Integrated Surgical Training: Academia and Shelters. Lynetta Freeman, Purdue University Monica Neal, PetSmart Charities March 10, 2013

Transcription

1 Integrated Surgical Training: Academia and Shelters Lynetta Freeman, Purdue University Monica Neal, PetSmart Charities March 10, 2013

2 Agenda Benefits Shelter context Veterinary college context Purdue s program Other models Funding Questions Insert photo: Surgery 2

3 Habit 4: Think Win-Win* Need for spaying & neutering shelter animals Need for teaching basic surgical skills to veterinary students *From Stephen R. Covey: The 7 Habits of Highly Effective People

4 Benefits Experience Social awareness Readiness Respect Students Profession CVM Community Competitive advantage Respect More pets adopted Allies 4

5 Pet Overpopulation in the US Experts believe that there are about the same number of un-owned animals as owned i.e. about 78.2 million dogs & 86.5 million cats Cat 2 litters/year x 4-6 kittens (12, 66, 2021, 3822, 12,680) Dog 1 litter/year x 4-6 puppies One way to limit overpopulation is by spaying and neutering animals that are adopted from shelters.

6 The Unmet Need Between 4 and 7 million animals are presented to animal shelters every year* <2% of cats & 15-20% of dogs are returned to their owners 60% of dogs and 70% of cats are ultimately euthanized *Data from ASPCA

7 Challenge for Shelters To manage the number of animals that are presented for care with a limited budget

8 Purdue College of Veterinary Medicine Students perform spays and neuters on (1-3) shelter animals during their third year 4 th year students perform (0-2) spays and neuters on client-owned animals

9 Unmet Need in Veterinary Education Students must have entry-level proficiencies when they graduate Spays and neuters are the most commonly performed procedures in veterinary medicine Ŧ,^ Challenges in Veterinary Colleges Class size and case load Budget, regulatory & animal welfare concerns Balancing teaching, research, and service *JAVMA : ; Ŧ JAVMA : ; ^J Vet Med Educ :26-30.

10 Surgical Skills A recent survey identified 21 surgical skills where proficiency is expected of entry-level graduates* *JAVMA 240(11): , 2012

11 Benefits of Shelter Teaching* Students are able to practice clinical skills such as physical examination, venipuncture, administration & monitoring of anesthesia, and surgical skills in a less intense environment Students become aware of shelter issues & are more likely to volunteer to assist upon graduation *J Vet Med Educ (1):26-30; J Vet Med Educ (4):553-8; J Vet Med Educ (4):637-40

12 Process of development Internal Administration Faculty Students Other External Shelters Veterinary community Sponsors/Donors Benchmarking 12

13 Habit 5: Seek First to Understand, Then to be Understood* Pilot Study at Almost Home Humane Society Benchmarking Rural Area Veterinary Service (RAVS) North Dakota *From Stephen R. Covey: The 7 Habits of Highly Effective People 13

14 Our Inspiration The Mississippi State University Mobile Veterinary Clinic 38 foot gooseneck trailer On road 4 days/week Staffed w/ 1 faculty, 1 shelter med resident, 1 veterinary technician 3 students 2 part-time students who clean & restock the trailer each night

15 Further Understanding Humane Alliance Asheville, NC VIDA SPOT 15

16 Habit 5: Seek First to Understand, Then to be Understood* Administration Faculty Students Donors Veterinarians Alumni *From Stephen R. Covey: The 7 Habits of Highly Effective People 16

17 Habit #6: Synergize* Support from Development Office Sponsors/ Donors Hospital Support Veterinary Community *From Stephen R. Covey: The 7 Habits of Highly Effective People 17

18 University Support 18

19 Key Hires Strong interest in teaching, clinical service and shelter medicine Maintain relationships with shelters great passion for those we serve 19

20 Working with Shelters When to engage How to engage Shelter selection Maintaining relationships Purdue Fall Conference sessions 20

21 Working with Shelters We Provide Elective spays and neuters Records that document what was done On-site training for shelter teams: Selection of animals for surgery Immediate postoperative recovery Follow-up care They Provide Healthy animals A prioritized list A recovery team in a safe area Electrical outlet Lunch Follow-up care 21

22 Purdue University Rotation (elective): 3 weeks (8 days of surgery) th year students/year 74 surgeries/student (avg.) Partners: 12 shelters within 100 -mile radius 23

23 Costs: Purdue University Start-up Trailer, truck, clinic equipment, build-out and installation, including initial stock of consumable supplies: $370K Sources: Grants In-kind product support University Operations Clinician, technician, supplies, vehicle: $ 32.5K per month Sources: Grants In-kind 24

24 Serving Local Shelters Follow protocols for surgical procedures taught by Humane Alliance (Ashville, NC) ASV medical care guidelines for spay-neuter programs* Operate under PVTH hospital guidance Offer spay and neuter surgical procedures, other procedures at discretion of attending veterinarian Shelters only pay for lunch, or food & lodging for overnight trips *JAVMA 2008, 223:74-96.

