Award winners

• 1st place - Animal Trust Dewsbury CIC

The practice team aimed to reduce their use of highest-priority, critically important antibiotics (HPCIAs) and ensure that any use followed the principles of good antimicrobial stewardship. Changes were incrementally introduced to increase and prioritise culture and sensitivity testing to guide antimicrobial prescribing, along with the introduction of new stock control measures for HPCIAs and an increase in stocking levels of first and second-line HPCIA alternatives, and a requirement for there to be a specific indication for use of a long-acting antibiotic. The inappropriate use of the long-acting injectable decreased rapidly, and after five months, the team decided to stop stocking several HPCIAs. However, the ability to order these medications based on culture and sensitivity testing remained a priority to ensure animal welfare was not compromised. By the end of the project, the prescription rates for HPCIAs fell from 3% to just 0.46% of all consultations.

Listen to the Tighearnan Mooney give an overview of the Animal Trust team project: Knowledge Award audio overview: Reduction of highest-priority critically important antibiotic use by Animal Trust, Dewsbury

• 2nd place - Cockburn Vets

This independent practice team researched the appropriate use of antibiotics for dental procedures as part of the practice's commitment to improving antibiotic stewardship in general. Antibiotic prescribing over 2023 was audited, and the data was used to discuss the reduction of unnecessary usage. The practice team met regularly during 2024 to review progress and discuss concerns, using re-audits to monitor progress. The practice achieved a significant reduction in antibiotic usage from 35% of cases in 2023 to 6% of cases in 2024. 

Listen to Caitlin Burchill give an overview of the Cockburn Vets team project: Knowledge Award audio overview: Antibiotic use in cat and dog dental procedures by Cockburn Vets

• 3rd place - Burghfield Veterinary Surgery

The project aimed to look at how re-educating and ongoing monitoring of antibiotic prescriptions in first opinion veterinary practice may improve antimicrobial stewardship. The goal was to reduce overall prescriptions and reduce the EMA category of antibiotics used, without compromising patient welfare. Facilitated by education on antimicrobial use, preventative technique, and regular group discussion, the group reduced their use by 24.6% in November, and in November and December, they met their target to only prescribe following culture and sensitivity testing.  

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• 1st place - Linnaeus Medical Quality Team

The Linnaeus Quality Medical Team supported their practices to embed a culture of psychological safety through the reporting of safety incidents and near misses by practice teams. They used error and near-miss data to understand risks to patients at a group level and implement guidance and actions to improve patient safety. Open discussion and sharing of incidents resulted in a shift towards a more open, transparent, and learning focussed culture, where teams felt confident to report incidents and near misses. Individual teams were empowered to make improvements in their local practice settings, and wellbeing support was offered to team members involved in a serious incident. Through promoting and facilitating the reporting of safety incidents, there were demonstrable improvements in patient outcomes. Reporting rates increased from 86% to 100%, with an increased rate of full significant event audits and reviews from 55% to 80%. As a result of the focus on patient safety, there have been huge learnings about the nature of medical error and harm in the veterinary profession. The team are committed to sharing that learning internally and with the wider profession.  

• 2nd place - Clinical Improvement Team, CVS Group

The CVS Clinical Improvement Team has led wide-scale change in sustaining a successful antimicrobial stewardship programme with a focus on reducing the use of highest priority critically important antibiotics (HPCIAs). Guided by the CVS Clinical Governance Framework, which promotes a culture of clinical improvement through psychological safety, human factors, and systems thinking to enhance teamwork, inclusive leadership, and accountability, they brought together individuals from all areas of the organisation to discuss potential improvements. Engaging their teams to help shape the work created a greater sense of ownership of the project by all involved. Together, they implemented systems to facilitate good stewardship, including the development of a digital dashboard for prescribing data, ensuring the availability of appropriate clinical resources, holding team meetings for clinical and strategic discussions, and effectively communicating their purpose and progress. As a result of these efforts, in 2024, they achieved approximately 35,000 fewer HPCIA prescriptions compared to the benchmark.

• 3rd place - Oral Health Working Group, Linnaeus

The Linnaeus Oral Health Working Group focused on improving clinical quality of dentistry in their first opinion practices across the company by increasing the percentage of tooth extractions receiving nerve blocks and increasing the percentage of dental radiographs being taken. Dental disease is a significant healthcare concern in the small animal population in the UK, with suggested prevalence of periodontal disease being at least 80% in dogs over 3 years old. The working group aimed to reduce the prevalence of disease and therefore, reduce morbidity. Their project focused on empowering their teams to provide quality oral care for patients through increasing team knowledge and confidence. As a result, dental radiography increased from an average of 48% in 2023 to 53% in 2024 and 57% in the last period of data records available for 2024 and dental nerve blocks performed in dentals with extractions increased from an average of 52% in 2023 to 60% in 2024 and 62% in the last period of data records available for 2024.  

Listen to Sean Cameron give an overview of the Linneaus project: Knowledge Awards audio overview: Oral Health Strategy by Linnaeus Oral Health Working Group

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• 1st place - Paragon Veterinary Referrals

Armed with data from this year’s QI to Lead Organisational Change Knowledge Award winners, Paragon Referrals adapted the HUSH Huddles concept to their own local practice dispensary processes to reduce medication errors in ward patients. Huddle Up for Safer Care Huddles (HUSH) is an innovative team-based approach to improving patient safety, developed within NHS hospitals. It combines daily team huddles with measuring and celebrating improvements in patient safety. The huddle focuses on preventing medication and dispensing errors by embedding key principles, including involving all members of the clinical and non-clinical teams to identify at-risk patients and agree on actions to mitigate that risk. These daily huddles to share information and learnings resulted in 10 error-free weeks in five months compared to 10 error-free weeks over the previous 12 months. Additionally, they saw a 10% reduction in total medication errors from August to December 2024 when compared to August to December 2023. 

Listen to Helen Garbett give an overview of the Paragon Veterinary Referral team's project: Knowledge Award audio overview: HUSH Huddles: Huddle up for safer healthcare by Paragon Veterinary Referrals

• 2nd place - Vets Now, Bristol 

The team at Vets Now carried out an audit to investigate whether fluid therapy rates for dehydrated patients were being calculated according to current guidelines due to the risk of fluid overload in critically ill patients. Retrospective data revealed that fluid therapy rates were only calculated according to current guidelines in 23% of cases. After implementing a poster resource in the prep area, fluid rates for dehydrated patients were calculated according to published guidelines in 87% of cases. This improvement means that many more patients had their fluid therapy rates tailored according to their unique needs and the current guidelines, reducing the likelihood of fluid overload and potentially shortening their hospital stay due to hydration being replaced at a more appropriate rate. The team are now more aware and considerate of appropriate fluid therapy prescription, positively impacting patient safety.  

