As the world grapples with the coronavirus pandemic, clients are still depending on you to provide a high standard of veterinary care. Maintaining an optimal level of care while helping protect your human clients and staff from a highly contagious virus is a major challenge that requires a dramatic shift in operations.
Any operational changes you make at your clinic will largely hinge upon the guidelines and laws set by your local government. Also consider that what works for other practices may not work for you. Finally, since COVID-19 is an evolving issue, contact your local veterinary association to stay up to date on changing policies.
To help navigate the coronavirus landscape, here are some practical tips from fellow veterinarians.
Limit Human-to-Human Interaction
While all of the veterinarians we spoke with have taken steps to reduce human contact in their clinics, their approaches differ. Consider the following options to help keep clients and staff safe and help prevent the spread of infection:
Reschedule Non-Urgent Visits and Elective Procedures
Many veterinarians are restricting their practice to critical cases to help reduce the risk of inadvertent exposure to the coronavirus. “Wellness and most vaccine appointments and elective surgeries are being postponed for now,” says Susan Jeffrey, DVM, a veterinarian at Truesdell Animal Care Hospital in Madison, Wisconsin.
Rescheduling visits that can be safely postponed helps to decrease the number of clients coming through the facility. Contact clients directly if you need to cancel or reschedule their pet’s upcoming appointment, or list a phone number on your website they should call to reschedule. You can also use your website to share regular updates on the precautions your clinic is taking and any policy changes to ensure the safety of both clients and staff.
Limit Visits to One Owner Per Patient
Limited visitor procedures can also help reduce the chances of clients unknowingly bringing infection into the clinic. For times when it’s essential for a client to accompany a pet into the building (such as in the case of euthanasia), the visit should be limited to one person, says Ernie Ward, DVM, CVFT, a veterinarian based in Ocean Isle Beach, North Carolina.
“Ideally, have the client disinfect their hands before or immediately upon entry and provide a face mask if possible to reduce the chances of the client transmitting the virus to your team,” he adds. “Be sure to ask if the client or anyone in their home has been diagnosed with COVID-19 or is experiencing any symptoms. If your community is severely affected, consider checking the body temperature of staff and clients before entering your facility.”
As a necessary precaution, clinics are instructing both staff and clients to stay home if they or someone in their household has a fever, cough, or cold-like symptoms.
Space Out/Stagger Appointment Times
Another way some clinics are minimizing exposure risks is by spacing out or staggering appointments. “Some practices…are only allowing one client per 30- to 60-minute time intervals to allow proper time to disinfect and minimize human interaction,” says Sasha Gibbons, DVM, an associate veterinarian at Just Cats Veterinary Hospital in Stamford, Connecticut. “Other facilities are staggering appointments and exam rooms so that multiple clients are not in the waiting room at the same time, and there is proper time to disinfect the rooms.”
Eliminate the Waiting Room
Since people can be contagious before they show any signs of being sick, clinics are also temporarily closing waiting rooms and lobbies to help limit exposure to germs. While Ingersoll Animal Hospital in Des Moines, Iowa, still allows clients to enter the clinic, they’re keeping them out of the waiting room. “Clients call or text from the parking lot and are allowed in the clinic directly into an exam room,” says owner Nancy T. Peterson, DVM, CCRT, CVA, CVSMT. “At the end of the visit, they are checked out in the exam room and then exit directly to the parking lot.”
Offer Curbside Care
It’s easier and potentially safer to offer curbside veterinary care than to let pet parents enter your clinic during the pandemic, Ward says. “If possible, the staff member should perform as much of the examination or treatment outside the veterinary clinic,” he says. Schedule a time by phone or text for the client to arrive in your parking lot and ask clients to call or message you as soon as they arrive, he recommends. “Using online services should be encouraged instead of handling cash, checks, or even credit cards,” Ward adds.
Truesdell Animal Care Hospital recently started implementing a similar protocol. “When a person makes an appointment, the reception staff asks the client to park in the lot and call the clinic,” Jeffrey says. “The technician takes a history over the phone and then goes outside to get the pet. We wear jackets for this purpose only and wear gloves when retrieving the pet.”
Many clinics are also offering curbside delivery for medications and foods. “If the owner has an urgent need, they can drive up and call a specific number,” says Virginia Sinnott-Stutzman, DVM, DACVECC, an emergency and critical care veterinarian at Angell Animal Medical Center, a referral hospital in the Boston area. “We take payment over the phone and then a runner brings the medications out.”
