition a number of face-to-face Point Of Care ultrasound training days were held specifically to upskill nurses – so that they could start scanning to support their vets.
An audit of each participating practices’ ultrasound scan rates was conducted at the start of the project. Results were then shared with each practice every month.
One year after its nation-wide launch, data shows that the number of ultrasound scans has increased by over 3,000. Anecdotal evidence has also shown that colleague confidence and practice team culture has improved as a result of the project.
Victoria Woods, Hub Clinical Leader at CVS who was responsible for the ultrasound clinical improvement project, said: “Ultrasound is a powerful diagnostic imaging tool. It can be used to identify a wide number of small animal complications and diseases. It’s fantastic to see the benefits increased ultrasonography is already bringing to our practices on this project – especially as a result of upskilling our nurses. I am certain that this will help contribute towards them providing some of the best clinical diagnosis and care in our profession.”
The CVS ultrasound clinical improvement project will continue for another year. It will be rolled out to other CVS Group practices who wish to be involved and will continue to run in current practices.
The next stage of the project will see echocardiography added to the project. Two group training days for vets and two days for nurses will be held, along with practical sessions and lectures. An online resource centre will also have additional guidelines on echocardiography, mitral valve disease, and murmurs. In addition, the hub clinical lead team will continue their face-to-face in practice training and support – to help the clinicians develop their echocardiography skills.
CVS Group operates across small animal, farm animal, equine, laboratories and crematoria, with over 500 veterinary practices and referral centres in the UK, the Republic of Ireland and the Netherlands. In the last five years the company has invested nearly £80 million in its sites, facilities and equipment, in addition to industry leading training and support, to give the best possible care to animals.
[i] VetCompass 2014