Listen to Emily Hudson give an overview of the Vets Now team project: Knowledge Awards audio overview: Clinical audit on fluid therapy rates in dehydrated patients by Vet Now, Bristol

• 3rd place - Wildbore Vetstop

This team conducted an audit to investigate feeding plans, Resting Energy Requirements (RER), inappetence rates and interventions, and what food was being offered to inpatients. Data was analysed from hospital records both before and after additional team training was provided. The actions implemented included a presentation, distributing questionnaires, and amending hospital sheets. The audit achieved several targets, such as reducing chicken being offered as a sole diet from 24% to 5%, increasing the recording the patient’s usual diet from 58% to 89%, improved documentation of the interventions to resolve inappetence from 50% to 92%, and enhanced creation of feeding plans from 3% to 53%. A small improvement was seen in patients meeting RER for the entire duration of their stay, increasing from 9% to 16%. A more significant improvement was seen when including patients who either fully or partially met their RER, from 9% to 32%.

Listen to Amy Wells give an overview of the Wildbore Vetsop team project: Knowledge Awards audio overview: Inpatient feeding audit by Wildbore Vetstop

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• Bishopton Vets identified an increase in post-operative surgical site infections caused by Serratia marcescens. An initial audit, mapping of Serratia cases and environmental swabbing found the bacteria in a soap dispenser. Interventions were introduced, including continuing to swab all wounds showing signs of surgical site infections to monitor and map cases, updating the disinfection protocols to include bleach, updating the nail care protocols to include the banning of gel/acrylic nails, and ensuring all surgical wounds were covered during hospital stays. These changes led to a reduction in Serratia cases, from four per month to none in December 2024, and improved the inappropriate long-acting antibiotic use in 31 cases without the culture and sensitivity reports to support the choice. 
• Central 2 Region, CVS Group, carried out an audit aimed at reducing the unnecessary use of high-priority critically important (HP-CIA) antibiotics in the 21 small animal practices within Central 2 Region. Teams were empowered to set individual targets and design interventions based on the principles of ‘Plan, Prevent, Protect’ that suited their local circumstances. These interventions included team discussions, client education material, reducing HP-CIAs available in pharmacies, and visual reminders. Between October 2023 to September 2024, antibiotic use reduced from 1.43% to 1.06% in the participating practices. 
• North West Equine Vets Ltd carried out an audit looking at the prescribing of antibiotics in non-theatre castrations. The audit aimed to reduce unnecessary antibiotic use and improve the recording of the reason why antibiotics were prescribed. Interventions included team discussions and using ‘Plan, Prevent, Protect’ to develop and introduce antimicrobial stewardship guidelines and a template for recording clinical notes. Over three years, prophylactic antibiotic use decreased from 45 cases (44.6%) to 11 cases (11.7%), and the recording of justification for antibiotic use improved significantly, with documented reasons increasing from 11% to 63.6%. 
• Parkside Veterinary Group aimed to reduce the use of inappropriate use of metronidazole in dogs presenting with diarrhoea. Data was collected in August and September 2023 and again in 2024. By promoting the appropriate use of probiotics, binding agents, and pain relief, along with client education on environmental management, and introducing proactive faecal analysis, the initiative led to an 83% reduction in metronidazole prescriptions, from 53 cases in 2023 to 9 in 2024 across their three branches. 
• VetPartners Ltd conducted a comprehensive antibiotic stewardship program across their extensive network of practices, focusing on reducing, refining, and replacing antibiotic use. Over six years, they achieved a 44% reduction in total antibiotic use and up to 78% reduction in highest-priority critically important antibiotics (HP-CIAs) in some practices. The initiative involved working together across different practices, species and teams, providing them with practical tools and resources. The project was driven by strong clinical leadership, evidence-based practices, and a commitment to sustainable change, resulting in improved responsible antimicrobial use. 

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• IVC Evidensia introduced care frameworks and clinical benchmarking across the group, forming evidence-based recommendations for a range of clinical presentations combined with a patient-centred approach to support clinical decision-making. The frameworks were developed with front line first opinion teams, with the aim of empowering them to provide quality, tailored care. Regular audit and benchmarking of the adoption of the framework recommendations provide insights into where adaptations, team support and training may be needed, and to share learning to inspire and support teams in the wider practice group. 
• The Ralph Veterinary Referral Centre aimed to improve organisational learning from adverse events by promoting the adoption of VetSafe reporting.  Interventions included adaptations to the reporting process to aid easy submissions. As a result, the average number of reports increased from 8 to 30 per month, a fantastic 275% increase. This helped the team to identify issues, trends and themes that affect patient safety. Several initiatives to address these concerns have provided opportunities for continual learning and positive changes across the organisation. 

