Sample "Starting Point" for Horizontally-Integrated Wellness Surveillance Program

Puppy Wellness

Heartworm and Flea/tick Prevention

6, 9, 12 weeks (9 and 12 could be nurses consult in some jurisdiction)

12-system Physical (nurse asymmetry exam each time)

DHPP (distemper, hepatitis, parainfluenza, parvo virus) each visit

Bordetella (1 x @ 8 weeks or older)

Fecal - float and Giardia SNAP if from shelter or Pet Store

Deworming (CDC Strategic deworming program)

15 weeks

 2-system Physical

 DHPP (distemper, hepatitis, parainfluenza, parvo virus)

 +/- Complete the paper work and draw blood for the following week surgery

 Rabies, 1 year (tag additional)

 Fecal

Puppy Wellness

16 week JPS screening for breeds predisposed to hip dysplasia

4-6 months female or male

 Nurse asymmetry exam upon admission

 Risk Level 1 (PCV, TP, BUN minimum Panel pre-surgery)

 Spay / Neuter

 Microchip

 *some practices provide pet population "credits" to reduce spay/neuter cost IF the client has stayed on the program for the four previous visits.

9 months

 Nurse asymmetry exam - 12-system Doctor Physical is anything is atypical

 Bordetella

 Fecal

13 months

 Rabies, 3-year

 DHPP (1st annual then w/extended DOI vaccines, every 3 years)

 ^ Use age chart (Idexx or Pfizer) as client handout, add genetic predisposition web site above age chart using folder label

19 months

 Nurse asymmetry exam - 12-system Doctor Physical is anything is atypical

 Review changes in dietary needs

 Review dental hygiene

 Bordetella

 Fecal

Starting at 2 Years of Age

Canine Life Cycle Consult (1 of 2 Semi-Annual)

 12-system Physical

 Rabies tag additional if three year vaccine and one year tag law

 Bordetella

 Fecal - Float & Giardia SNAP

 Heartworm test

 Urine sample - ERD

Canine Life Cycle Consult (2 of 2 Semi-Annual)

 12-system Physical

 DHPP (w/extended DOI vaccines, only once every 3 years)

 Bordetella

 Young Adult Panel (Chem-6) - or - Over-40 Panel (Chem 12)

 Fecal - Float & Giardia SNAP

Legend

 ^ Use age chart (Idexx or Pfizer) as client handout

 # Geriatric screening starts at ~ 70

Diagnostic Intensity means X-rays "needed" for limping animals, rales, static gut, late grade 2+ mouth or later and similar SOC.

Diagnostic Intensity means when there is an atypical laboratory value, it is assigned to a nurse to follow, get sequential blood/urine samples, and continue until atypical condition is resolved, or doctor determines it is "typical" for this specific animal.

Every Need ([ ] or CR-_) Statement has "two yes" alternatives, then client response: W-D-A-X

Kitten Wellness

Heartworm and Flea/tick Prevention

6, 9, 12 weeks (9 and 12 could be nurses consult in some jurisdictions)

 12-system Physical (nurse asymmetry exam each time)

 PRC (panleukopenia, rhinotrachi, Calci virus) each visit

 Felv vax (for 2 separate visits)

 Felv/ Fiv test ( 1x)

 Fecal - float & Giardia SNAP if from shelter or Pet Store

 Deworming (CDC Strategic deworming program)

15 weeks

 12-system Physical

 PRC (panleukopenia, rhinotrachi, Calci virus)

 Rabies

 Fecal

4-6 months female or male declaw optional

 Nurse asymmetry exam upon admission

 Risk Level 1 (PCV, TP, BUN minimum Panel), FIV test (lab work)

 Spay / Neuter / declaw

 Microchip

 *some practices provide pet population "credits" to reduce spay/neuter cost IF the client has stayed on the program for the four previous visits.

13 months

 Rabies, 3-year

 ^ Use age chart (Idexx or Pfizer) as client handout, add genetic predisposition web site above age chart using folder label

19 months

 Nurse asymmetry exam

 PRC (1st annual then every 3 years)

 Review changes in dietary needs

 Review dental hygiene

Starting at 2 Years of Age

Feline Life Cycle Consult (1 of 2 Semi-Annual)

 12-system Physical

 Rabies tag additional if three year vaccine and one year tag law

 Fecal - Float & Giardia SNAP

 Urine sample - ERD

Feline Life Cycle Consult (2 of 2 Semi-Annual)

 12-system Physical

 PRC (1st annual then every 3 years)

 FELV (only if exposed or at risk)

 Fecal - Float & Giardia SNAP

 Young Adult Panel (Chem-6) - or - Over-40 Panel (Chem 12)

 PLUS - Thyroid Screen starts at about age 7

Legend

 ^ Use age chart (Idexx or Pfizer) as client handout

 # Geriatric screening starts at ~ 70 on age chart

Diagnostic Intensity means X-rays "needed" for limping animals, rales, static gut, late grade 2+ mouth or later and similar SOC.

Diagnostic Intensity means when there is an atypical laboratory value, it is assigned to a nurse to follow, get sequential blood/urine samples, and continue until atypical condition is resolved, or doctor determines it is "typical" for this specific animal.

Every Need ([ ]or CR-_) Statement has "two yes" alternatives, then client response: W-D-A-X

We have met the enemy and it is us. The client cannot reasonably decide on the merits of different healthcare delivery issues; that is a graduate veterinarian's responsibility. When the medical records do not match the invoice(s), it is pure fraud from an auditor's standpoint. There cannot ever be "forgotten care" or "forgotten charges", or even falsified information (e.g., "45 minutes anesthesia" and "30 minute surgery", being invoiced as "30 minutes of surgery and anesthesia"). We are required by the respective practice acts to have full and accurate records and disclosure to the animal steward on patient and professional "needs". The client has the right to allow the animal access the needed care or not, but at no time are we as healthcare professionals allowed to hide the actual healthcare facts or needs from the client.

"Compliance" to inviolate Core Values and inviolate Standards of Care is internal to the practice, and not a client issue. Compliance starts from the providers and is reinforced by the staff and providers; when there is a consistency in the expected Standards of Care, the subsequent continuity of care become easier as well as more beneficial to patient, client, staff, providers, and business.