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Treatment room quarterback (Proceedings)

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Nov 01, 2009

Have you ever stopped to think about how organized (or disorganized) the treatment area in your hospital truly is? Has an animal ever been admitted into the hospital for a procedure but you didn't realize that it was there until the owner came by to pick it up? How about having that dog in for a dental prophy/polish, and after everything went smoothly and the dog is already fully recovered from anesthesia, you discover that the dog's owner also wanted you to remove that little growth on the belly? Or, how often have you had to fight with a nasty cat (you know the one which makes you wonder why you ever went into this field in the first place), coax it into the induction box (getting thoroughly clawed up in the process), anesthetize it, perform whatever minor procedure it came in for, then, after it has recovered (and hopefully you have too) and is back in its cage you realize that it was also due for its vaccines? Well, don't feel too badly because these things have happened in all of our practices at one time or another. Naturally the larger and busier practices experience these problems even more often.

I'm sure you've all heard the expression that "too many cooks spoil the broth?" This is exactly why these mistakes happen in most veterinary hospitals–there are simply too many people in charge and there's either too much, or not enough, overlap. What happens to a patient and the patient file in your hospital when the pet is brought back to be admitted? Is the procedure different if the animal is admitted by a doctor than if it is brought in as a drop-off? Who, or better yet, how many different people are allowed to place admitted patient records in the file rack? If more than one person has this responsibility, you are looking for trouble! Think about who is allowed to re-file a book pulled off of a shelf in a library–certainly not you!

I discovered a great and simple solution to this problem that has plagued many veterinary hospitals for years, and I refer to it as the Treatment Area List Person. This "person" is sort of like the director or manager of the hospital's main treatment area. In a busy practice it is definitely a full-time position and should be filled by someone who has a lot of technician experience. This person handles every file that comes through the back of the hospital–whether it belongs to an animal being admitted for hospitalization, surgery, grooming, or boarding, or even if the file is being brought back for a medication refill. Our list person sits by a computer in our main treatment room just adjacent to our file rack and our large erasable "treatment board." To the right of the computer terminal is our "in" box, where all records are placed in order to be "processed" by our list person. Except for those files which have already been processed and are already in the appropriate location in the file rack, the list person is the only person who is allowed to place a newly admitted file into the rack–and that includes you, the doctors!