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• Avenue Vet Centre (Malvern) carried out a hypothermia audit looking at improving recovery temperatures for patients undergoing dental procedures under general anaesthesia. After implementing changes such as the use of multiparameter monitors for better temperature monitoring, updating protocols to include the use of warm air blankets, heat pads and blankets for premedicated patients, and enhanced communication between vets and nurses, the practice saw a marked improvement. By 2024, 100% of cats and 66.7% of dogs maintained a recovery temperature of 37°C or higher.  
• Bath Vet Referrals, Bath Vet Group, carried out a clinical audit, led by RVN Carla Husband, to assess the levels of team confidence following the introduction of a formalised CPR training programme. The training programme, led by RVN Carla Husband, consisted of theory-based training and practical scenario-based sessions delivered to all members of the team, including client care and other support teams. Initial audits showed an increase in confidence, with scores rising from 71% to 80% immediately post-training. Two years later, confidence remained high, with 62 out of 64 participants maintaining or improving their scores. 
• Blue Cross Hospital Victoria undertook an audit on dental procedure times to ensure the quality of the service while minimising anaesthetic risks. The baseline data collected in the initial audit found the average dental time was lower than expected, with an average dental anaesthetic time of 86 minutes.  This led to in-house team training and the implementation of guidelines for staging dental procedures if they approached 2.5 hours.  The re-audit confirmed the effectiveness of these measures with a further reduction to an average of 76 minutes, with no dentals exceeding 2.5 hours of anaesthetic time. 
• Dalehead Veterinary Group conducted an anaesthetic audit to address patient thermoregulation issues with their anaesthetic protocols. The team undertook a literature review and team training to implement new guidelines and protocols. After the practice established the baseline, they introduced a new pre-medication approach.  A re-audit to assess the outcome of the change showed 100% of patients maintained a temperature above 36.50C. Other improvements noted included lower propofol and isoflurane requirements, and more stable blood pressure, demonstrating a positive sustainability impact as well as improved patient care. 
• Garston Veterinary Group audited post-operative complications in routine neuters. The initial audit identified 160 patients returning with complications. Gastrointestinal issues, particularly diarrhoea, was a recurring problem in 71 (44%) of cases. Changes implemented included advising owners to feed pets their normal diet post-surgery instead of a bland meal. The re-audit showed a 59.15% reduction in diarrhoea cases. Further improvements and audit cycles are planned to address other complications such as swelling. 
• Gower Veterinary Surgery conducted an audit on their in-house laboratory slide staining protocol due to contamination and false positive results, which increased costs and delayed diagnoses. The team were also concerned about the environmental implications of inappropriately discarded solution. They implemented in-house training, updating protocols and equipment changes, including using glass bottles with narrow necks and pipettes to avoid contamination, and creating a stain bath to prevent environmental contamination. Further changes after the second audit included using dropper bottles to prevent evaporation and contamination. The second re-audit showed zero false results, indicating the new protocol's success. 
• Hale Veterinary Group conducted an audit to assess the retention of CPR skills and knowledge among veterinary professionals. Using the RECOVER guidelines, teams were trained every 3-6 months, with their skills evaluated via a CPR training cube and a multiple-choice questionnaire. The audit revealed that frequent training improved knowledge retention and psychomotor skills, with those trained within 6 months to 1 year achieving the highest scores. The initiative led to the introduction of a formal annual training aimed at enhancing preparedness and potentially improving patient outcomes. 
• IVC Evidensia Sheep Clinical Working Group, following on from an initial audit which won an RCVS Knowledge Award in 2021-2022, the team conducted a clinical audit to assess veterinary practices during lambing and ovine caesarean sections. The initial 2021-2022 audit identified areas for improvement in antibiotic choice, infection control, and anaesthesia and a set of recommendations and guidelines were introduced.  The 2022-2023 follow-up audit showed adoption of several of the recommendations. Significant changes in antibiotic choice were seen with a shift from category C to category D antibiotics being selected 53% of the time. However, uptake of some of the other recommendations remained low. The project highlighted the impact of clinical guidelines on veterinary practices and identified barriers to further improvements, which are being discussed as a team.  
• Medivet carried out an audit aimed at evaluating and improving the use of non-steroidal anti-inflammatory drugs (NSAIDs) in routine neutering procedures. Interventions focused on standardising NSAID inclusion in estimates and improving client communications about postoperative pain management. The re-audit found the use of peri-operative NSAIDs during routine neutering procedures had improved from 91% in dogs and 94 % in cats to 99% for both species, and from 95% to 100% in rabbits.  However, although in general the use and duration of prescribed post-operative oral NSAIDs improved, variation was noted in dog laparoscopic spays and castrates, identifying further areas for improvement in the next audit cycle. The initiative demonstrated improvements in NSAID use, contributing to better pain management and patient outcomes. 
• Overdale Veterinary Practice conducted an audit to measure the number of patients experiencing hypotension under general anaesthesia and improve patient monitoring and the effectiveness of hypotension management. Interventions included team discussions, team training, creation of monitoring protocols and the purchase of additional equipment. The initiative improved knowledge in hypotension monitoring and management, enabling earlier detection and initiation of corrective measures such as perioperative IV fluids. 
• Paragon Veterinary Referrals for their initiative, led by Kirsty White, RVN, aimed at ensuring the pre-emptive calculation of emergency drug doses before procedures in a veterinary practice. Initiated in May 2022, the project involved educating the team, amending the surgical safety checklist, and conducting audits to monitor compliance and identify any barriers to completing the calculations. Initial audits showed 91.5% compliance, which improved to 100% after interventions. The final audit in April 2024 confirmed sustained high compliance at 99.6%, demonstrating the effectiveness of the implemented changes in enhancing patient safety and preparation. 
• Regional Clinical Leads, CVS Group, carried out audits aimed at enhancing clinician confidence in ocular examinations, improving diagnosis and treatment of conditions like corneal ulcers and glaucoma. Across the region, 22 practices took part in the 2023-2024 audit. Baseline data showed that an average of 4% of patients receiving eye medication also received a full eye examination. Interventions included in-house training, updated guidance, and a shift to a contextualised care approach, with the 2024-2025 reaudit showing 48.8% of treated patients received appropriate ocular diagnostic tests, a significant improvement in patient outcomes and improved client-vet relationships. 
• Roundhouse Referrals for their fifth annual TPLO+ Quality Improvement audit, focusing on clinical outcomes and customer experience for dogs undergoing TPLO surgery. The 2025 audit showed significant improvements. Enhancements in referral appointment process saw the Net Promoter Score increase from 79 to 97, and satisfaction with continuity of care and explanation of post-operative plans reached 100%. 
• Roundhouse Veterinary Hospital conducted an audit on the compliance of their surgical safety checklists introduced in 2023, winning an RCVS Knowledge Award in 2024. Since introducing the checklist, the team has engaged in regular reviews and updates, leading to significant improvements. This audit revealed that over 75% of checklists were fully completed, with five months achieving above 91% compliance. The checklist helped identify multiple breed and anaesthetic risks, enhancing patient safety and empowering the nursing team to actively participate in perioperative care. 
• Station House Vets conducted an environmental swabbing audit to assess the effectiveness of their cleaning protocols. Initial swabs in May 2023 revealed high levels of pathogens in 10 areas of the practice. The practice implemented changes in cleaning methods and products, leading to significant improvements. By November 2024, key areas like kennel and cattery doors, and the theatre table mat showed sterile cultures. The ongoing audit, with swabbing every six months, ensures sustained cleanliness and highlights the importance of effective cleaning protocols in maintaining a safe clinical environment. 
• The Ralph Veterinary Referral Centre. The Clinical Audit Team at the Ralph Veterinary Referral Centre carried out an audit to reduce medication errors by ensuring medications were checked and signed by two people at the point of dispensing. Over eight audits from August 2022 to December 2024, the practice implemented several changes, including developing a standard operating procedure (SOP), increasing pharmacy staffing levels, and providing team training. These actions led to a significant improvement, with the percentage of inpatient medications being countersigned increasing from 19% to 95%, with the aim of reducing the risk of errors and improving patient safety.  
• Westmoor Vets, CVS, conducted a clinical audit to review their prescribing of a medicine for cats and dogs. The initial audit revealed that while the correct dose was prescribed in all cases, 63% of prescriptions did not follow the recommended twice-daily dose frequency, and 43% were for inappropriate indications. After discussing the guidelines and implementing changes, a re-audit showed significant improvement: 76% of prescriptions followed the twice-daily dose frequency, and 76% were prescribed for appropriate indications. This audit improved prescribing practices, benefiting both patients and the clinical team. 
• Yew Tree Veterinary Surgery, CVS, conducted an audit, led by Bethan Panter RVN, to improve inpatient post-operative pain scoring. Initially, only 24% of patients had their pain scores recorded. After implementing team training, changes to the hospital forms, and the introduction of a ‘buddy-system’ to support less experienced team members, the re-audit found the percentage of patients with recorded pain scores increased to 94.2% in just six months. This significant improvement enhanced pain management and patient care. 

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• Blue Cross audited the usage of metronidazole in Blue Cross Hospitals and the impact of new antimicrobial stewardship guidelines. The guideline used ‘Plan, Prevent, Protect’ principles aimed at reducing the inappropriate use of metronidazole for acute diarrhoea in cats and dogs. The audit revealed a 30.28% reduction in metronidazole dispensing post-guideline implementation. Further re-audits are planned to measure for continued reductions. 
• Medivet audited antimicrobial use in dental procedures, successfully reducing overall antibiotic prescribing from 48% to 27%. While this marks a significant achievement, the audit highlighted an increase in non-evidence-based prescriptions, except for routine extractions, where usage impressively dropped from 10% to 2%. The project is notable for its candid assessment of both progress and ongoing challenges, with the team recommending prescribing prompts to ensure antibiotics are used only when clinically necessary.  

