Winter 2020, Practice Management

A Focus on Utilization

Kenichiro YagiMS, RVT, VTS (ECC, SAIM)

Ken has spent nearly 20 years in practice. He obtained his VTS certification in emergency and critical care, as well as small animal internal medicine, and earned his master’s degree in Veterinary Science. He served as ICU Manager and Blood Bank Manager at Adobe Animal Hospital until 2018, and is now Program Director for the RECOVER CPR Initiative and simulation lab manager of the Park Veterinary Innovation Laboratory at Cornell University. He co-chairs the Veterinary Nurse Initiative and serves as a board member of the Veterinary Emergency and Critical Care Society, the Academy of Veterinary Emergency and Critical Care Technicians, and the Veterinary Innovation Council.

Heather PrendergastRVT, CVPM

Heather has spent over 25 years in small animal practice, teaches veterinary technology and assistance programs, and is the author of Front Office Management for the Veterinary Team. She lectures on topics ranging from grief management for health care professionals to nutrition, inventory, communications, and veterinary team management. She has also written several articles and participated in published roundtable discussions on these topics.

Currently, Heather provides consulting services for veterinary hospitals and is an instructor for Patterson Veterinary University and VetMedTeam. She serves on several advisory committees and is the Program Chair of the Technician Program at the North American Veterinary Conference. Heather was named the 2014 Veterinary Technician of the Year and Continuing Educator of the Year for 2016 at the Western Veterinary Conference.

A Focus on Utilization
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If one asks a veterinary practice owner “Is your veterinary nursing care staff being utilized?” the typical answer that comes back would likely be “Yes, of course! They are hard-working people, who work all around the clock! There is no wasted time.” So why is it that one of the key factors for dissatisfaction brought up by our profession is “underutilization”?

There has been a significant amount of focus on veterinary technician utilization—or rather, underutilization—as an issue within our profession. While a credentialed veterinary technician has obtained the education and skills to serve as an effective critical thinker, veterinary nursing care provider, and patient advocate, the disgruntled conversation regarding how to best utilize our profession within veterinary practices has been a decades-long discussion that is still an issue today.

The Issues

Veterinarians Performing Nursing Care: Since veterinary practice acts in all 50 states declare that the act of diagnosis, prognosis, surgery, and prescription is restricted to be performed by licensed veterinarians, all other tasks related to veterinary medicine aside from those can be performed by credentialed veterinary technicians under varied degrees of supervision. In that case, veterinarians performing tasks such as placement of IV catheters, blood sampling, bandage application, administration of medication, and other veterinary nursing care tasks when veterinary technicians are available is an inefficient use of the team’s time.

Not Functioning to the Fullest Extent of the Law: Veterinary technicians not being able to perform urinary catheterization, administering partial or total intravenous anesthesia, applying mechanical ventilation, providing client education on diabetes, suturing of cutaneous wounds, performing ultrasound exams, and other advanced tasks that are not legally restricted to veterinarians adds to the frustrations of being unable to grow in our career. These tasks should be delegated to appropriately trained credentialed veterinary technicians.

Inappropriate Utilization: With the current shortage of members of our profession, it is easy for our time to be occupied with all tasks conducted in the veterinary practice. However, having our time engaged with tasks is not exactly the same as being utilized appropriately; especially if our shifts are comprised of janitorial, reception, assistant, kennel, clerical, and other work that does not capitalize on the education and training of credentialed veterinary technicians. While the members of our profession do not ever feel we are above any kind of work in the hospital in a time of need, a clear division of labor routing team members to their specific areas of expertise will lead to less burnout.

Violation of Scope of Practice Regulation: Many states have scope of practice regulations for credentialed veterinary technicians; thus, certain tasks are restricted to be performed by credentialed veterinary technicians. These regulations ensure the safety of patients by declaring that educated and qualified individuals perform said tasks. Theoretically, this should create a clinical team structure such that veterinarians focus on the medicine, veterinary technicians focus on the nursing care, and veterinary assistants support the activities of each. However, reports from NAVTA members and others within our profession indicate that scope of practice regulations are often violated in practice. These violations can compromise patient care and lead to the devaluation of our credential. Instead, appropriately routing work to credentialed veterinary technicians which is best suited for them to perform, while creating workflow that allows veterinary assistants to support their work, will improve patient safety and team efficiency.

While the members of our profession do not ever feel we are above any kind of work in the hospital in a time of need, a clear division of labor routing team members to their specific areas of expertise will lead to less burnout.

The Positive Effects of Utilization

Properly utilizing credentialed veterinary technicians will bring better patient care, job satisfaction, retention, and profitability to the practice. In addition, when credentialed vet techs perform the veterinary nursing care role they are trained for, veterinarians have the ability to see more patients and the team is able to provide patient care that results in positive outcomes. Veterinary technicians who are able to utilize their skill sets and grow in their career enjoy better job satisfaction. The tasks they undertake can alleviate the workload of veterinarians, allowing them to have a more manageable shift and work schedule, leading to a better work-life balance. Studies have pointed to increased practice revenue when credentialed veterinary technicians are on staff and utilized, demonstrating the contribution of a veterinary technician to the practice’s success.1

Studies have pointed to increased practice revenue when credentialed veterinary technicians are on staff and utilized, demonstrating the contribution of a veterinary technician to the practice’s success.1

Forward Movement

While the conversation regarding underutilization in our profession has been around for many years, there are promising efforts being made to improve this aspect of our profession today. NAVTA is participating in the work by the AVMA’s Veterinary Technician Utilization Task Force through veterinary technician representatives (Michelle Krasicki-Aune, representing the NAVTA Executive Board; Ed Carlson, representing the Committee on Veterinary Technician Specialties; and Janet McConnell, representing NAVTA as a member) alongside the Veterinary Hospital Manager’s Association (represented by Leslie Boudreau), the American Association of Veterinary State Boards (represented by Amy Haywood), and the AVMA Committee on Veterinary Technician Education and Activities (represented by Kelly Foltz), all of which are tasked to produce recommendations regarding improvements in veterinary technician utilization. Additionally, one of the goals of the Veterinary Nurse Initiative aims to bring standardization to the scope of practice defined throughout the nation.

NAVTA will continue to seek input from its members on important issues such as this, to provide the input necessary to advocate for the profession to create the change the profession needs. NAVTA leadership has had the pleasure of in-depth discussion with passionate individuals that make our profession great and look forward to further discussions on the various issues at hand.

References

1Fanning J, Shepherd AJ. Contribution of veterinary technicians to veterinary business revenue, 2007. JAVMA. avmajournals.avma.org/doi/full/10.2460/javma.236.8.846. Accessed November 2019.

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