Can you document the quality of your patient care?
One of the major drivers of change regarding promotion of infection control in human healthcare has been the use of standardized
surveillance tools. This helped demonstrate a need for these efforts, promoted the use of benchmarking to assess the quality
of care that is being achieved at individual hospitals, and allowed greater comparability of research findings across different
Unfortunately, this type of surveillance is not commonly used in veterinary medicine. Few would argue that a core goal for
every clinical practice is to compassionately deliver the highest quality care to patients and clients. But what if I asked
you to prove that you were meeting this goal in your practice—could you do it? What evidence can you provide documenting the
quality of patient care in your practice?
This question strikes at the heart of the need to actively pursue excellence in infection control. You do not really know
if you are controlling surgical site infections or catheter-related problems if you are not actively documenting their occurrence.
This can be accomplished quite simply (e.g. tracking the number of catheters placed and the number that show defined evidence of problems) or can be implemented with
a bit more rigor in more comprehensive programs. For example, syndromic surveillance methods are quite easy and inexpensive
to implement and show great promise for use in veterinary settings.5
Regardless of the approach, it is clear that we need to improve our ability to develop formalized infection control programs
for all veterinary care settings, and we need to develop methods that document the quality of our care if we are to compassionately
deliver the highest quality care to our patients and clients.
Paul S. Morley, DVM, DACVIM, is a professor at Colorado State University (CSU) and the Director of Infection Control at CSU's
James L. Voss Veterinary Teaching Hospital.
1. Morley PS, Anderson ME, Burgess BA, et al. Report of the third Havemeyer workshop on infection control in equine populations.
Equine Vet J 2013;45(2):131-136.
2. Morley PS. Evidence-based infection control in clinical practice: if you buy clothes for the emperor, will he wear them? J Vet Intern Med 2013;27(3):430-438.
3. Morley PS, Weese JS. Biosecurity and infection control for large animal practices. In: Smith BP, ed. Large animal internal medicine. 4th ed. New York, NY: Elsevier, 2008;1524-1550.
4. Canadian Committee on Antibiotic Resistance (CCAR). Infection prevention and control best practices for small animal veterinary
clinics. 2008 Available at: http://www.ovc.uoguelph.ca/cphaz/resources/documents/GuidelinesFINALInfectionPreventionDec2008.pdf. Accessed Aug 16, 2013.
5. Ruple-Czerniak AA, Aceto HW, Bender JB, et al. Using syndromic surveillance to estimate baseline rates for healthcare-associated
infections in critical care units of small animal referral hospitals. J Vet Intern Med [In Press].