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• Highcliff Veterinary Practice collected baseline data to be used in an audit to investigate post-operative complications in dog castrate patients. Data from January to June 2024 revealed a 36% complication rate. Several interventions have been implemented, including changes to discharge information sheets, the introduction of illustrated post-operative complication reporting sheets, and testicular local anaesthetic blocks. A re-audit is planned to assess the effectiveness of these changes. 
• The Ralph Veterinary Referral Centre collected initial data over 5 weeks to be used in an audit to assess workflows and efficiency, aimed at identifying where improvements could be made. Data collected included the duration of diagnostics and procedures, and causes of delays. The audit's baseline findings will inform future activities to improve workflow and efficiency. 

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The Award winner is CVS South 4 Region. 

• CVS South 4 Region used ‘Plan, Prevent, Protect’ to devise strategies to reduce antibiotic use, including team training and guidance documents.  The team achieved an impressive 70% reduction in the use of long-acting antibiotics in the treatment of bite wounds and superficial skin infections in cats, without compromising patient welfare. This improved their overall responsible use of Highest Priority, Critically Important Antibiotics (HPCIAs), achieving a 65% reduction in their average use. 

Read the CVS South 4 Region case example here

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The Award winners are Group Hub Clinical Leadership Team (CVS UK Ltd), White Lodge Veterinary Surgery and Yorkshire Vets.

• Group Hub Clinical Leadership Team, CVS (UK) Ltd

For carrying out a clinical audit into blood pressure in cats on a national scale. The team created a wide range of guidance documents and provided team training. The nationwide initiative led to an increase in blood pressure monitoring, enabling earlier identification and treatment of hypertension in cats aged 7 years or older.  

Read the Clinical Leadership Team case example here.

Listen to the 'Knowledge Natter: Hypertension: Enhancing the identification and treatment of at-risk patients', a friendly and informal discussion about the Clinical Leadership Teams project.

• White Lodge Veterinary Surgery

Picking up an RCVS Knowledge Award for the second year in a row after winning an Antimicrobial Stewardship Award in 2023, the team looked at pain-scoring in bitch spays. Team training and updating pain management protocols enabled them to both improve their pain scores and reduce the number of dogs requiring rescue analgesia to just 10% of patients. 

Read the White Lodge Veterinary Surgery case example here.

Listen to the 'Knowledge Natter: Post-operative pain scoring bitch spays: A Clinical Audit', a friendly and informal discussion about White Lodge Veterinary Surgery's project.

• Yorkshire Vets

For an initiative to reduce the use of oxygen and volatile anaesthetic gasses by auditing fresh gas flow rates within the practice. This nurse-led initiative included team training leading to a substantial overall reduction in oxygen and isoflurane use. The reduction in carbon footprint is equivalent to driving 2,023 miles (Leeds to Andorra, or London to Rome, and back!). 

Read the Yorkshire Vets case example here.

Access the Yorkshire Vets Fresh Gas Flow Rate Calculator they designed for their audit.

Listen to the 'Knowledge Natter: Could we improve our carbon footprint?', a friendly and informal discussion about Yorkshire Vets project.

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• Lauren Green from Warren House Veterinary Centre decided to audit antibiotic use in surgical cases. This student nurse led initiative included a holistic approach to engaging the whole team. Team training along with creating new protocols and guidelines on peri-operative antibiotic selection led to a reduction of antibiotic use in routine surgeries from 25% to just 6% without compromising patient welfare. 
• Orchard Veterinary Surgery for their clinical audit to identify where improvements could be made to their responsible use of antibiotics, and introduction of Antibiotic Rounds discussing cases where antibiotics had been prescribed. The team developed strategies based on ‘Plan, Prevent, Protect’ to responsibly reduce the use of Highest-Priority, Critically-Important Antimicrobials (HPCIAs), resulting in a 76.6% reduction in HPCIA use. 
• PDSA for producing their first Antimicrobial Stewardship (AMS) Report, aimed at raising the profile of and informing discussions around AMS initiatives across the professions. The Report details the impact of PDSA AMS activities, including the introduction of protocols and guidelines on a range of topics since 2010. More specifically, the Report demonstrates an overall 67% reduction in antibiotics used in preventative surgeries. 
• Quarry Veterinary Group, VetPartners, reviewed aspects of the BSAVA Protect ME Poster to facilitate discussions on their antimicrobial stewardship activities and rational use of antibiotics in eye and skin conditions. This led to several initiatives including all team training and new guidelines, resulting in an impressive 89% reduction in long-acting antibiotic use. 

Read the Quarry Veterinary Group case example here.

Listen to Lizzie Booth from Quarry Veterinary Group give an overview of her teams initiative: Knowledge Award audio overview: The Protect Me poster project and reducing our cefovecin use. 

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• Amy Campbell from Parkside Veterinary Group for her audit assessing the effects of different pre-medication protocols on blood pressure in cats under general anaesthetic for dental treatment. The audit revealed that 84.6% of patients remained within the normal range with the updated protocols becoming adopted as standard within the practice. 
• Fiona Thomson from Roundhouse Referrals, for her process and outcome audit to assess clinical outcomes and client experience with Laparoscopic Ovariectomy. This project is in its second year, demonstrating that updated checklists and guidance for both clinical teams and owners led to improvements from the 2023 baseline audit data.  
• Francesca Pritchard (nee Beorby) from Putlands Veterinary Surgery for her audit on hypotension in dogs and cats under general anaesthesia. Sharing and discussing the baseline data as a team led to a new pre-medication protocol and a second audit to assess the outcome showed a reduction in the number of patients becoming hypotensive.

Read Francesca's case example here.

• Hannah Jones from Avenue Veterinary Centre (Malvern) for her prospective audit using post-operative pain scoring to assess the analgesia protocols for neutering in feline patients. A change in the protocols led to a 61% reduction in the number of cats requiring rescue analgesia post-operatively.  

Read Hannah's case example here.

Listen to Hannah Jones give an overview of her teams initiative: Knowledge Award audio overview: Post-operative pain management in cats spays. 

• Harriet Peck from McMurty and Harding Veterinary Practice looked at the prevalence, duration and management of hypotension during canine and feline anaesthesia. The audit process and subsequent new hypotension troubleshooting documents empowered the team to make positive changes in the way they approach hypotension. 
• Lauren Jobson from Cogges Veterinary Surgery for her audit to reduce their carbon footprint from isoflurane use in routine neutering. Team training and the introduction of a new protocol for using local anaesthetic at the site of surgery helped to reduce their carbon footprint related to oxygen and isoflurane use and improved patient recovery times. 
• Leanne Morrison from Donview Veterinary Centre used a process audit to assess their repeat prescription processes. This led to an improvement in pharmacy organisation and stock rotation, reducing errors, and financial waste by 41%. The audit also identified further areas for improvement. 
• Maxine Richards from Straid Veterinary Clinic, IVC, audited the use of blood pressure monitoring equipment during anaesthesia. Team discussions and further training on new equipment led to 100% of patients having their blood pressure monitored under anaesthetic. 
• Megan Orr from Roundhouse Veterinary Hospital assessed how well a new surgical safety checklist had been introduced in her nurse-led audit. Monthly data collection on its use and adaptations based on team feedback achieved an impressive 94% compliance with completing checklists, benefitting patient safety and team communication.  