25 Documenting Impact We must demonstrate impact: On the students In the communities we serve

26 Documenting Impact* Mean Surgical Time for Sequentially Performed Procedures *unpublished data from 21 students performing adult canine and feline OHE, 2012

29 What the Students LIKE having the stress of being responsible, but also having the safety net of an experienced teacher available at all times learning different techniques for performing spays and neuters. learning from an error and figuring out how to overcome it exposure to shelters and recognizing how important this program is to them 31

30 DVM Response Priority 4 Paws has relieved some of the financial burden on our clinic by decreasing the number of at or below cost sterilizations, while still encouraging new adoptions to visit a veterinarian This is a win-win situation. I am glad Purdue is giving its students the opportunity to gain surgical experience. In my experience, veterinary school was a controlled environment that gave me the freedom to make mistakes but I was not always given the opportunity to hold the scalpel in the teaching hospital. Allowing students to practice on shelter animals gives the students experience and makes the animals more adoptable to the public. Priority 4 Paws will produce Purdue graduates who will be more confident to serve the people and pets of Indiana. 32

31 To provide a source of continuing funding for this work Endowed Chair in Shelter Medicine & Surgery Endowment for continuing operating budget Challenge gifts with matching funds Our Challenge

32 Models Mobile unit CVM Location of surgeries Shelter HQHVSN clinic 34

33 Model selection: Intersection between agencies and CVM Animal welfare organizations Number of animals Availability of patients < 5 months Logistical ease Cash or in-kind resources Willingness to address any challenges CVM Availability of space Infrastructure for recordkeeping Logistical ease Cash or in-kind resources Willingness to support procedures for robust volume 35

34 Shelter: Texas A&M University Rotation (required): Shelter Rotation 2 weeks (4 days of surgery) th year students/year surgeries/student (avg.) Being launched in May 2013 Partner: Houston SPCA (about 90 miles from campus) Other examples: Oregon State University The Ohio State University Tufts University* Others in development 36

35 Costs: Texas A&M University Start-up capital Clinic equipment: $90K Operations Clinician, technician, supplies, housing for students: $218K per year (not including shelter costs) Sources: Grants Houston SPCA Sources: Grants Alumni & major gifts Houston SPCA 37

36 CVM: University of Florida Merial Shelter Medicine Clerkship Rotation (elective): 2 weeks (6 days of surgery) rd & 4 th year students/year surgeries/student (avg.) Partners: 4 shelters and 6 rescue groups in the area 38

37 Costs: University of Florida Start-up capital Clinic equipment: $85K + substantial amount of re-cycled equipment Sources: Merial Private donations University capital and inkind Operations Instructors, technicians, supplies: $394K per year Sources: Grants University In-kind supplies Shelters and rescue groups pay $20-$75 per surgery for adults 39

38 HQHVSN Clinic: Louisiana State University Spay/Neuter Rotation Rotation (elective): 2 weeks (8 days of surgery) 40 3 rd & 4 th year students/year 46 surgeries/student (avg.) When the Class of 2014 did their scheduling during the fall of 2012, the Spay/Neuter Rotation was the most requested elective. Partners: Baton Rouge Spay/Neuter - high-quality, high-volume spay/neuter clinic, mentored by Humane Alliance 7 shelters and rescue groups using clinic for pre-adoption surgeries Other examples: None, although externships available at Humane Alliance and at individual clinics 40

39 Costs: Louisiana State University Start-up capital $0 already owned by the spay/neuter clinic Operations Clinician, technician, supplies: $150K per year Sources: In-kind by the clinic (funded by earlier grants while clinic was starting up) Sources: Grants University Clinic fees paid by the rescue groups and shelters 41

40 Funding from PetSmart Charities Primary objective: To increase hands-on spay/neuter training offered by CVMs, including pediatric, to ensure pre-adoption sterilization $3M paid + committed to date across 9 schools 6 schools in discussion Grants: Have ranged from $20K to $250K Equipment and/or operations Higher amounts for higher number of surgeries Renewable Non-project overhead limited to no more than 10% 42

41 Important resources Humane Alliance Pediatric spay/neuter video Externships and CEUs Association of Shelter Veterinarians Spay/neuter task force Spay/neuter guidelines published in JAVMA 43

42 Presenters Lynetta Freeman, DVM, MS, MBA, ACVS Associate Professor, Small Animal Surgery & Biomedical Engineering Purdue University Monica Neal Program Manager PetSmart Charities 44

43 Contact information Lynetta Freeman Monica Neal 45