Move to Telemedicine
Ward recommends that veterinarians begin experimenting with telemedicine during this crisis as an alternative to some in-person visits. “This is an excellent opportunity to offer remote consultations and virtual minor medical checkups for existing clients,” he says. “Skin allergies, osteoarthritis, many minor medical and follow-up visits can be safely and accurately conducted by videoconference. If you determine a pet’s condition is more serious or complicated and needs to be seen in your office, you can do that, too.”
Aside from free telecommunication tools like Skype, veterinarians can connect with clients and patients through a variety of veterinary telehealth apps and platforms. When evaluating and comparing potential telemedicine service providers, look for one that captures and shares consultation details in your practice management software so it becomes part of the medical record. (Check out the American Veterinary Medical Association’s handy checklist.) Some providers may even be offering deals to offset some of the financial challenges clinics are facing during this time. For instance, Elanco Animal Health has partnered with VetNOW, an industry-leading telemedicine platform, to provide veterinarians with two free months of access.
While it may be an ideal time to implement virtual medicine, it’s essential to first know the laws governing this practice where you live. In the U.S., for instance, the Food & Drug Administration (FDA) has traditionally required veterinarians to have an existing professional relationship with the client and the patient in order to make a virtual diagnosis or prescribe medications. For the short-term, however, the FDA is temporarily suspending enforcement of certain requirements to give veterinarians more leverage in treating animals during the pandemic.
Maintain Proper Infection Control
Evidence-based hygiene practices are critical to fighting COVID-19. “Constant washing of hands, availability of hand sanitizers, and wearing of face masks to minimize contamination from human sources from start to finish (doorknobs, pet leashes and carriers, credit card machines) must be ever present,” says Dr. Jerry Klein, DVM, chief veterinary officer for the American Kennel Club (AKC).
To minimize the risk of spreading infection, make sure to:
Practice Hand Hygiene
The American Animal Hospital Association recommends a 30- to 60-second protocol for washing hands with soap and water, and a 20- to 30-second protocol for using hand sanitizer. Both hand hygiene protocols require using the cleanser on the palms, back of the hands, between the fingers, the fingertips, thumbs, thumb web, and wrists. ALL STAFF should adhere to these guidelines.
Clean and Disinfect Surfaces
“Proper cleaning would be removing surface dirt and material and to make sure any antiviral cleaning agents are left on for the proper contact time for that particular agent,” Peterson says, adding that her staff is setting a timer. The AAHA has additional guidelines on how to properly clean and disinfect.
Wear Personal Protective Equipment
Your employees should wear PPE, “including N95 respirators (keep in mind that studies show common surgical masks do little to prevent SARS-CoV-2 infection), eye shields, and gowns,” Ward says.
The AAHA also recommends a specific sequence for putting on and taking off PPE. “It is important to remember, however, that PPE is not the most important or effective way to prevent infections,” says Dr. Heather Loenser, DVM, veterinary advisor to the AAHA.
The Centers for Disease Control and Prevention (CDC) currently does not believe that pets can spread COVID-19. “The current evidence from IDEXX suggests that dogs cannot spread the virus through their saliva or mucus via oral or airborne transmission,” Loenser says. “What is not understood is whether or not a pet can carry COVID-19 on their fur (as a fomite) if they become contaminated by an infected person sneezing or coughing on them.”
Take Care of Each Other
You already work in a high-stress profession, and COVID-19 has made your environment that much more challenging to navigate. Fear and anxiety incited by the outbreak can be downright overwhelming. Practicing kindness and patience can go a long way.
When staff members at Angell Animal Medical Center receive expressions of gratitude from clients for remaining open, they share these positive sentiments with the rest of the team to help “spread the love,” says Sinnott-Stutzman.
“It’s also interesting, now that we only really get face-to-face contact with the pets, I’ve found that we really get to know them and their idiosyncrasies,” she adds. “I currently have a feline patient that I am pretty confident has been purring and kneading his blankets for eight hours straight. Given that he has a urinary catheter in place, he’s been given the ‘best attitude’ award by our staff. When we share these stories with clients, I think it helps them know we are connecting with their pet even if we can’t be face-to-face with them.”
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