Read Megan's case example here.

Listen to the full 'Knowledge Natter: Introduction and compliance of surgical safety checklists', a friendly and informal discussion about Megan's project.

Listen to Megan's overview of her initiative: Knowledge Award audio overview: Introduction and compliance of surgical checklist use. 

• Peter O’Hagan, at Aireworth Vets, and the Central Clinical Board Team, VetPartners, for a process audit to improve adherence to drug data sheet recommendations in dogs. 
• Rachel Clay from Cedar Veterinary Group, for leading a collaborative effort with other practices in the XL Vets group to address compliance with new protocols for recording prescriptions of parasiticides in line with the Under Care Guidelines. 
• Rosemullion Veterinary Practice used clinical audit to assess the type, frequency and patterns of errors and near misses with dispensing medication to inform changes to avoid them happening again. Team training and updated protocols for all teams led to a reduction in errors. Near misses associated with ‘look alike’ medication were fed back to the pharmaceutical company, helping to inform a design change in the packaging. 
• Roundhouse Referrals for their TPLO + Quality Improvement project, now in the fourth year of their project. A retrospective audit was carried out to assess adaptations in their service provision since their 2023 audit, demonstrating a number of improvements.  
• Southfields Veterinary Specialists for several initiatives to assess client satisfaction, workflow, accurate record keeping and client care. This series of audits showed that Quality Improvement is becoming embedded in the daily activities of the hospital. 
• Victoria Woods from Tone Veterinary Centre assessed the use of ultrasonography as a diagnostic tool. A group-wide initiative to improve training and confidence in performing ultrasound scans resulted in increased use by both vets and nurses. 
• Wendover Heights Veterinary Centre for a process audit looking at pain scores in cats and dogs undergoing ovariohysterectomy and ovariectomy. Interventions included further team training and the introduction of the feline grimace scale to aid pain scoring in cats, resulting in improved compliance with pain scoring protocols to over 80% in cats and 100% in dogs. 

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• CVS Equine for their audit across a number of practices within the group to assess their antibiotic use in equine first-opinion practice. The baseline data they collected allowed the team to quantify the type and frequency of antibiotics that were prescribed to raise awareness of responsible antibiotic use. 

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• Integrated Care Council, CVS, for the development of an organisational clinical governance framework. The framework was designed to identify what matters to frontline teams and provide support and guidance for improvement activities. 
   
• Mary Fraser from Girling and Fraser Ltd for developing an online CPD course for nurses, providing students with the knowledge and resources to apply QI techniques to the care of exotic patients. 
   
• Medivet Group for an initiative to support embedding Quality Improvement techniques throughout the organisation. This initiative led to forming Divisional and National Committees to foster the use of Clinical Audits, Benchmarking and Significant Event Audits as part of their day-to-day activities. 
   
• Mia Williams from Warren House Veterinary Centre for conducting a Significant Event Audit, and Root Cause Analysis after a serious incident. The nurse-led review and team discussions demonstrated a strong learning culture. 

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• Paragon Veterinary Referrals

Paragon focused on the protection of critically important antimicrobials by bringing together an Antimicrobial Stewardship Team, creating guidelines based on the Plan Protect Prevent mantra and running in-house CPD. The team found improvements in prescribing culture, communication and a more open environment when discussing the appropriate use of antibiotics.  

Read the Paragon Referrals case example here.

• Rachel Forster

Rachel Forster from Market Veterinary Group, IVC, used the Farm Vet Champions mantra Plan Prevent Protect to reduce prophylactic antibiotic use in neonatal lambs. With the introduction of CPD materials, audits and team meetings for practice teams, as well as client awareness meetings and support materials for farmers, the initiative saw a reduction in neonatal antibiotic use of 75%.  

• Tonia Simms

Tonia Simms from The Farm Vets at Hampden Veterinary Hospital (VetPartners), explored the use of antibiotics in surgical calf castrates. Tonia created a risk assessment and policy to reduce the routine use of prophylactic antibiotics.  The actions of the team following the introduction of the interventions led to an increase in morale and confidence around not prescribing prophylactic antibiotics without compromising welfare. 

Listen to the Knowledge Natter: Antibiotic use in surgical calf castrates, a friendly and informal discussion about Tonia's project.

Read Tonia's case example here.

• White Lodge Veterinary Surgery

White Lodge Veterinary Surgery, CVS, carried out a prospective audit to review the use of antibiotics, with a focus of antibiotic use in cat bite abscesses. With the introduction of checklists and in-house CPD they were able to treat 86% of their patients successfully without antibiotics without compromising welfare.

Read the White Lodge Veterinary Surgery case example here.

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• David Charles

David Charles, from Scarsdale Vets, part of the IVC Evidensia Farm Vets group, carried out an audit across a number of practices within the UK to collect baseline data on ovine lambings and caesareans. David introduced training and how-to guides, used SMART goals and put several recommendations on the provision of analgesia, selection and use of antibiotics and the use of adjunctive medications in place for the team to follow. The strong adoption of the recommendations across the practices resulted in a reduction in prophylactic antibiotic use, with improved use of local anaesthetics and the provision of analgesia.

Read David's case example here.

• Leanne McLeod

Leanne McLoed from Earlswood Veterinary Hospital introduced a hypothermia audit with a focus on pre-warming patients before general anaesthesia. By introducing new protocols for the provision of passive warming from pre-medication, her team reduced the incidence of hypothermic patients from 100% to 16%.  

Read Leanne's case example here.

• Rosemullion Veterinary Practice

Rosemullion Veterinary Practice carried out an audit to improve infection control and cleaning methods in all areas. By updating protocols and products, providing hand sanitising stations and cleaning materials in high-touch areas and improving training and education, the team significantly decreased the risk of environmental contamination. The project is now being used as an example for other practices.  

• Royal Veterinary College

Royal Veterinary College (RVC) incorporated Quality Improvement (QI) within their post-registration qualifications through a number of measures to help guide students through QI initiatives. These included activities on how to write a Knowledge Summary, plan a clinical audit proposal, how to conduct and reflect on the results of an audit, and group discussion and knowledge sharing sessions. Students have used the teaching and resources to perform audits and QI projects in their practices, submitted to peer review journals and presented at conferences.

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• Animal and Plant Health Agency (APHA) carried out an on-farm mastitis testing project. The project included CPD and using the Plan Prevent Protect method which resulted in increased knowledge and awareness about On Farm Testing and antimicrobial resistance activities.  
• CVS Equine Group carried out repeated point prevalence surveys of antimicrobial use in first-opinion equine practice and introduced QI leads to each practice which helped create a baseline audit and raise awareness of antimicrobial stewardship.  
• Kate Matthews from Kite Consulting carried out a cross-industry antibiotic monitoring and reduction programme which included regular meetings with farmers to provide training on the use of antibiotics and reviewing usage on farms. Farmers are able to receive individual feedback on their usage and Kite Consulting have found an overall reduction in trends showing a successful industry collaboration. 
• Tracy Latham from Moorland Veterinary Centre used Farm Vet Champion CPD to update herd and flock health plan templates and focused on reducing antibiotic usage. This resulted in setting SMART Goals to involve farmers in discussions surrounding antibiotic use.
• Warren House Veterinary Centre carried out a clinical audit to measure otitis externa cases treated without justification from culture and sensitivity results. All staff undertook a veterinary prescriber’s course and carried out an audit which showed a reduction in sales of antibiotics.  
• VetPartners Ltd carried out an antibiotics stewardship project which aimed to identify how many antibiotics were being used, and how they were being used and draw up a plan to reduce and refine use. Their project resulted in a 14.3% reduction in antibiotic use. 

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• Active Vetcare, CVS, focused on re-finding Joy in Work by carrying out a baseline survey to discover how the team felt about working at the practice. They introduced ‘What Matters to You?’ training and followed the Joy in Work framework. They introduced a Joy in Work Board, a Joy-O-Meter and a suggestion box. The team felt more engaged and felt they were being listened to and the Practice has a productive approach to addressing issues.  

Read the Active Vetcare case example here.

• Aireworth Vets, VetPartners, Introduced a number of processes to the practice such as monthly meetings and data entries on the PMS for serious errors and surgical complications, and the creation of surgical checklists and updating protocols. 
• Fiona Thomson from Roundhouse Referrals, Linnaeus, created a process and outcome audit to assess clinical outcomes and client experience in relation to Laparoscopic Ovariectomy. This was a successful baseline audit.  
• Hayley Potter from Old Golf House Vet Group introduced a ‘What Matters to You?’ initiative to improve workplace wellbeing with Joy in Work resources used to aid the change. The introduction of wellbeing meetings brought about several interventions to help boost morale and Net Promoter Score (NPS) score. 

Read Hayley's case example here.

• Lesley Moore from IVC Evidensia carried out an Ear cytology Pilot with the aim to increase proactive identification and treatment. The initiative saw a decrease of 70% in the use of antibiotics and an improvement in the use of cleaners and steroids.  
• Nicole Dyer from Ash Tree Vets, VetPartners, carried out an outcome audit to measure the effects of introducing lidocaine to analgesia protocol for dog castrates after reading an RCVS Knowledge Summary. The audit showed a positive impact both financially and environmentally. 
• Old Golf House Veterinary Group submitted a sustainability application looking at various ways of reducing their carbon footprint. They focused on auditing the consumption of energy and consumables and a true data set will be analysed over a 12-month basis.  
• Roundhouse Referrals, Linnaeus, submitted two applications. The first application focused on improving infection control by looking at the frequency of punctures of their surgical gloves and changing their gloves to ones that punctured less.  

Their second application was their TPLO + Quality Improvement project, the third year of their project and was a retrospective audit to assess adaptations since their 2022 applications. There were a number of improvements from their 2022 audit.  

• Samantha McGaw from Queen Mother Hospital for Animals, RVC created a clinical audit on nutrition for the ECC patient. Samantha carried out a retrospective process audit to assess the current nutritional support provisions and measure interventions which saw a greater awareness and improved prioritisation of nutritional support. 
• Tawny Kershaw from IVC Evidensia carried out a hypothermia audit for peri-operative temperatures by looking at the processes in place and measuring updated protocols. Their numerous interventions created an improvement in all audit measures.  
• The Queens Veterinary School Hospital of the University of Cambridge developed structures and systems to help the integration of QI across the teaching hospital environment. This included the audit of QI activities, adoption of VetSafe and the introduction of a new role to focus on the implementation of QI. Off the back of the review, a number of recommendations have been implemented and feedback from hospital staff has been positive. 
• VetsNow Sheffield initiative focused on reducing errors and improving customer service when dealing with individual cremations through a process and outcome audit of procedures for handling cremations. A baseline audit of processes resulted in a new Standard Operating Procedure and no major incidents have occurred since the audit came about. 

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• BARTA provided evidence-based guidelines and training for emergency first responders to provide pre-veterinary immediate care and developed a handover checklist to use when handing over to veterinary professionals. They provided a training centre for first responders and have seen an increase in the use of Smokey Paws Oxygen Therapy Kits.  
• Emmeline Macedo from Blue Cross carried out a process and outcome audit for anaesthetic fresh gas flow rates to gain insight and evidence to drive team training on anaesthetic circuit use. After providing training and creating ‘cheat sheets’ etc., reaudit results show a general improvement in correct flow rate use. 

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• Vets Now Ltd

Vets Now Ltd took feedback from their wider team and identified room for improvement in the care of dystocia cases. Due to an increase in the number of dystocia cases being seen, the team requested updated guidelines and training. A working group was created to support this. The group began by auditing and capturing benchmarks for dystocia cases across Vets Now Ltd. With the aim of supporting clinicians with decision-making and improving patient welfare, the group used these data to inform guidelines and resources relevant to care provided by Vets Now Ltd. Both the data and the resources were disseminated to the team via training. The level of engagement in the audit highlighted team-wide commitment to improving patient outcomes.

Read the full published article: Leicester, L. et al. (2022) Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary-care emergency practice. Veterinary Record, p. e2485. https://doi.org/10.1002/vetr.2485 (CPD: 40 minutes)

Watch the Knowledge Natter: Dystocia Dilemmas, a friendly and informal discussion about the Vets Now Ltd project.

Read the Vets Now Ltd case example here.

• Donview Veterinary Centre

Donview Veterinary Centre demonstrated a strong learning culture through an initiative aimed at improving post-op temperatures. Working together, the team performed an audit, and used the results to assess where they could improve. Suggestions from the team were successfully implemented across the practice, and investments in new equipment were made. The audit showed a robust dedication to improvement, with the whole team working together to identify gaps in care.

Read Donview Veterinary Centre's case example here.

• Anderson Moores Veterinary Specialists

Anderson Moores Veterinary Specialists introduced a Notice to Anaesthetists (NOTAN), a notice inspired by the aviation industry that highlights any changes that might have safety implications. The NOTAN was introduced after a team survey identified gaps in knowledge about the latest information on anaesthesia practice, protocols, and equipment. The team agreed that an electronic notification would be an effective change and increase confidence. Follow up team engagement showed that a simple, effective initiative can create measurable improvements.

Read Anderson Moores Veterinary Specialists case example here.

• Eloise Collins

Eloise Collins, Head Veterinary Nurse at Beech House Veterinary Centre, used checklists, auditing, benchmarking, team meetings and journal clubs to help improve patient care and outcomes and to improve practice culture. Eloise helped to create psychological safety amongst the team through her open and honest approach. The application showed an improvement culture involving the entire team creates positive change.

Read Eloise Collins' case example here.

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• Filham Park used clinical audit to review their use of the dental x-ray machine, identifying gaps in x-ray provision and providing clients with appropriate estimates. Training was implemented to improve skills and confidence, leading to an increase in service provision on repeat audit, and increased client satisfaction.

Read Filham Parks case example here.

• Manchester Veterinary Specialists performed an anaesthesia service review to address any gaps in care, improve team roles and morale, and report practice anaesthetic-related mortality rates.
• Okeford Veterinary Centre for embedding QI into their daily routine with the use of morning rounds, huddles, checklists, and audit. The application showed a good culture towards improvement.
• PDSA audited their provision of remote consultations and services during the pandemic, to ensure that they were complying with RCVS COVID guidelines, and whether the service being provided was satisfactory to clients. Their audit reassured the team and stakeholders that they were complying with guidelines, ensuring good clinical care, and maintaining animal welfare throughout the pandemic.
• Roundhouse Referrals continued to audit their provision of their TPLO+ service throughout the pandemic, using their previous outcomes measure scores and client satisfaction scores as a benchmark.
• Silverton Vets used a literature review to encourage the purchase of dental radiography and held dry lab training sessions remotely to train their team on its use. Audits were performed monthly to monitor its use. Separate audits were undertaken that identified an increase in revenue, diagnosis (and therefore patient care), team confidence, and client satisfaction.
• Small Animal Division CVS UK developed guidelines for common conditions and presentations for use at a first opinion practice level. The 43 guidelines allow the provision of a more consistent service and offer support to less experienced team members.

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• CVS Equine established a QI team within the equine division, to support equine practices with QI in practice. The application demonstrated a team approach with good leadership and implementation of QI projects.
• Rosemullion Vets performed a process audit on the use of surgical safety checklists showing an increase in the understanding and use of the lists from the team.
• Putlands Veterinary Surgery developed a QI group with members from the vet, nursing, and reception team. They started to look at patient safety checklists, significant event audits and auditing analgesia for neutering procedures. 
• VetPartners submitted two applications, one auditing the number of adverse events after equine vaccinations, and the other auditing the outcome of cow caesareans. The adverse events after equine vaccinations allowed the collection of data which improved the information relayed to clients, allowing them to make more informed decisions. This baseline audit has provided good benchmarks. The outcome of cow caesareans showed good planning and data. 
• Vetled performed observational audits within practices, to offer a fresh perspective on non-technical skills within everyday practice. The observational audits looked at whether QI tools have been adapted and implemented successfully, to ensure continuous improvement cycles.

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• Dr Jessica Pennock

Dr Jessica Pennock from CVS South Hub was awarded as a Knowledge Champion for her outcome audit on peri-operative hypothermia. The audit was inspired after the practice purchased a warm air circulating blanket for anaesthetic procedures, prompting the team to perform a process audit to ensure that the equipment was being utilised, and an outcome audit to see if the equipment was having a positive effect on patient care and recovery. The results demonstrate what can be achieved with an accessible audit that will have a positive impact on patient welfare.

Read Jessica's case example here.

• Samantha Fontaine

Samantha Fontaine from the University of Glasgow was awarded as a Knowledge Champion for implementation of a new course that teaches QI to veterinary nurses, including those in practice and education. For the first time, there is a QI route to achieving the RCVS Certificate in Advanced Veterinary Nursing (CertAVN). The course covers Quality Improvement in Veterinary Nursing, Research and Evidence-based Veterinary Nursing and Developing Evidence-Based Practice through Reflection. The curriculum has equipped national and international students with the confidence and ability to apply quality improvement initiatives to their work.

Read Samantha's case example here.

• Plymouth Veterinary Group

Plymouth Veterinary Group created guidelines for performing cytology on patients presenting with ear pathology, utilising the whole teams’ skillset to improve the patient journey for a common and often persistent presentation. The application showed a bottom-up approach – increasing training, utilising RVN skills and demonstrating strong evidence that their changes led to an overall decrease in the number of antibiotics prescribed.

Read Plymouth Veterinary Group's case example here.

Read the Knowledge Natter Q&A here.

• CVS Small Animal Team

The Small Animal Team within CVS audited small animal ear cytology on a national scale, over a long period, resulting in an increase in diagnostic tests and a reduction in antibiotic use across a wide range of practices. One of the key outcomes of introducing this QI initiative was the widespread improvement in the knowledge and skill of vets and nurses in all stages of their careers. Their audit demonstrated strong leadership for QI initiatives and highlighted that meaningful culture change can take time.

Read the CVS Small Animal Teams' case example here.

• The School of Veterinary Medicine, University of Nottingham

The SVMS at the University of Nottingham was also named a Champion Team for teaching QI to undergraduate and postgraduate students. QI and evidence-based veterinary medicine (EBVM) is integrated within the curriculum, with the SVMS being one of the first of the UK Veterinary institutions to offer postgraduate courses to veterinary surgeons, focused on both QI and EBVM and providing the only veterinary curriculum to use QI within formative assessments for undergraduates. QI and EBVM have been integrated across both their undergraduate and postgraduate curriculums, often in a novel way, which has been informed by a research-led agenda focused on the application of QI and EBVM into veterinary clinical practice. Embedding QI in the curriculum in such a comprehensive way is an important introduction for students to see the benefit that QI can bring to their future careers.

Read the SVMS, University of Nottingham's case example here.

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• Samantha Morgan-Hourd from Abbeydale Vetlink Veterinary Training Ltd for teaching students how to perform audit within the CQ Level 3 Diploma in Veterinary Nursing course. Students are given the tools to research EBVM protocols and then perform process audits within their placement practice.
• Charlotte Thomas from Rosevean Veterinary Practice identified a need for a new admission form protocol during the COVID-19 pandemic. The implementation and repeat audit showed an improvement in completion of admission forms by 60% and an overall improvement in informed consent.

Read Charlotte's case example here.

• Hannah Almond from Pauline Brown Clinical Skills Centre, University of Cambridge introduced practical simulations for CPR with a debriefing process, allowing for student discussion and for an audit of the teaching.
• Ross Allan from Roundhouse Referrals for auditing ‘TPLO outcomes and client satisfaction’. An audit was completed on customer service and clinical outcomes post-TPLO procedure. The practice used a literature search to identify a benchmark and worked towards making improvements. Clinical outcomes between 2019 and 2020 improved greatly with clients feeling informed and supported throughout the referral process.

Read Ross's case example here.

• ChesterGates Veterinary Specialists for ‘auditing theatre efficiency’.  A ‘Golden Patient’ initiative was introduced as an incentive for the team to improve theatre efficiency.

Read ChesterGates Veterinary Specialists case example here.

• Kathryn Wale from YourVets referral service (CVS) audited surgical site infections and gastro-intestinal complications, involving the whole team from the outset. Monthly audits monitored infection rate and reduced both complications by 42%.
• Arbury Road Vets audited peri-operative pain. The case example showed how the practice reviewed their analgesia processes against the latest evidence and audited their processes. The figures showed an achievement in implementing the new protocols and an improvement in patient care.
• Equicall audited their emergency attendance times. Calls were categorised into different degrees of importance and were audited on the average time taken to reach each call category. Reasons for delays in times were investigated, resulting in an improvement in the time taken to reach high-risk category patients.
• Regan Vet Group created pre-operative surgical information client sheets to reduce errors. Regan vet group identified that time constraints due to COVID-19 were affecting pre-operative surgical discussions. To combat this a pool of pre-operative surgical information sheets were created for clients to receive detailing information on surgeries their pet would be receiving.

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• Linnaeus post-registration team developed a programme to equip early career nurses with the skills and knowledge to drive Quality Improvement measures in practice. The programme was started in 2020 and has set a good foundation for Quality Improvement within the practice.                  
• VetPartners Ltd audited QI initiatives that were being undertaken across the group with the aim of bolstering areas that require support and learning from activities that can be replicated in other settings. This has provided the group with their baseline, which the group have used to inform their targets. Their first intervention has been to create a common language for QI.
• Kathrine Blackie from Linnaeus for auditing patient safety reporting. There was involvement in the initiative across practice team members and there has been an increase in reports submitted since the beginning of the initiative, helping to promote a just culture.

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• Louise Northway VNCertECC NCert(Anaesth) RVN

Louise Northway of Wendover Heights Veterinary Centre, known online as ‘Lou the Vet Nurse’ from her successful Facebook page, is a winner for the second year in a row; for her lead in auditing post-operative neutering complications and using evidence-based veterinary medicine to implement updated guidelines to reduce complication rates by half.

Read Louise’s case example here.

• Small animal theatre team at Animal Health Trust

The Small Animal theatre team at Animal Health Trust received their award for their creation, implementation and continued use of the surgical safety checklist; improving unity in communication; a reduction in serious surgical errors and greater compliance in swab and instrument counts.

Read Animal Health Trusts case example here.

• Vale Vets

Vale Vets won for their introduction and continuation of clinical meetings and QI initiatives that help the team to work as one. Their application discussed their work on several audits, but in particular post-operative complications and hand hygiene; using pre-existing guidelines and developing their own checklists. Vale Vets encourage all team members to get involved in QI, allocating time during quiet shifts for data collection, and have promoted a just culture within the practice.

Read the hygiene audit case example here.

Read the post-operative complication audit case example here.

• PDSA

PDSA picked up a Practice Champion award for their national auditing of pain relief guidelines, cruciate surgery outcomes and incident reporting. Their work in this area showcased improvements in adherence to pain relief protocols; reductions in lost to follow-up cases for post-cruciate surgery patients; and the role of audits in providing an evidence base at a practice level for treatment options.

Read the cruciate surgery outcome audit case example here.

Read the clinical incident reporting case example here.

Read the analgesia process audit case example here.

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• Meghan Conroy of Brook House Vets for her clinical audit on ear cytology, identifying a gap in care and providing training to the whole team. Results were shared with local practices and promoted more responsible medication prescribing.
• Sandra Hunt of The Laurels for the introduction of anaesthetic and wound care checklists after significant events. Other QI initiatives included hand hygiene and hypothermia audits. This application included a huge amount of data which showed data collection being performed regularly.
• Liron Levy-Hirsch of Vets Now for his introduction of root cause analysis after significant events. These identified required system changes including shift changes, promoting a better work-life balance, updates to guidelines and the introduction of checklists to improve patient safety. 
• Kay Lockwood of Riversbrook Vets for the introduction of clinical governance meetings that instigated updates for anaesthetic monitoring, crash protocols, post-operative complication audits and auditing of infection control. 
• Sam Thompson of North Downs Specialist Referrals for her post-operative temperature audit, increasing the average patient post-operative temperature from 36.7° to 37°. This audit also identified areas of focus for specific guidelines to help improve temperatures after certain procedures. 
• Holly Warrilow of White Cross Vets for her post-operative temperature audit which started out as a process audit, and, after identifying a gap in care and introducing guidelines, identified the need for an outcomes audit. The audit cycle saw a decrease in patients that returned from theatre hypothermic. 
• Lizzy Whiting of City Road Vets for her change management by introducing clinical governance meetings to a well-established practice. These meetings provided a place to discuss guidelines and protocols and approach the updating technical skills to improve not only the team member’s confidence but patient care. This approach to evidence and a learning culture initiated training and team confidence to expand their scope of service and provide an increased range of surgical options and geriatric clinics.

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• Millhouse Veterinary Surgery and Hospital for their areas of responsibility system change. By instigating an entire system change within the practice, they placed responsibility into the hands of the team, improving teamwork and promoting changes from the bottom-up. This initiative also increased awareness of QI in each area across the board. 
• Newnham Court Equine Clinic for their implementation of a surgical safety checklist. An initial process audit has been completed, which gave initial numbers of compliance and identified that further training was required. A checklist champion was appointed and a further audit is due in 2020.

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• Louise Northway VNCertECC NCert(Anaesth) RVN

Louise, Clinical Nurse Lead, won for her dedication to continuously improving care by undertaking clinical audits; setting and reviewing protocols based on evidence; and instigating discussion and adoption of QI by the entire practice team.

Read Louise’s case example here.

• Alison Thomas BVSc CertSAM MRCVS

Alison, Head of Veterinary Services at Blue Cross, won for her project to deliver a consistent approach to diagnosis and treatment throughout the charity by developing guidelines for more than 60 common syndromes and conditions. The guidelines were based on the best available evidence and took into account ethical and quality of life (QOL) considerations. Their introduction coincided with significant cost savings for the charity, placing them on track to treat an additional 2,639 animals.

Read Alison’s case example here.

• Angela Rayner BVM&S MRCVS

Angela, Clinical Services Manager at CVS Group plc, was recognised for her role in cementing an annual controlled drugs audit across the group’s practices. In just one year, CVS’s drug discrepancies for ketamine and methadone improved more than ten-fold and six-fold respectively, and improved still further the following year.

Read Angela’s case example here.

• Vets Now Macclesfield

The nursing team at Vets Now Macclesfield won the practice award for their work on improving general anaesthetic monitoring in an emergency setting. The introduction of a quarterly clinical audit and tailored training for nurses elevated the practice’s general anaesthesia and sedation monitoring to a comprehensive level of excellence, incorporating detailed notes and patient observations. As a result, the practice suffered zero patient deaths or significant events related to anaesthesia or sedation.

Read the case example from Vets Now here.

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• ChesterGates Veterinary Specialists established a QI initiative which set out to improve patient care, use of resources, productivity and theatre efficiency. The initiative has resulted in more consistent data recording and improved retrieval of data for audit purposes.
• Optivet Referrals Ltd developed a system for capturing the adverse events that arise in patients following anaesthesia.
• Vets Now Referrals Glasgow was highly commended for its clinical audit which assessed adherence to WHO hand washing guidelines.

Read this team's case example here.

• Elisa Best BVSc CertSAS MRCVS created a sealed emergency ‘BOAS box’ to be prepared for a BOAS patient in crisis. Each box contains a tracheostomy tube, an endotracheal tube, a pulse oximeter, a spay hook, a pre-drawn induction agent, post-BOAS treatment guidelines and a drug dosage list.

Read Elisa's case example here.

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